The prevalence of cervical abnormalities: Comparison of youth with perinatally acquired HIV and older women in Botswana

Thabo Phologolo; Mogomotsi Matshaba; Bathusi Mathuba; Keboletse Mokete; Ontibile Tshume; Elizabeth Lowenthal

doi:10.4102/sajhivmed.v24i1.1455

The prevalence of cervical abnormalities: Comparison of youth with perinatally acquired HIV and older women in Botswana

South Afr J HIV Med. 2023 Mar 28;24(1):1455. doi: 10.4102/sajhivmed.v24i1.1455. eCollection 2023.

Authors

Thabo Phologolo¹, Mogomotsi Matshaba^{2

3}, Bathusi Mathuba², Keboletse Mokete², Ontibile Tshume², Elizabeth Lowenthal^{4

5}

Affiliations

¹ Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
² Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.
³ Department of Pediatrics, Section of Retrovirology, Baylor College of Medicine, Houston, United States of America.
⁴ Departments of Pediatrics and Epidemiology, Biostatistics and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America.
⁵ Global Health Center, Children's Hospital of Philadelphia, Philadelphia, United States of America.

Abstract

Background: Cervical cancer burden and prevalence of precursor lesions is unknown among young women living with HIV in high prevalence settings. Current cervical cancer screening guidelines in resource-limited settings with high HIV prevalence typically exclude adolescents and young women. After observing two cases of advanced cervical cancer among young women with perinatally acquired HIV, a pilot screening programme was established in Botswana.

Objectives: To compare the prevalence of cervical abnormalities in young women with perinatally acquired HIV with women aged 30-49 years, regardless of HIV status.

Method: We conducted a cross-sectional study of 30-49-year-old women who had visual inspection with acetic acid screening through the Botswana public sector programme, and youth (aged 15-24 years) with perinatally acquired HIV, at a single referral site between 2016 and 2018. We describe the prevalence of cervical abnormalities in each group as well as the crude prevalence ratio.

Results: The prevalence of cervical abnormalities in women 30-49 years of age was 10.9% (95% confidence interval [CI]: 10.4, 11.4), and 10.1% (95% CI: 4.7, 18.3) for youth. The crude prevalence ratio was 1.07 (95% CI: 0.58, 2.01).

Conclusion: Inclusion of youth living with HIV in cervical cancer screening services should be considered in settings with a high prevalence of HIV and cervical cancer.

Keywords: Africa; cervical cancer screening; perinatal HIV; visual inspection with acetic acid; young women.