Cervical cancer screening among HIV-positive women Retrospective cohort study from a tertiary care HIV clinic

OBJECTIVE To determine the rate of cervical screening among HIV-positive women who received care at a tertiary care clinic, and to determine whether screening rates were influenced by having a primary care provider. DESIGN Retrospective chart review. SETTING Tertiary care outpatient clinic in Ottawa, Ont. PARTICIPANTS Women who were HIV-positive receiving care at the Ottawa Hospital General Campus Immunodeficiency Clinic between July 1, 2002, and June 30, 2005. MAIN OUTCOME MEASURES Whether patients had primary care providers and whether they received cervical screening. We recorded information on patient demographics, HIV status, primary care providers, and cervical screening, including date, results, and type of health care provider ordering the screening. RESULTS Fifty-eight percent (126 of 218) of the women had at least 1 cervical screening test during the 3-year period. Thirty-three percent (42 of 126) of the women who underwent cervical screening had at least 1 abnormal test result. The proportion of women who did not have any cervical tests performed was higher among women who did not have primary care providers (8 of 12 [67%] vs 84 of 206 [41%]; relative risk 1.6, 95% confidence interval 1.06 to 2.52, P < .05), although this group was small. CONCLUSION Despite the high proportion of abnormal cervical screening test results among HIV-positive women, screening rates remained low. Our results support our hypothesis that those women who do not have primary care providers are less likely to undergo cervical screening.