Barriers to cervical cancer screening exist despite integrating HIV and gynaecological services for HIV-positive women in Poland.

Abstract:

OBJECTIVES:HIV-positive women are at increased risk of HPV infection and cervical cancer. European and national guidelines advise yearly screening for cervical cancer, however due to the lack of a central registration of HIV infected persons there is a gap in offering such care through general healthcare services in many countries, including Poland. MATERIAL AND METHODS:In response to the above limitations, integrated gynaecological care (IGC) was established at the HIV Out-Patient Clinic in Warsaw. We analysed data from January 2007 to May 2014. Logistic regression models were used to identify factors associated with not using IGC by patients. RESULTS:Two hundred and forty women were registered in the observation period:59.6% infected through sexual contact, 18.7% through IDUs, 19.2 % through unknown causes and 2.5% by other (two were vertically infected). The median follow-up time was 2.35 (IQR 0.9-4.5) years and 78.3% were on combination antiretroviral therapy (cART). In total 145 of the women (60.4%) used IGC, from 72.1% of those registered in 2007 to 27.3% registered in 2014. There were in total 1075 gynaeco-logical visits and 254 cervical cytology tests performed. Seventy-five (51.7%) women were tested for HPV infection. Fac-tors decreasing the odds of not using IGC identified by multivariate regression models were being on cART (OR 0.25 [IQR: 0.10-0.59]; p = 0.003) and longer time of observation (0.69 [0.58-0.83]; p = 0.0001). CONCLUSIONS:The utilisation of IGC was very high, but with a delay in commencing the IGC. Women on cART and with longer periods of follow-up had lower odds of not using IGC. A screening approach for women not yet on cART, or newly registered in the clinics, needs special attention.

journal_name

Ginekol Pol

journal_title

Ginekologia polska

authors

Kowalska JD,Wroblewska A,Ząbek P,Firląg-Burkacka E,Kalinowska M,Byczot Z,Horban A

doi

10.5603/GP.a2018.0012

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

68-73

issue

2

eissn

0017-0011

issn

2543-6767

pii

VM/OJS/J/56535

journal_volume

89

pub_type

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