A study on modifiable and nonmodifiable risk factors associated with developing pap smear abnormalities in HIV-positive women
Sasindra Kumar Das, Nandita Dutta
Objectives: This study aims to estimate the frequency of abnormal pap smears with early detection of lesions, to assess the risk factors in HIV-positive women and the process increase their awareness. Methods: Hospital-based cross-sectional analytical study carried out in Gauhati Medical College and Hospital from March 2019 to June 2020. Pap smears from 100 HIV-positive women (18 - 60 years) were taken randomly. The association between risk factors and pap smear abnormality was determined by calculating chi-square, p-value, attributable risk and relative risk. Results: Most cases had NILM (79%). 19% intraepithelial lesions (14 ASCUS, 3 LSIL, 2 HSIL) and zero invasive cancer. Lower CD4 count (<200cells/cu mm), unhealthy cervix, and postmenopausal state are significant unmodifiable risk factors while early age at coitarche (<18 years), multiple partners of spouse, duration of HAART are significant modifiable risk factors for developing pap smear abnormality (P <0.05). Women with multiple sexual partners were found to have a higher relative risk of developing ECA. Conclusion: HIV-positive women have various risk factors (modifiable as well as non-modifiable) which have a significant association with developing cervical epithelial abnormalities which if not intervened will lead to invasive lesions in the cervix. It is pertinent to educate these women about the modifiable risk factors which can play a great role in risk reduction and prevention of cervical cancer.