265429 Cervical cancer screening in a population-based sample of Human Immunodeficiency Virus (HIV)-infected women Virginia, 2008-2009

Monday, October 29, 2012

Anne Zehner, MPH , Division of Policy and Evaluation, Virginia Department of Health, Richmond, VA
Danielle Henderson, MPH , Division of Policy and Evaluation, Virginia Department of Health, Richmond, VA
Celestine Buyu, MPH, MHSA , Division of Disease Prevention, Virginia Department of Health, Richmond, VA
Background: Infection with human papillomavirus (HPV) is more prevalent in women who are co-infected with HIV, and immunosuppression may increase the risk that an HPV infection will progress to cervical disease. Routine cervical Papanicolaou (Pap) tests are recommended in this population. This report considers cervical cancer screening data from a statewide, population-based HIV surveillance project.

Methods: Medical record abstractions from the Virginia Medical Monitoring Project (MMP) were used to determine how frequently cervical Pap tests were documented in the HIV specialty medical record during the previous year and what factors were related to testing. Supplemental demographic data were pulled from the state HIV surveillance database. Fisher's exact test or chi square tests of independence were used to determine the relationship between demographic variables and documented cervical cancer testing as well as the relationship between the Ryan White Program funding status of patients' care facilities and documented testing.

Results: A cervical Pap test was documented in the previous year for only 34% (73) of the 217 women in the sample. Younger age (p=0.0493) and Hispanic ethnicity (p=0.0064) were determined to be significantly related to having a documented cervical Pap test, as was the Ryan White funding status of the patient's care facility (p=0.0002).

Conclusions: A cervical Pap test was not documented in the majority (66%) of medical records reviewed. Assessment of the cause of missing documentation is necessary to determine if changes in cervical cancer screening practices are needed for HIV-infected women.

Learning Areas:
Provision of health care to the public
Public health or related research

Learning Objectives:
1. Analyze population-based HIV surveillance data to determine cervical cancer screening documentation rates among HIV-infected women. 2. Describe demographic factors related to variations in cervical cancer screening documentation rates among HIV-infected women.

Keywords: HIV/AIDS, Cervical Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work as an HIV Epidemiology Specialist within the HIV surveillance field. I have collected and analyzed data for a statewide HIV surveillance project. My scientific interests include exploring the impact of HIV on women's health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.