Jolly Pauline E, Mthethwa-Hleta Simangele, Padilla Luz A, Pettis Jessica, Winston ShaCoria, Akinyemiju Tomi F, Turner Hannah J, Ejiawoko Amarachi, Brooks Raina, Preko Lena, Preko Peter O
Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA.
Ministry of Health and Social Welfare, 2nd Floor Ministry of Justice & Constitutional Affairs Building, Mhalambanyatsi Road, Mbabane, Swaziland.
BMC Public Health. 2017 Feb 21;17(1):218. doi: 10.1186/s12889-017-4120-3.
Cervical Cancer (CC) is the number one cancer among women in sub-Saharan Africa. Although CC is preventable, most women in developing countries do not have access to screening.
This cross-sectional study was conducted to determine the prevalence and risk factors for cervical lesions using visual inspection with acetic acid (VIA) among 112 HIV positive and 161 negative women aged 18-69 years.
The presence of cervical lesions was greater among HIV positive (22.9%) than HIV negative women (5.7%; p < 0.0001). In logistic models, the risk of cervical lesions among HIV positive women was 5.24 times higher when adjusted by age (OR 5.24, CI 2.31-11.88), and 4.06 times higher in a full model (OR 4.06, CI 1.61-10.25), than among HIV negative women. In the age-adjusted model women who had ≥2 lifetime sexual partners were 3 times more likely (OR 3.00, CI 1.02-8.85) to have cervical lesions compared to women with one lifetime partner and the odds of cervical lesions among women with a history of STIs were 2.16 greater (OR 2.16, CI 1.04-4.50) than among women with no previous STI. In the fully adjusted model women who had a previous cervical exam were 2.5 times more likely (OR 2.53, CI 1.06-6.05) to have cervical lesions than women who had not.
The high prevalence of HIV infection and the strong association between HIV and cervical lesions highlight the need for substantial scale-up of cervical screening to decrease the rate of CC in Swaziland.
宫颈癌（CC）是撒哈拉以南非洲地区女性中的头号癌症。尽管宫颈癌是可预防的，但发展中国家的大多数女性无法获得筛查服务。
本横断面研究旨在通过醋酸肉眼观察法（VIA）确定112名18至69岁的HIV阳性女性和161名HIV阴性女性中宫颈病变的患病率及危险因素。
HIV阳性女性中宫颈病变的发生率（22.9%）高于HIV阴性女性（5.7%；p < 0.0001）。在逻辑模型中，经年龄调整后，HIV阳性女性发生宫颈病变的风险比HIV阴性女性高5.24倍（比值比[OR] 5.24，可信区间[CI] 2.31 - 11.88），在完整模型中高4.06倍（OR 4.06，CI 1.61 - 10.25）。在年龄调整模型中，与一生仅有一个性伴侣的女性相比，一生有≥2个性伴侣的女性发生宫颈病变的可能性高3倍（OR 3.00，CI 1.02 - 8.85），有性传播感染病史的女性发生宫颈病变的几率比无既往性传播感染的女性高2.16倍（OR 2.16，CI 1.04 - 4.50）。在完全调整模型中，既往接受过宫颈检查的女性发生宫颈病变的可能性比未接受过检查的女性高2.5倍（OR 2.53，CI 1.06 - 6.05）。
HIV感染的高患病率以及HIV与宫颈病变之间的强关联凸显了在斯威士兰大幅扩大宫颈筛查规模以降低宫颈癌发病率的必要性。
