Department of social epidemiology, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS1136), UPMC Univ Paris 06, Sorbonne University, INSERM, Paris, France.
Department of Epidemiology of Occupational and Social Determinants of Health, Center for Research in Epidemiology and Population Health, INSERM, U1018, Villejuif, France.
HIV Med. 2017 Mar;18(3):181-195. doi: 10.1111/hiv.12412. Epub 2016 Jul 6.
Cancer is a growing concern for HIV-infected people, and screening plays a major role in alleviating the burden it causes. We sought to investigate the levels and determinants of breast cancer screening (BCS) and cervical cancer screening (CCS) in HIV-infected women as compared with the general population.
The Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS)-Vespa2 study was conducted in 2011 in a national representative sample of 3022 HIV-infected hospital out-patients in France. The rates and correlates of BCS and CCS among HIV-infected women were compared with those in the general population using multivariate Poisson regression models.
The BCS rate during the 2 years preceding the survey interview was 80.7% among HIV-infected women vs. 89.1% in the general population (P = 0.146). The CCS rate during the preceding 3 years was 88.1% among HIV-infected women vs. 83.1% in the general population (P = 0.021). During the preceding year, the CCS rate among HIV-infected women was 76.5%. The barriers to BCS and CCS were a low educational level [BCS: adjusted prevalence rate ratio 0.88; 95% confidence interval (CI) 0.80-0.97; CCS: adjusted prevalence rate ratio 0.91; 95% CI 0.83-0.99], not having supplementary health insurance (CCS: adjusted prevalence rate ratio 0.92; 95% CI 0.86-0.98), an irregular gynaecological follow-up (BCS: adjusted prevalence rate ratio 0.77; 95% CI 0.64-0.92; CCS: adjusted prevalence rate ratio 0.72; 95% CI 0.64-0.81) and a low CD4 count (BCS: adjusted prevalence rate ratio 0.83; 95% CI 0.71-0.97; CCS: adjusted prevalence rate ratio 0.78; 95% CI 0.63-0.98). The disparities in CCS uptake in terms of age, employment and gynaecological follow-up were less pronounced among HIV-infected women than in the general population.
BCS and CCS uptake was not lower among HIV-infected women than in the general population, but CCS was suboptimal. Specificities in the profile of barriers to screening emerged.
癌症是感染艾滋病毒人群日益关注的问题，筛查在减轻其负担方面起着重要作用。我们旨在研究与一般人群相比，艾滋病毒感染者的乳腺癌筛查（BCS）和宫颈癌筛查（CCS）的水平和决定因素。
Agence Nationale de Recherche sur le Sida et les Hépatites Virales（ANRS）-Vespa2 研究于 2011 年在法国进行，调查了全国范围内 3022 名感染艾滋病毒的门诊患者的代表性样本。使用多变量泊松回归模型比较了 HIV 感染者中 BCS 和 CCS 的发生率和相关性。
在调查访谈前的 2 年内，HIV 感染者中 BCS 的比率为 80.7%，而一般人群中为 89.1%（P=0.146）。在过去 3 年中，HIV 感染者中 CCS 的比率为 88.1%，而一般人群中为 83.1%（P=0.021）。在过去的一年中，HIV 感染者的 CCS 率为 76.5%。BCS 和 CCS 的障碍包括教育水平低（BCS：调整后的患病率比 0.88；95%置信区间（CI）0.80-0.97；CCS：调整后的患病率比 0.91；95%CI 0.83-0.99），没有补充健康保险（CCS：调整后的患病率比 0.92；95%CI 0.86-0.98），妇科随访不规律（BCS：调整后的患病率比 0.77；95%CI 0.64-0.92；CCS：调整后的患病率比 0.72；95%CI 0.64-0.81）和低 CD4 计数（BCS：调整后的患病率比 0.83；95%CI 0.71-0.97；CCS：调整后的患病率比 0.78；95%CI 0.63-0.98）。与一般人群相比，HIV 感染者中年龄、就业和妇科随访方面 CCS 利用率的差异不太明显。
与一般人群相比，HIV 感染者的 BCS 和 CCS 利用率并不低，但 CCS 并不理想。筛查障碍的特殊性凸显出来。
