Screening for cervical cancer in HIV-infected women receiving care in the United States

We examined the sociodemographic, clinical and provider factors associated With screening for cervical cancer among HIV-infected women. Methods: We studied a national sample representing 43,490 women receiving t reatment of HIV infection who completed first follow-up surveys of the HIV Cost and Service Utilization Study (HCSUS). All women were asked, "In the p ast 12 months, have you had a Pap test?" Women reporting an abnormal Pap te st result were asked whether they had been told antibiotics could cure abno rmal cells, and whether they were scheduled for another Pap test or for a c olposcopy within 3 months. Results: Of the population represented, 81% had had a Pap test in the past 12 months. Women who reported having a gynecologist and primary care physic ian at the same clinical site were almost twice as likely (odds ratio, 1.9; 95% confidence interval, 1.3-3.0) as other women to report Pap testing. Am ong women who reported abnormal Pap test results and were not told antibiot ics could cure abnormal cells, 95% were scheduled for a repeat Pap test or colposcopy, but 15% of the women had not received their repeat Pap test or colposcopy. Conclusion: Although Pap test rates and appropriate referral for abnormal f indings were high among HIV-tested women, many women with initially abnorma l Pap test results did not actually receive follow-up Pap testing or colpos copy. Providing gynecologic care at the same site as primary HIV care would likely improve delivery of needed gynecologic ca-re for women.