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Original Research
The prevalence of cervical abnormalities: Comparison of youth with perinatally acquired HIV and older women in Botswana
Submitted: 28 October 2022 | Published: 28 March 2023
About the author(s)
Thabo Phologolo, Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, BotswanaMogomotsi Matshaba, Botswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana; and, Department of Pediatrics, Section of Retrovirology, Baylor College of Medicine, Houston, United States of America
Bathusi Mathuba, Botswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana
Keboletse Mokete, Botswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana
Ontibile Tshume, Botswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana
Elizabeth Lowenthal, Departments of Pediatrics and Epidemiology, Biostatistics and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America; and, 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.
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