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Cervical Cancer Screening Adherence among HIV-Positive Female Smokers from a Comprehensive HIV Clinic

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Abstract

HIV-positive women are at elevated risk for developing cervical cancer. While emerging research suggests that gynecologic health care is underutilized by HIV-positive women, factors associated with adherence to Pap testing, especially among HIV-positive female smokers are not well known. We utilized baseline data from a smoking cessation trial and electronic medical records to assess Pap smear screening prevalence and the associated characteristics among the HIV-positive female participants (n = 138). 46 % of the women had at least 1 Pap test in the year following study enrollment. Multiple logistic regression analysis indicated that younger age, African American race, hazardous drinking, increased number of cigarettes smoked per day, and smoking risk perception were associated with non-adherence to Pap smear screening. Cervical cancer screening was severely underutilized by women in this study. Findings underscore the importance of identifying predictors of non-adherence and addressing multiple risk factors and behavioral patterns among HIV-positive women who smoke.

Resumen

Las mujeres VIH positivas tienen un alto riesgo de desarrollar cáncer cervical. Aún cuando recientes investigaciones sugieren que la salud ginecológica es subutilizada por las mujeres VIH positivas, no son bien conocidos los factores asociados a la realización de la prueba de Papanicolaou (Pap) o citología vaginal entre mujeres VIH positivas que fuman. En este estudio utilizamos los datos de base de un ensayo clínico para dejar de fumar y registros médicos electrónicos para evaluar la prevalencia y las características asociadas a la realización de la prueba de Pap entre las mujeres VIH-positivas participantes (n = 138). Cuarenta y seis por ciento de las mujeres tenían al menos 1 prueba de Pap en el año siguiente de iniciarse el estudio. El análisis de regresión logística múltiple indicó que las mujeres más jóvenes, de raza afroamericana, con ingestión peligrosa de bebidas alcohólicas, con aumento del número de cigarrillos fumados por día, y con percepción de riesgo de fumar, estaban asociadas a la falta de adherencia a la prueba de Pap. La detección del cáncer cervical fue subutilizada severamente por las mujeres en este estudio. Hallazgos subrayan la importancia de identificar predictores del incumplimiento o no-adherencia de la prueba de Pap, abordando múltiples factores de riesgo y los patrones de conducta de las mujeres VIH-positivas que fuman.

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Acknowledgments

This work was supported by a National Cancer Institute Grant, R01CA097893, awarded to Ellen R. Gritz; National Cancer Institute Grant, R25TCA5770, awarded to Shine Chang; and National Cancer Institute Grant, P30CA16672, awarded to Ronald DePinho. 

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The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, PO Box 301439, Unit 1330, Houston, TX, 77030-1439, USA

    Faith E. Fletcher, Damon J. Vidrine, Irene Tami-Maury, Heather E. Danysh, Meredith Buchberg & Ellen R. Gritz

  2. Cancer Prevention Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Rachel Marks King

  3. Division of Infectious Diseases, The University of Texas Health Science Center at Houston Medical School, Houston, TX, USA

    Roberto C. Arduino

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  1. Faith E. Fletcher
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Correspondence to Faith E. Fletcher.

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Fletcher, F.E., Vidrine, D.J., Tami-Maury, I. et al. Cervical Cancer Screening Adherence among HIV-Positive Female Smokers from a Comprehensive HIV Clinic. AIDS Behav 18, 544–554 (2014). https://doi.org/10.1007/s10461-013-0480-6

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