PT  - JOURNAL ARTICLE
AU  - Alexandra de Pokomandy
AU  - Ann N. Burchell
AU  - Kate Salters
AU  - Erin Ding
AU  - Nadia O’Brien
AU  - Dada Mamvula Bakombo
AU  - Karène Proulx-Boucher
AU  - Isabelle Boucoiran
AU  - Neora Pick
AU  - Gina Ogilvie
AU  - Mona Loutfy
AU  - Angela Kaida
ED  - ,
TI  - Cervical cancer screening among women living with HIV: a cross-sectional study using the baseline questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS)
AID  - 10.9778/cmajo.20180151
DP  - 2019 Apr 01
TA  - CMAJ Open
PG  - E217--E226
VI  - 7
IP  - 2
4099  - http://www.cmajopen.ca/content/7/2/E217.short
4100  - http://www.cmajopen.ca/content/7/2/E217.full
SO  - CMAJ2019 Apr 01; 7
AB  - Background: Cisgender women with HIV experience an elevated risk of cervical cancer compared with HIV-negative women, but this cancer can be prevented through regular cervical cancer screening. Our study objective was to measure adherence to current national cervical cancer screening guidelines among women with HIV in 3 Canadian provinces and identify factors associated with delays.Methods: We conducted a cross-sectional study using the baseline questionnaire of the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS). Participants were recruited through clinics, peers and community organizations in British Columbia, Ontario and Quebec. Women were eligible for inclusion if they were cisgender female with HIV, aged 21–70 years, and never had cervicectomy/hysterectomy.Results: Of 1189 eligible participants, 815 (68.5%) had received cervical cancer screening less than 1 year ago (i.e., as recommended), 211 (17.7%) 1–3 years ago (i.e., moderate delay) and 163 (13.7%) at least 3 years ago or never (i.e., long delay). Overall, 309 (26.0%) had never discussed the need for a Papanicolaou smear with a nurse/doctor. Factors associated with a long delay were living in Ontario (adjusted odds ratio [OR] 2.51, 95% confidence interval [CI] 1.29–4.88) or Quebec (adjusted OR 3.70, 95% CI 1.79–7.67) (v. BC), being sexually inactive in the past 6 months (adjusted OR 2.02, 95% CI 1.25–3.25), having unknown or < 200 cells/mm3 CD4 counts (adjusted OR 1.78, 95% CI 1.11–2.85) and having a male HIV care provider (adjusted OR 2.15, 95% CI 1.36–3.42).Interpretation: Over one-third of women reported cervical cancer screening delays, and one-quarter had never discussed cervical cancer screening recommendations with a health care provider. Additional efforts are needed to improve women’s and health care providers’ awareness of cervical cancer screening recommendations, particularly among women who are sexually inactive, who are immunosuppressed and who have male HIV care providers.