Abstract:
Background High HIV prevalence, and lack of organized screening for the indigent population receiving care and
treatment within HIV clinics in low-resource settings increases cervical cancer incidence. We sought to determine
predictors of cervical precancer in women living with HIV and receiving cervical cancer screening in Jos, Nigeria.
Methods A cross-sectional study of women living with HIV and receiving care and treatment in adult HIV/AIDS
clinics in Jos-Metropolis, Nigeria between June 2020 and April 2023. Ethical approvals were obtained from the
ethics committee in Jos, Nigeria and Northwestern University IRB, USA. Informed consent was obtained from
eligible participants, and data on socio-demographics, cancer risk factors, and cytology reports were collected. The
outcome variables were cervical precancer lesions. The independent variables were prior Pap smear status, sociodemographics,
income, educational, and other reproductive health factors. Descriptive statistics was done to obtain
means ± sd, frequencies, and percentages for the variables. Univariate and bivariate analyses were done to determine
predictors of cervical dysplasia. Analyses were performed using R software.
Results Of 957 women screened, 570 were living with HIV and 566 women had cytology report and were included in
the final analysis. The mean age was 45.08 ± 8.89 years and 81.6% had no prior evidence of Pap test (under-screened).
Prevalence of cervical dysplasia was 24% (mild and severe dysplasia were 12.9% and 11.1%, respectively). Age above
45 years (aOR = 3.48, p = 0.009), postmenopausal status (aOR = 7.69, p = 0.000), and women with no history of prior
IUCD use (aOR = 5.94, p = 0.0001), were predictors for severe dysplasia. Women who had history of STI (aOR = 0.17,
p = 0.000), prior use of IUCD (aOR = 0.32, p = 0.004), prior use of condom (aOR = 2.50, p = 0.003) and had co-morbidities
(aOR = 0.46, p = 0.009) were more likely to have had a Pap test in the past.
Conclusions The majority of indigent women receiving care at HIV clinics had their first Pap test screening, and
lack of organized screening among older and
