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APHA 1996 Abstract: Abnormal Pap Smears are Common in Women with HIV
and Better Measures are Needed to Enhance Compliance with Colposcopy
Presented at: American Public Health Association 124th Annual Meeting, November 1996
Abnormal Pap Smears are Common in Women with HIV and Better Measures are Needed to Enhance Compliance with Colposcopy. L. M. Mundy, K. Meredith, M. Horgan, B. Sims, D. DeMarco, C. Williamson, V. J. Fraser. Women with HIV have an increased risk of cervical invasive neoplasia (CIN). To determine the effectiveness of Pap smear screening and follow-up of atypical squamous cells of undetermined significance (ASCUS) and CIN with colposcopy, we reviewed the results among our practice. Over a one year period our comprehensive center for women with HIV showed that 111 of 137 women (81%) agreed to Pap smears. Thirty women (27%) had normal Pap smears and 81 women (73%) had abnormal results (below).
ATYPIA ASCUSCINI CINII CINIII
No. (%) 25(31) 29(36) 15(19) 6(7) 5(6)
Colposcopy N/A 4 7 3 2
Median CD4 325 219 345 185 163
Despite numerous attempts to schedule colposcopy for women with CIN, only 29% underwent this procedure. The primary reasons for not having colposcopy were 1) fear of pain, 2) terminal stage of HIV disease. We have scheduled focus groups and structured interviews with clients to understand what they consider barriers and incentives to recommended follow-up. Questions will be based upon the Health Belief Model and Stages of Change theory. Results will be analyzed according to demographics, stage of HIV infection, and other psychological factors. Conclusion: More effective measures are needed to enhance compliance with follow-up colposcopy after abnormal Pap smears are identified in HIV-infected women.
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