CERVICAL NEOPLASIA IN WOMEN LIVING WITH HIV AT CERVICAL CANCER SCREENING CLINICS IN MUTARE, EASTERN ZIMBABWE

Title: Cervical neoplasia in women living with HIV at cervical cancer screening clinics in Mutare, Zimbabwe, 2015. Introduction: Cervical cancer in H IV infected women occurs at a younger age and progresses faster compared to those without the HIV infection. In resource limited setting with HIV prevalence like Zimbabwe targeted screening of women living with HIV is an option. The aim of the study was to determine the prevalence of cervical neoplasia and the risk factors amongst HIV infected women attending cervical screening clinics. Methods: A cross sectional study was conducted at visual inspection with acetic acid and cervicography (VIAC) clinics, in Mutare city in Eastern Zimbabwe from May to July 2015. Two hundred and forty four women living with HIV who were screened for cervical cancer were enrolled in the study. Data were collected by an interviewer administered structured and pretested questionnaire. Data was entered and analysed using Epi info version 7.0. Results: Out of the 242 participants, 77(31.8%) had cervical abnormality. For the abnormalities 28 underwent cryotherapy, 29 for LEEP and 20 with invasive cancer were referred and attended to in gynaecological clinic. History of genital warts [AOR 5.80(2.00; 16.90)], having more than one lifetime sexual partner [AOR 3.20 (1.16; 8.86)], first pregnancy after the age of 18 [AOR 0.32(0.10; 0.97)], CD4 count ? 250 copies/mm3 at antiretroviral commencement [AOR 0.27(0.09; 0.85)] and a latest CD4 count ? 500 cell/mm3 [AOR 0.25(0.09; 0, 68)] were independent factors associated with cervical neoplasia. Conclusion: The prevalence of cervical neoplasia among women living with HIV is high and cervical screening should be part and parcel of management of these women. The need of early initiation of highly active antiretrovirals cannot be over-emphasised.