scholarly journals Cervical cancer risk and impact of Pap-based screening in HIV-positive women on antiretroviral therapy in Johannesburg, South Africa

2017 ◽  
Vol 141 (3) ◽  
pp. 488-496 ◽  
Author(s):  
Eliane Rohner ◽  
Mazvita Sengayi ◽  
Bridgette Goeieman ◽  
Pamela Michelow ◽  
Cynthia Firnhaber ◽  
...  
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Antiretroviral Therapy ◽  
Cancer Risk ◽  
Hiv Positive ◽  
Cervical Cancer Risk ◽  
Hiv Positive Women

scholarly journals Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
South African ◽  
Access To Health Care ◽  
Health Facilities ◽  
Hiv Positive ◽  
The South ◽  
Hiv Positive Women ◽  
Access To Health

Abstract Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.

scholarly journals Highly active antiretroviral therapy and cervical dysplasia in HIV-positive women in South Africa

2012 ◽  
Vol 15 (2) ◽  
Author(s):  
Cynthia Firnhaber ◽  
Daniel Westreich ◽  
Doreen Schulze ◽  
Sophie Williams ◽  
Maureen Siminya ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Cervical Dysplasia ◽  
Hiv Positive ◽  
Highly Active ◽  
Hiv Positive Women

scholarly journals Human papillomavirus type-specific risk of cervical cancer in a population with high human immunodeficiency virus prevalence: case–control study

2011 ◽  
Vol 92 (12) ◽  
pp. 2784-2791 ◽  
Author(s):  
Pontus Naucler ◽  
Flora Mabota da Costa ◽  
Joao Leopoldo da Costa ◽  
Otto Ljungberg ◽  
Antonio Bugalho ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Immunodeficiency Virus ◽  
Human Papillomavirus ◽  
Effect Modification ◽  
Hiv Positive ◽  
Hpv 16 ◽  
Cervical Cancer Risk ◽  
Hiv Positive Women ◽  
Immunodeficiency Virus ◽  
Hiv Negative

There are limited data on human papillomavirus (HPV) type-specific cervical cancer risk among human immunodeficiency virus (HIV)-positive women. Previous studies have suggested that HPV 16 would be relatively less important as a causative agent among HIV-positive compared with HIV-negative women. This study investigates HPV type-specific cervical cancer risk in a population in which HIV is endemic. At the Central Hospital, Maputo, Mozambique, 221 cervical cancer cases and 203 hospital-based controls were consecutively enrolled. HPV typing from cervical samples, HIV testing and recording of socio-demographic factors were performed. Logistic regression modelling was used to assess HPV type-specific risk and effect modification between HIV and HPV infection. Infection with HPV 16, 18 and ‘high-risk non-HPV 16/18 types’ (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59) was associated with cervical cancer in both crude and adjusted analyses. HPV 16 and 18 were the most common types detected in cancer biopsies among both HIV-negative and HIV-positive women. There was no significant evidence of effect modification between any HPV type and HIV infection, and there were no significant differences in the HPV type-specific prevalence when cervical cancers among HIV-positive and HIV-negative women were compared. Within the limitations of the study, the relative importance of different HPV types in cervical carcinogenesis appears not to be modified greatly by HIV infection, suggesting that HPV vaccines might not need to be type-specifically modified to be suitable for populations where HIV is endemic.

scholarly journals Potential Impact of Antiretroviral Therapy and Screening on Cervical Cancer Mortality in HIV-Positive Women in Sub-Saharan Africa: A Simulation

PLoS ONE ◽  
2011 ◽  
Vol 6 (4) ◽  
pp. e18527 ◽  
Author(s):  
Julius Atashili ◽  
Jennifer S. Smith ◽  
Adaora A. Adimora ◽  
Joseph Eron ◽  
William C. Miller ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Antiretroviral Therapy ◽  
Cancer Mortality ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Positive Women ◽  
Cervical Cancer Mortality ◽  
Potential Impact ◽  
Sub Saharan

scholarly journals Abnormal cervical cytology amongst women infected with human immunodeficiency virus in Limpopo province, South Africa

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Samuel T. Ntuli ◽  
Eric Maimela ◽  
Linda Skaal ◽  
Mabina Mogale ◽  
Provia Lekota
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Human Immunodeficiency Virus ◽  
Limpopo Province ◽  
Cervical Cytology ◽  
Hiv Positive ◽  
Abnormal Cytology ◽  
Abnormal Cervical Cytology ◽  
Hiv Positive Women ◽  
Immunodeficiency Virus

Background: Cervical cancer remains the major public problem worldwide and the most common gynaecological malignancy in the developing world, particularly in sub-Saharan Africa.Aim: To determine the prevalence of abnormal cervical cytology amongst women with and without human immunodeficiency virus (HIV) and examine the association between HIV and histological grading.Setting: The study was conducted in Limpopo province, which is the northernmost province of South Africa. The province has five district municipalities with one tertiary, five regional and thirty four district hospitals.Methods: We retrospectively reviewed cervical cancer cases in Limpopo province (LP) of South Africa, using data collected routinely by the National Health Laboratory Services (NHLS). The data on smears submitted for cytology between 2013 and 2015 were extracted from the Central Data Warehouse (CDW) database.Results: A total of 84 466 women were screened for cervical cytology smears. Their mean age was 39.8 ± 13.6 years, with range from 15 to 113 years; 77.2% were in the age group 30 years and older and 19.6% had an abnormal cervical cytology result. Overall, 46.4% of the women screened for cervical cancer were HIV infected. A significantly higher proportion of HIV-positive women had abnormal cytology than HIV-negative women (31.8% vs. 9.2%).Conclusion: The prevalence of abnormal cytology amongst HIV-positive women is relatively high, and the risk appears to be significantly greater in all age groups. This finding highlights the need to ascertain HIV status of all women presenting with cervical cancer.

Examining attitudes and knowledge about HPV and cervical cancer risk among female clinic attendees in Johannesburg, South Africa

Vaccine ◽  
2010 ◽  
Vol 28 (50) ◽  
pp. 8026-8032 ◽  
Author(s):  
Shelley A. Francis ◽  
Jennifer Nelson ◽  
Joan Liverpool ◽  
Soji Soogun ◽  
Nokuthula Mofammere ◽  
...  
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Cancer Risk ◽  
Cervical Cancer Risk ◽  
Attitudes And Knowledge

scholarly journals Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: A nationwide study

2020 ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
Access To Health Care ◽  
Hiv Positive ◽  
Equitable Access ◽  
Access To Health Services ◽  
Hiv Positive Women ◽  
Access To Health ◽  
Physical Barriers

AbstractDisparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the associated factors among HIV positive women in South Africa. We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004-2014. We used the Thembisa model to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.Novelty and ImpactThis is the first nationwide study in South Africa to evaluate spatial and spatiotemporal distribution of cervical cancer in women diagnosed with HIV. The results show an increased incidence of cervical cancer in affluent municipalities and in those with better access to health care. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers.

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