Local health departments: A point source to prevent cervical cancer among HIV-infected women

Background: HIV infection accelerates progression of cervical abnormalities in women. Incorporating cervical screening during HIV-care visits in local health departments (LHDs) can prevent cervical cancer through early detection of cervical abnormalities and treatment.

Objective: This study determined the proportion of HIV-infected women screened for cervical cancer at the Hillsborough County Health Department as per the CDC guidelines, and examined associations between demographic factors and receipt of pap smears.

Methods: Demographic and pap smear data were extracted from randomly selected medical records of 200 HIV-infected women receiving care between January 2000 and May 2006. Descriptive statistics and Chi-square associations were determined.

Results: Overall, 83% of women received at least one pap smear in their first year after enrollment; 24.5% received the recommended two pap smears. The women were predominantly minorities (57.4% Blacks; 22.8% Hispanics) and economically disadvantaged (mean income $8180). First year pap smear rate was significantly associated with type of insurance (p = .0185) and pap smear facility (p <.0001), borderline association with HIV risk behavior (p=.0593) and not associated with age (p=.5366) or income (p=.3079).

Conclusions: Our findings demonstrate that LHDs are a point source to prevent cervical cancer among disadvantaged, minority HIV-infected women. Although the CDC-recommended second pap smear rate was modest, the first pap smear rate was consistent with the national rate for HIV-infected women. Future research must address the low second pap smear rate and develop strategies to increase these rates among HIV-infected women.