Hysterectomy among women with HIV: indications and incidence

To describe hysterectomy rates and indications among women with HIV and to compare them with at-risk HIV-seronegative women.

Reports of hysterectomy were collected from 3752 participants in a prospective cohort study of women with HIV and comparison uninfected women. Available operative notes were retrieved and abstracted. Comparisons were made using the Fisher exact, chi, Wilcoxon 2-sample, and Student's t tests.

Incident hysterectomy was performed for 106 (4.5%) of 2361 HIV-seropositive women, most often for cervical neoplasia, and for 24 (2.9%) of 837 HIV-seronegative women (P = 0.04). The incidence of hysterectomy was 7.7 per 1000 person-years for HIV-seropositive women and 5.3 per 1000 person-years for HIV-seronegative women (P = 0.09). HIV-seropositive and HIV-seronegative women undergoing incident hysterectomy were similar, except for a higher likelihood of an abnormal preoperative Papanicolaou test result in the former (P = 0.001). Surgical indications did not differ by serostatus.

Women with HIV are more likely than uninfected women to require a hysterectomy, most often for cervical neoplasia.