Author(s): Vasuki Shanmugam, Balakrishnan Kumbalingam
As on 2015 Human immunodeficiency virus estimations in India, people living with HIV are 21.17 lakhs, women with HIV constituting 2/5th of the total. The prevalence of sexually transmitted infections and malignancy are more in HIV infected people. Cervical cancer is one of the leading cancers among Indian women. HIV infection and sexually transmitted infections, Human Papilloma Virus infection in particular act synergistic in predisposing to cervical neoplasia. Undetected cervical cancer may increase the mortality of HIV infected women.
MATERIALS AND METHODS
This is a case control study done at STI clinic of tertiary hospital of South India involving 100 HIV infected women and 50 HIV uninfected women as control. STI screening and cervical cytology was done for both the group.
Sociodemographic profile was similar for both the groups pertaining to Age, Occupation, Literacy. 80% of women in study group and control group were married and monogamous. 34% of HIV infected women had early sexual debut because of early marriage (P value .006). 86% of HIV infected and 40% of HIV uninfected women had sexually transmitted infections. (P value .000).Abnormal cervical cytology was found more in HIV infected women. Inflammatory smear was found in 65% of HIV infected women and in 42% of HIV uninfected women. Epithelial cell abnormalities were found in 25% of HIV infected women and in 2% of control group. High grade squamous intraepithelial lesion was found in 4% of study group and none in control group.
Prevalence of STI and abnormal cervical cytology are more common in HIV infected women. Sexually transmitted infections, HIV and HPV in particular, are the proven risk factors of cervical malignancy .So prevention of cervical cancer lies in controlling STI and preventing HPV infection by early vaccination. Screening for STI and periodic Pap smear screening should be ideally done for all HIV infected women as per NACO guidelines.