Papanicoleau Smear Usage and Prevalence of Premalignant Cervical Lesion among Women Living with HIV Attending a Federal Teaching Hospital in South-West Nigeria: A Comparative Study

Aim: Cancer of the cervix is the third most common cancer among women worldwide, and in Nigeria it is the second most common female cancer. Infection with the Human immunodeficiency virus (HIV) is associated with an increased risk of prevalent, incident and persistent squamous intraepithelial lesions (SILs) of the cervix. The aim was to determine the level of awareness of cervical cancer screening test and the development of premalignant cervical lesions among HIV positive women.

Study Design: A Hospital based comparative cross-sectional study.

Place and Duration of the Study: The study was carried out in the HIV clinic and general outpatient clinic of Federal Teaching Hospital Ido-ekiti, Ekiti state Nigeria. It was carried out from July to September 2015.

Methodology: The study was carried out among 65 HIV-positive and 65 HIV-negative women. Data were collected from the interviewees. Participants also had Pap smear. Data collected were analyzed using statistical package for social sciences version 19.

Results: The mean age was 39.73 (±8.57) and 40.98 (±10.68) among the HIV positive and negative women respectively. Only 27.7% of the HIV-positive women compared to 56.9% of the HIV negative women had heard of cervical cancer with P= 0.001. The level of awareness of cervical cancer screening test was 15.4% and 50.8% among the HIV positive and negative women respectively (P= 0.001). The prevalence of premalignant cervical lesions among the study and control groups was 26.2% and 16.9% respectively. This showed that premalignant cervical lesion was more prevalent among HIV-positive women though not statistically significant (P=0.201). However, using risk ratio (RR), the risk of developing cervical lesions is 1.55 times more in HIV exposed women than HIV negative women.

Conclusion: There is therefore need for the Physicians to use every opportunity to counsel their clients on the need for routine cervical cancer screening especially in adult HIV clinics.