Comparison of findings on cervical cancer screening by visual inspection with acetic acid (VIA) between HIV-positive women on ARTs and HIV-negative women in faith alive hospital Jos, North-Central Nigeria

Abstract

Background: Cervical cancer is the second most common cancer among women in Nigeria, and the leading cause of cancer-related death in sub-Saharan Africa. HIV-positive women are at heightened risk of developing cervical cancer than HIV-negative women due to immune suppression. In resource constrained settings, visual inspection with acetic acid (VIA) and subsequent treatment of precancerous lesions with thermal ablation remains the practical approach for secondary prevention. Objective: To compare prevalence of cervical precancerous lesions and suspected cancer between HIV-infected women on ART and HIV-negative women; and to determine the risk factors for precancerous lesions. Method: A retrospective data review of sexually active HIV-positive women on ART and HIV negative women aged 16-55 years screened for cervical cancer by VIA at Faith Alive hospital Jos, North-Central Nigeria over a period of 16 months. Precancerous cervical lesions were treated with thermal ablation and monitored for 2-6 weeks after treatment, then yearly. Those with cancer suspicious lesions were referred to Jos University Teaching Hospital for further management. Socio demographic characteristics of the study participants and the screening results were presented in frequency tables, and logistic regressions performed to determine risk factors for cervical pre-cancerous lesions. Data analysis was performed using IBM-SPSS 26. Results: 1,113 HIV-positive women on ART and 1,073 HIV-negative women were screened for cervical cancer by VIA. Insignificantly higher prevalence of cervical precancerous lesions (9.1% versus 7.6%, p-value=0.091) and insignificantly lower prevalence of suspected cancer (1.6% versus 2.6%, p value >0.05) was noted among HIV-positive women on ART compared to HIV-negative women. STI and parity ≥3 were the significant risk factors for cervical precancerous lesions. Conclusion: We found no significant difference between the prevalence of cervical precancerous lesions and suspected cancer between HIV-positive women on ART and HIV-negative women. STI and parity ≥3 were risk factors for cervical precancerous lesions.