Utilization of Pap testing among women living with HIV enrolled in primary care in Baltimore, Maryland: A 10-year longitudinal study, 2005–2014

Sally Peprah , Jenell S. Coleman , Anne F. Rositch , Christopher J. Vanden Bussche , Richard Moore , Gypsyamber D’Souza
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引用次数: 4

Abstract

Frequent Pap testing is recommended among women living with HIV (WLWH) due to their elevated risk for cervical cancer. However, there are few recent longitudinal evaluations of utilization and determinants of Pap testing among WLWH. Medical and pathology records of WLWH seen at Johns Hopkins Hospital between 2005 and 2014 were assessed using Prentice, Williams, Peterson models.

Of 554 WLWH in care for ≥ 18 months, 79% received Pap testing, however only 11% consistently received Pap testing at the recommended interval. Some women (5%) were consistently under-screened (tested at longer intervals) and 21% did not receive any Pap testing at during follow-up.

WLWH with decreased likelihood of screening included older women, injection drug users, whites and those who had lived for longer with HIV. In contrast, only women with a prior abnormal Pap result were more likely to receive Pap testing. CD4 cell count and health insurance were not significant determinants.

Although many WLWH in care received Pap testing, some WLWH were unscreened or underscreened. Determinants of Pap testing for WLWH include socio-demographic factors and a prior abnormal result; these present potential targets in an urban HIV care setting for closer monitoring and directed interventions to improve utilization among WLWH.

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在马里兰州巴尔的摩市接受初级保健的艾滋病毒感染者中使用巴氏涂片检查:一项2005-2014年的10年纵向研究
由于感染艾滋病毒(WLWH)的妇女患宫颈癌的风险较高,建议她们经常进行巴氏涂片检查。然而,很少有最近的纵向评价利用和决定因素的巴氏涂片检查在WLWH。使用Prentice, Williams, Peterson模型评估2005年至2014年在约翰霍普金斯医院看到的WLWH的医疗和病理记录。在554名接受治疗≥ 18个月的产妇中,79%接受了巴氏试验,但只有11%在推荐的间隔时间内持续接受了巴氏试验。一些妇女(5%)一直未接受筛查(间隔时间较长),21%的妇女在随访期间未接受任何巴氏试验。筛查可能性降低的WLWH包括老年妇女、注射吸毒者、白人和感染艾滋病毒时间较长的人。相比之下,只有宫颈抹片检查结果异常的女性更有可能接受宫颈抹片检查。CD4细胞计数和健康保险不是显著的决定因素。尽管许多护理中的产妇接受了巴氏涂片检查,但一些产妇未接受筛查或筛查不足。巴氏涂片检测WLWH的决定因素包括社会人口因素和既往异常结果;这些都是城市艾滋病毒护理环境的潜在目标,需要进行更密切的监测和有针对性的干预,以提高WLWH的利用率。
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期刊介绍: The official Journal of the International Papillomavirus Society Papillomavirus Research (PVR), the Journal of HPV and other Small DNA Tumor Viruses publishes innovative papers related to all aspects of papillomaviruses and other small DNA tumor viruses. The official journal of the International Papillomavirus Society, PVR is an open access publication that aims to bring together virologists, immunologists, epidemiologists and clinicians working in the booming field of HPV and animal papillomaviruses, polyomaviruses and other small DNA tumor viruses and their associated diseases, in order to foster and facilitate interdisciplinary communication. The journal welcomes original research articles, reviews, short communications, opinion articles and regional update reports on papillomaviruses and other tumor viruses in the following sections: a. Biology of papillomaviruses and related viruses from life cycle to cancer b. Epidemiology etiology and natural history studies c. Natural and induced immunity including vaccine research d. Intervention studies and strategies including i. Clinical studies and trials ii. HPV treatments iii. HPV vaccination programs iv. Diagnostics and screening e. Infection and disease prevention, modeling studies f. Guidelines and public health recommendations g. HPV Studies in special populations Regional and local studies on these viruses.
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