Cervical Cancer in Women With HIV: A Call to Action for Equitable Prevention in Low- and Middle-Income Countries

Cervical cancer is preventable; however, it remains the leading cause of death in low- and middle-income countries (LMICs). Women with HIV (WWHs) have a sixfold higher risk of developing and dying from cervical cancer than women without HIV. Cervical cancer can be prevented by vaccination against high-risk human papillomaviruses (hrHPVs) and by screening for and treating precancer cervical lesions. While these preventive measures are routinely available to WWHs in developed countries, they are lacking in most LMICs, where the burden of HIV and cervical cancer is the highest. To prevent cervical cancer deaths among WWHs in LMICs, it is imperative to determine the dual burden of HIV and cervical cancer in LMICs. This narrative review synthesized scientific papers and policy documents on the intersection of HIV and cervical cancer in LMICs published between August 2006 and July 2025. We searched PubMed, Scopus, Web of Science, and Google Scholar for articles and official reports from the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) on cervical cancer burden, prevention strategies, barriers, and outcomes among WWHs. Despite its proven effectiveness, HPV vaccination coverage in LMICs is under 30%, and screening uptake is below 20%. Weak health systems, workforce shortages, stigma, reliance on donor funding, and late-stage case presentation are major challenges in curbing cervical cancer in LMICs. Urgent political commitment is required to integrate precancer screening and HPV testing into routine HIV care and scale-up HPV vaccination to achieve the WHO's triple-intervention targets to eliminate cervical cancer among WWHs in LMICs.