Audit of cervical screening in women with HIV infection in the Auckland and Northland regions of New Zealand.

AIM

We aimed to review our current cohort of women with HIV infection to document the number of women who had received a yearly cervical smear since their diagnosis of HIV infection and the number of women who were likely to have had undiagnosed HIV infection at the time of their first abnormal cervical smear.

METHOD

This audit was a retrospective review of the cervical smear history of all adult women (> or =16 years) with HIV infection who were under active follow-up by the Infectious Diseases and Sexual Health Services at Auckland City Hospital on 31 December 2007.

RESULTS

Sixty-nine of the 123 (56%) women in this audit met the definition for yearly cervical smears. The factor associated with not receiving yearly cervical smears was women who had received cervical smears from their general practitioner (GP). Taking into account the women's CD4 count at the time of the diagnosis of their HIV infection, it is very likely that seven women had undiagnosed HIV infection at the time of their first abnormal cervical smear.

CONCLUSION

The proportion of women with HIV infection in the Auckland and Northland regions who received a yearly cervical smear during the audit period was low. We have put a number of interventions in place that we expect will improve this rate. These interventions include informing GPs of the need for yearly cervical smears for women with HIV infection, informing the National Cervical Screening Unit that these women are immunocompromised which will result in a yearly recall comment and informing these women of options for obtaining a cervical smear at little or no cost. Cervical smear takers should consider offering an HIV test to all women with an abnormal cervical smear who have resided in areas with high rates of HIV infection.