Original Research

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
Southern African Journal of HIV Medicine | Vol 24, No 1 | a1455 | DOI: https://doi.org/10.4102/sajhivmed.v24i1.1455 | © 2023 Thabo Phologolo, Mogomotsi Matshaba, Bathusi Mathuba, Keboletse Mokete, Ontibile Tshume, Elizabeth Lowenthal | This work is licensed under CC Attribution 4.0
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, Botswana
Mogomotsi 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.


Keywords

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

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