Gynecologic issues of women with human immunodeficiency virus infection

Women are the fastest growing population with newly diagnosed acquired immune deficiency syndrome (AIDS) in the United States. Although little is known of specific female manifestations, research trends suggest an increase in genital tract infections and neoplasms that may be recurrent and difficult to treat. The initial presentation of early human immunodeficiency virus (HIV) infection in many women is recurrent and chronic vaginal candidiasis. Abnormal cervical cytology is common, and biannual Papanicolaou (Pap) smear screenings are recommended, preferably with a colposcopic examination. Because such human papillomavirus (HPV)-related dysplasias often are multifocal, anal Pap smears also are recommended. This article addresses the gynecologic problems and care of HIV-positive women.