BACKGROUND: The incidence of invasive cervical cancer in HIV-positive women is higher than in the general population. There is evidence that HIV-positive women do not participate sufficiently in cervical cancer screening in Italy, where cervical cancer is more than 10-fold higher in women with AIDS than in the general population. The aim of the present study was to evaluate the history of Pap-smear in HIV-positive women in Italy in recent years. We also examined the sociodemographic, clinical, and organizational factors associated with adherence to cervical cancer screening.METHODS: A cross-sectional study was conducted between July 2006 and June 2007 in Emilia-Romagna region (Northern Italy). All HIV-positive women who received a follow-up visit in one of the 10 regional infectivology units were invited to participate. History of Pap-smear, including abnormal smears and subsequent treatment, was investigated through a self-administered anonymous questionnaire. The association between lack of Pap-smear in the year preceding the interview and selected characteristics was assessed by means of odds ratios (OR) and 95% confidence intervals adjusted for study centre and age.RESULTS: A total of 1,002 HIV-positive women were interviewed. Nine percent reported no history of Pap-smear, and 39% had no Pap-smear in the year prior to the date of questionnaire (last year). The lack of Pap-smear in the last year was significantly associated with age <35 years (OR = 1.4, compared to age > or =45 years), lower education level (OR = 1.3), first HIV-positive test in the last 2 years (OR = 1.4), and CD4 count <200 cells/microl (OR = 1.6). Conversely, when women were advised by a gynecologist rather than other health workers to undergo screening, it significantly increased adherence. Non-significantly higher proportions of lack of Pap-smear in the last year were found in women born in Central-Eastern Europe (OR = 1.8) and Africa (OR = 1.3). No difference in history of Pap-smear emerged by mode of HIV-acquisition or AIDS status.Three hundred five (34%) women reported a previous abnormal Pap-smear, and of the 178 (58%) referred for treatment, 97% complied.CONCLUSIONS: In recent years the self-reported history of Pap-smear in HIV-positive women, in some public clinics in Italy, is higher than previously reported, but further efforts are required to make sure cervical cancer screening is accessible to all HIV-positive women.

Self-reported history of Pap-smear in HIV-positive women in Northern Italy: a cross-sectional study / L., Dal Maso; S., Franceschi; M., Lise; P. S., De' Bianchi; J., Polesel; F., Ghinelli; F., Falcini; A. C. FinarelliCollaborators: L., Droghini; D., Serraino; F., Alberici; A. D., Antoni; G., Magnani; Guaraldi, Giovanni; F., Chiodo; L., Sighinolfi; G., Ballardini; C., Cancellieri; A., Stagno; M., Arlotti; A., Govoni. - In: BMC CANCER. - ISSN 1471-2407. - STAMPA. - 10:(2010), pp. 310-310. [10.1186/1471-2407-10-310]

Self-reported history of Pap-smear in HIV-positive women in Northern Italy: a cross-sectional study

GUARALDI, Giovanni;
2010

Abstract

BACKGROUND: The incidence of invasive cervical cancer in HIV-positive women is higher than in the general population. There is evidence that HIV-positive women do not participate sufficiently in cervical cancer screening in Italy, where cervical cancer is more than 10-fold higher in women with AIDS than in the general population. The aim of the present study was to evaluate the history of Pap-smear in HIV-positive women in Italy in recent years. We also examined the sociodemographic, clinical, and organizational factors associated with adherence to cervical cancer screening.METHODS: A cross-sectional study was conducted between July 2006 and June 2007 in Emilia-Romagna region (Northern Italy). All HIV-positive women who received a follow-up visit in one of the 10 regional infectivology units were invited to participate. History of Pap-smear, including abnormal smears and subsequent treatment, was investigated through a self-administered anonymous questionnaire. The association between lack of Pap-smear in the year preceding the interview and selected characteristics was assessed by means of odds ratios (OR) and 95% confidence intervals adjusted for study centre and age.RESULTS: A total of 1,002 HIV-positive women were interviewed. Nine percent reported no history of Pap-smear, and 39% had no Pap-smear in the year prior to the date of questionnaire (last year). The lack of Pap-smear in the last year was significantly associated with age <35 years (OR = 1.4, compared to age > or =45 years), lower education level (OR = 1.3), first HIV-positive test in the last 2 years (OR = 1.4), and CD4 count <200 cells/microl (OR = 1.6). Conversely, when women were advised by a gynecologist rather than other health workers to undergo screening, it significantly increased adherence. Non-significantly higher proportions of lack of Pap-smear in the last year were found in women born in Central-Eastern Europe (OR = 1.8) and Africa (OR = 1.3). No difference in history of Pap-smear emerged by mode of HIV-acquisition or AIDS status.Three hundred five (34%) women reported a previous abnormal Pap-smear, and of the 178 (58%) referred for treatment, 97% complied.CONCLUSIONS: In recent years the self-reported history of Pap-smear in HIV-positive women, in some public clinics in Italy, is higher than previously reported, but further efforts are required to make sure cervical cancer screening is accessible to all HIV-positive women.
2010
10
310
310
Self-reported history of Pap-smear in HIV-positive women in Northern Italy: a cross-sectional study / L., Dal Maso; S., Franceschi; M., Lise; P. S., De' Bianchi; J., Polesel; F., Ghinelli; F., Falcini; A. C. FinarelliCollaborators: L., Droghini; D., Serraino; F., Alberici; A. D., Antoni; G., Magnani; Guaraldi, Giovanni; F., Chiodo; L., Sighinolfi; G., Ballardini; C., Cancellieri; A., Stagno; M., Arlotti; A., Govoni. - In: BMC CANCER. - ISSN 1471-2407. - STAMPA. - 10:(2010), pp. 310-310. [10.1186/1471-2407-10-310]
L., Dal Maso; S., Franceschi; M., Lise; P. S., De' Bianchi; J., Polesel; F., Ghinelli; F., Falcini; A. C. FinarelliCollaborators: L., Droghini; D., Serraino; F., Alberici; A. D., Antoni; G., Magnani; Guaraldi, Giovanni; F., Chiodo; L., Sighinolfi; G., Ballardini; C., Cancellieri; A., Stagno; M., Arlotti; A., Govoni
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