Barriers to cervical cancer screening exist despite integrating HIV and gynaecological services for HIV-positive women in Poland.
Ginekol Pol
; 89(2): 68-73, 2018.
Article
em En
| MEDLINE
| ID: mdl-29512810
ABSTRACT
OBJECTIVES:
HIV-positive women are at increased risk of HPV infection and cervical cancer. European and national guidelines advise yearly screening for cervical cancer, however due to the lack of a central registration of HIV infected persons there is a gap in offering such care through general healthcare services in many countries, including Poland. MATERIAL ANDMETHODS:
In response to the above limitations, integrated gynaecological care (IGC) was established at the HIV Out-Patient Clinic in Warsaw. We analysed data from January 2007 to May 2014. Logistic regression models were used to identify factors associated with not using IGC by patients.RESULTS:
Two hundred and forty women were registered in the observation period59.6% infected through sexual contact, 18.7% through IDUs, 19.2 % through unknown causes and 2.5% by other (two were vertically infected). The median follow-up time was 2.35 (IQR 0.9-4.5) years and 78.3% were on combination antiretroviral therapy (cART). In total 145 of the women (60.4%) used IGC, from 72.1% of those registered in 2007 to 27.3% registered in 2014. There were in total 1075 gynaeco-logical visits and 254 cervical cytology tests performed. Seventy-five (51.7%) women were tested for HPV infection. Fac-tors decreasing the odds of not using IGC identified by multivariate regression models were being on cART (OR 0.25 [IQR 0.10-0.59]; p = 0.003) and longer time of observation (0.69 [0.58-0.83]; p = 0.0001).CONCLUSIONS:
The utilisation of IGC was very high, but with a delay in commencing the IGC. Women on cART and with longer periods of follow-up had lower odds of not using IGC. A screening approach for women not yet on cART, or newly registered in the clinics, needs special attention.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Aceitação pelo Paciente de Cuidados de Saúde
/
Neoplasias do Colo do Útero
/
Soropositividade para HIV
/
Atenção à Saúde
/
Detecção Precoce de Câncer
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
/
Screening_studies
Limite:
Adult
/
Female
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Ginekol Pol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Polônia