Comparing a "See-and-Treat" HPV-Based to VIA-Based Cervical Cancer Prevention Strategies Among Women Living with HIV...

Women living with HIV (WLWH) have a higher vulnerability to developing cervical cancer and should be prioritized for screening. The objective of this study was to test the feasibility of integrating HPV-based vis-à-vis VIA-based cervical cancer prevention services into routine HIV Care and Treatment in Cameroon.

We conducted a comparative cross-sectional study of two groups of WLWH aged 25 years and above; a group screened with Human Papillomavirus (HPV) DNA (HPV Group) and a group screened with Visual Inspection with Acetic Acid (VIA) (VIA Group), using the see-and-treat approach. The proportion of treatment-eligible women who received treatment per screening approach was calculated.

A total of 325 WLWH were screened as follows; VIA Group, N = 184 (45.5%) and HPV Group, N = 177 (54.5%). Among these 325 women, 74 (22.8%) were positive for either HPV and/or VIA. Of these 74, 64 (86.5%) were of the HPV Group and 10 (13.5%) were of the VIA Group. Among the 74 positive women, 14 (18.9%) received treatment. Among the 36.2% treatment-eligible women in the HPV Group, 5/64 (9.4%) had VIA-positive lesions. Among the 10 women in the VIA Group who tested positive for VIA, only 1 (10%) received treatment. Whereas, among the 5 women with VIA-positive lesions in the HPV Group, 4 (80%) received treatment.

The treatment uptake was low (18.9%). Performing screening without treating the treatment-eligible cases will not create any reduction in cervical cancer morbidity/mortality. Therefore, more strategies are needed to enable WLWH who screen positive for HPV/VIA get adequate treatment.