AEGiS-15IAC: Cervical squamous intraepithelial lesions among HIV infected women in Lima, Peru: Screening implications in a resource limited setting.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Cervical squamous intraepithelial lesions among HIV infected women in Lima, Peru: Screening implications in a resource limited setting.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10357)

Basurco J, Samalvides F, Blas M, Levy V, Gotuzzo E
Universidad Peruana Cayetano Heredia, Lima, Peru

BACKGROUND: HIV infection has spread heterosexually in Peru with a decrease in the male/female ratio of AIDS cases from 11:1 in 1990 to less than 3:1 in 2000. We sought to determine the prevalence of cervical squamous intraepithelial lesions (SILs) and behavioral determinants of infection among HIV infected women compared to women attending a sexually transmitted diseases (STD) clinic in Lima, Peru.

METHODS: For our cross sectional study, we consecutively recruited 50 HIV infected women and 50 age matched controls from our public STD clinic (Programa de Control de Enfermedades de Transmision Sexual y SIDA-PROCETSS) between February 2001 and February 2002. All women were interviewed using a behavioral risk assessment and underwent Papanicolau smears. All smears were interpreted by two independent pathologists blinded as to patient's HIV status.

RESULTS: The majority of HIV infected women and controls were born in Lima (62% vs. 54%, respectively.) HIV infected women more likely smoked (p<0.01), consumed alcohol (p<0.01) and gave a history of genital ulcer disease (p<0.05). The mean number of sexual partners in the last year, 0.7 in the HIV infected group and 0.8 in the control group, and in the last 5 years, 1.3 in the HIV infected group and 1.2 in the control group were similar. All SILs occurred among HIV infected women (26% prevalence in HIV infected group vs. 0% in control group.) Among HIV infected women with CD4 lab testing (n=30), cervical SILs were associated with a CD4 count less than 200 cells/mm³ (mean CD4 count 163 cells/mm³).

CONCLUSIONS: Both HIV infected women and HIV negative STD attendees had similarly low number of reported sexual partners in the last year and 5 years. This finding supports other studies from Peru suggesting male bisexual behavior or commercial sex worker use confers principle risk to women partners. Prevention efforts should educate and support women in questioning their partner's about their sexual risk.

Keywords: AEGIS, HIV Seropositivity, Acquired Immunodeficiency Syndrome, HIV Infections, Prevalence, Sexually Transmitted Diseases, Sexual Partners, Mass Screening, Health Resources, Cross-Sectional Studies, CD4 Lymphocyte Count, Vaginal Smears, Ambulatory Care Facilities, Case-Control Studies, Peru, Humans, Female, Male, diagnosis

040711
C10357