The prevalence of CIN is increased in HIV infection. The UK National Health Service Cervical Screening Programme guidelines, therefore, provide specific recommendations for HIV-positive women. An audit of cervical surveillance in HIV-positive women who attend the genitourinary medicine department at the Leicester Royal Infirmary was conducted. The objectives were to assess adherence to the UK and local screening guidelines, cervical pathology prevalence, and appropriate colposcopy referrals.
Researchers undertook a retrospective case note review of 130 HIV-infected women attending the GUM department.
Results showed that 76.2% of patients had cervical cytology within a year of HIV diagnosis, and 42.4% had abnormal cytology. All patients with dyskaryosis were referred for colposcopy according to local and national guidelines. Cytology results were consistent with histological findings, and the prevalence of CIN was 15.2%.
The study concluded that a designated health advisor in the GUM department co-ordinates cervical surveillance in HIV-positive women. This, together with an increasingly integrated service with family planning services, may contribute to a relatively successful administration. Overall, patients are carefully monitored to ensure that management is adequate. However, extra vigilance is required, and further cost-effective measures in the future may include more active involvement of general practitioners.