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APHA Scientific Session and Event Listing

Women infected with HIV and Human Papillomavirus (HPV) : An emerging health problem in resource-constrained settings

Komal R. D'Souza, BS, BA1, Lynette J. Menezes, PhD2, Todd S. Wills, MD2, and Karina M. D'Souza, BS3. (1) Department of Global Health, University of South Florida, 9481 Highland Oak Drive #209, Tampa, FL 33647, 813-849-8407, kdsouza@hsc.usf.edu, (2) Division of Infectious Disease and International Medicine, University of South Florida, 2 Columbia Drive G318, Tampa, FL 33601, (3) Department of Epidemiology and Biostatistics, University of South Florida, 7172 Bonaventure Drive, Tampa, FL 33607

There is growing body of evidence worldwide that a majority of HIV-positive women are also infected with HPV. HPV causes nearly 95% of cervical cancer globally. With Africa and Asia bearing the largest burden of both cervical cancer and HIV, it is vital to define risk factors for HPV infection and subsequent development of cervical cancer among HIV-infected women in resource-constrained settings. Drawing upon research conducted in developing nations, this paper analyzes clinical correlates of HPV co-infection in HIV-positive women. Additionally, the paper examines important structural factors that increase cervical cancer risk in this population. Several risk factors emerged from our analysis of the published literature. Oncogenic HPV types 16/18 and infection with multiple HPV types were critical to the development and progression of cervical lesions among HIV-infected women. Other clinical correlates included low CD4+ count and elevated HIV viral load. Structural factors increasing the risk of cervical cancer include: poor access to pap smears, absence of management guidelines for HIV infected women, women's lack of knowledge regarding health screening and varying access to anti-retroviral medications. These clinical and structural factors are examined in detail in this paper. Cervical cancers among HIV-infected women in resource-constrained settings are preventable if effective screening and treatment measures are incorporated into routine HIV medical care. Preventative guidelines must address frequent screening of HIV-infected women particularly those with low CD4 counts. HPV vaccine research shows promising results which can further reduce the morbidity and mortality associated with cervical cancer.

Learning Objectives: At the conclusion of this session, the participant in this session will be able to

Keywords: Women and HIV/AIDS, Cervical Cancer

Presenting author's disclosure statement:

Not Answered

Topics in HIV/AIDS I

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA