Longitudinal assessment of abnormal Papanicolaou test rates among women with HIV

Leslie S. Massad, Xianhong Xie, Howard Minkoff, Seble Kassaye, Roksana Karim, Teresa M. Darragh, Elizabeth T. Golub, Adaora Adimora, Gina Wingood, Margaret Fischl, Deborah Konkle-Parker, Howard D. Strickler

Research output: Contribution to journalArticle

Abstract

Objective: To describe longitudinal changes in the prevalence of abnormal Papanicolau testing among women living with HIV.Design:Prospective cohort study with sequential enrollment subcohorts.Methods:Four waves of enrollment occurred in the Women's Interagency HIV Study, the US women's HIV cohort (1994-1995, 2001-2002, 2011-2012, 2013-2015). Pap testing was done at intake, with colposcopy prescribed for any abnormality. Rates of abnormal Pap test results (atypical squamous cells of uncertain significance or worse) and cervical intraepithelial neoplasia grade 2 (CIN2) or worse were calculated. Logistic regression models assessed changes in prevalence across cohorts after controlling for severity of HIV disease and other risk factors for abnormal Pap tests.Results:The unadjusted prevalence of any Pap abnormality was 679/1769 (38%) in the original cohort, 195/684 (29%) in the 2001-2002 cohort, 46/231 (20%) in the 2011-2012 cohort, and 71/449 (16%) in the 2013-2015 cohort. In multivariable analysis, compared with risk in the 1994-1995 cohort, the adjusted risk in the 2001-2002 cohort was 0.79 (95% CI 0.59-1.05), in the 2011-2012 cohort was 0.67 (95% CI 0.43-1.04), and in the 2013-2015 cohort was 0.41 (95% CI 0.27-0.62) with P for trend less than 0.0001.Conclusion:Rates of abnormal cytology among women with HIV have fallen during the past two decades.

Original languageEnglish (US)
Pages (from-to)73-80
Number of pages8
JournalAIDS
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2020

Keywords

  • HIV infection in women
  • Papanicolaou test
  • Women's Interagency HIV Study

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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  • Cite this

    Massad, L. S., Xie, X., Minkoff, H., Kassaye, S., Karim, R., Darragh, T. M., Golub, E. T., Adimora, A., Wingood, G., Fischl, M., Konkle-Parker, D., & Strickler, H. D. (2020). Longitudinal assessment of abnormal Papanicolaou test rates among women with HIV. AIDS, 34(1), 73-80. https://doi.org/10.1097/QAD.0000000000002388