Screening for cervical cancer in HIV-infected women receiving care in the United States
Screening for cervical cancer in HIV-infected women receiving care in the United States
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DOI：
10.1097/00126334-200108150-00007
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发表时间：
2001-08-15
期刊：
影响因子：
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通讯作者：
Shapiro, MF
中科院分区：
文献类型：
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作者：
Stein, MD;Cunningham, WE;Shapiro, MF
我们研究了社会人口，临床和供应商因素与宫颈癌筛查HIV感染women.Methods：我们研究了一个全国性的样本代表43,490名妇女接受治疗的HIV感染谁完成了第一次随访调查的HIV成本和服务利用研究（HCSUS）。所有的女性都被问到：“在过去的12个月里，你做过巴氏试验吗？“报告异常巴氏试验结果的妇女被问及是否被告知抗生素可以治愈异常细胞，以及她们是否被安排在3个月内进行另一次巴氏试验或阴道镜检查。结果：在所代表的人群中，81%在过去12个月内进行了巴氏试验。报告在同一临床地点有妇科医生和初级保健医生的妇女报告巴氏试验的可能性几乎是其他妇女的两倍（比值比，1.9; 95%置信区间，1.3-3.0）。在报告巴氏试验结果异常且未被告知抗生素可以治愈异常细胞的妇女中，95%的妇女计划进行重复巴氏试验或阴道镜检查，但15%的妇女没有接受重复巴氏试验或阴道镜检查。虽然接受艾滋病毒检测的妇女的巴氏试验率很高，并因发现异常而适当转诊，许多最初巴氏试验结果异常的妇女实际上没有接受后续巴氏试验或阴道镜检查。在艾滋病初级护理的同一地点提供妇科护理可能会改善妇女所需妇科护理的提供。
We examined the sociodemographic, clinical and provider factors associated With screening for cervical cancer among HIV-infected women.Methods: We studied a national sample representing 43,490 women receiving treatment of HIV infection who completed first follow-up surveys of the HIV Cost and Service Utilization Study (HCSUS). All women were asked, "In the past 12 months, have you had a Pap test?" Women reporting an abnormal Pap test result were asked whether they had been told antibiotics could cure abnormal cells, and whether they were scheduled for another Pap test or for a colposcopy within 3 months.Results: Of the population represented, 81% had had a Pap test in the past 12 months. Women who reported having a gynecologist and primary care physician at the same clinical site were almost twice as likely (odds ratio, 1.9; 95% confidence interval, 1.3-3.0) as other women to report Pap testing. Among women who reported abnormal Pap test results and were not told antibiotics could cure abnormal cells, 95% were scheduled for a repeat Pap test or colposcopy, but 15% of the women had not received their repeat Pap test or colposcopy.Conclusion: Although Pap test rates and appropriate referral for abnormal findings were high among HIV-tested women, many women with initially abnormal Pap test results did not actually receive follow-up Pap testing or colposcopy. Providing gynecologic care at the same site as primary HIV care would likely improve delivery of needed gynecologic ca-re for women.