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.
|Data di pubblicazione:||2010|
|Titolo:||Self-reported history of Pap-smear in HIV-positive women in Northern Italy: a cross-sectional study|
|Autore/i:||Dal Maso, L.; Franceschi, S.; Lise, M.; De' Bianchi, P. S.; Polesel, J.; Ghinelli, F.; Falcini, F.; Droghini, A. C. FinarelliCollaborators: L.; Serraino, D.; Alberici, F.; Antoni, A. D.; Magnani, G.; Guaraldi, Giovanni; Chiodo, F.; Sighinolfi, L.; Ballardini, G.; Cancellieri, C.; Stagno, A.; Arlotti, M.; Govoni, A.|
|Codice identificativo ISI:||WOS:000280357100002|
|Codice identificativo Scopus:||2-s2.0-77953679332|
|Citazione:||Self-reported history of Pap-smear in HIV-positive women in Northern Italy: a cross-sectional study / Dal Maso, L.; Franceschi, S.; Lise, M.; De' Bianchi, P. S.; Polesel, J.; Ghinelli, F.; Falcini, F.; Droghini, A. C. FinarelliCollaborators: L.; Serraino, D.; Alberici, F.; Antoni, A. D.; Magnani, G.; Guaraldi, Giovanni; Chiodo, F.; Sighinolfi, L.; Ballardini, G.; Cancellieri, C.; Stagno, A.; Arlotti, M.; Govoni, A.. - In: BMC CANCER. - ISSN 1471-2407. - STAMPA. - 10(2010), pp. 310-310.|
|Tipologia||Articolo su rivista|
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