OBJECTIVE: To estimate the frequency of and trends in abnormal Pap test results in women with human immunodeficiency virus (HIV) and HIV-uninfected women. METHODS: In a cohort study of HIV-infected and uninfected women, Pap tests were obtained every 6 months. Results of atypical squamous cells of undetermined significance (ASC-US) or worse were considered abnormal. RESULTS: Over a median of 8.4 years, 23,843 Pap tests were obtained from 1,931 HIV-positive women with 6,828 Pap tests from 533 HIV-negative women (13 women seroconverted during the study). Among women with HIV, Pap test results were ASC-US in 4,462 (19%), low-grade squamous intraepithelial lesion (LSIL) in 3,199 (13%), high-grade squamous intraepithelial lesion (HSIL) in 267 (1%), and cancer in 11 (0.05%). The incidence of abnormal Pap test results was 179 in 1,000 person-years for HIV-positive and 75 in 1,000 person-years for HIV-negative women (incidence rate ratio 2.4, 95% confidence interval 2.0-2.8). The incidence of HSIL or cancer was 4.4 in 1,000 person-years for HIV-positive and 1.3 in 1,000 person-years for HIV-negative women (incidence rate ratio 3.4, 95% confidence interval 1.2-9.5). CONCLUSION: Among women with HIV in a cervical cancer prevention program, Pap test abnormalities are common, but high-grade abnormalities are infrequent. LEVEL OF EVIDENCE: II.
OBJECTIVE: To estimate the frequency of and trends in abnormal Pap test results in women with human immunodeficiency virus (HIV) and HIV-uninfectedwomen. METHODS: In a cohort study of HIV-infected and uninfected women, Pap tests were obtained every 6 months. Results of atypical squamous cells of undetermined significance (ASC-US) or worse were considered abnormal. RESULTS: Over a median of 8.4 years, 23,843 Pap tests were obtained from 1,931 HIV-positive women with 6,828 Pap tests from 533 HIV-negative women (13 women seroconverted during the study). Among women with HIV, Pap test results were ASC-US in 4,462 (19%), low-grade squamous intraepithelial lesion (LSIL) in 3,199 (13%), high-grade squamous intraepithelial lesion (HSIL) in 267 (1%), and cancer in 11 (0.05%). The incidence of abnormal Pap test results was 179 in 1,000 person-years for HIV-positive and 75 in 1,000 person-years for HIV-negative women (incidence rate ratio 2.4, 95% confidence interval 2.0-2.8). The incidence of HSIL or cancer was 4.4 in 1,000 person-years for HIV-positive and 1.3 in 1,000 person-years for HIV-negative women (incidence rate ratio 3.4, 95% confidence interval 1.2-9.5). CONCLUSION: Among women with HIV in a cervical cancer prevention program, Pap test abnormalities are common, but high-grade abnormalities are infrequent. LEVEL OF EVIDENCE: II.
Authors: L Stewart Massad; Xianhong Xie; Teresa Darragh; Howard Minkoff; Alexandra M Levine; D Heather Watts; Rodney L Wright; Gypsyamber D'Souza; Christine Colie; Howard D Strickler Journal: Obstet Gynecol Date: 2011-10 Impact factor: 7.661
Authors: L Stewart Massad; Christopher B Pierce; Howard Minkoff; D Heather Watts; Teresa M Darragh; Lorraine Sanchez-Keeland; Rodney L Wright; Christine Colie; Gypsyamber D'Souza Journal: Int J Cancer Date: 2013-10-29 Impact factor: 7.396
Authors: L Stewart Massad; Xianhong Xie; Robert D Burk; Gypsyamber D'Souza; Teresa M Darragh; Howard Minkoff; Christine Colie; Pamela Burian; Joel Palefsky; Jessica Atrio; Howard D Strickler Journal: Am J Obstet Gynecol Date: 2015-11-14 Impact factor: 8.661
Authors: L Stewart Massad; Xianhong Xie; Gypsyamber D'Souza; Teresa M Darragh; Howard Minkoff; Rodney Wright; Christine Colie; Lorraine Sanchez-Keeland; Howard D Strickler Journal: Am J Obstet Gynecol Date: 2014-12-10 Impact factor: 8.661