Graduate School of Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
J Int AIDS Soc. 2024 Jul;27(7):e26303. doi: 10.1002/jia2.26303.
To eliminate cervical cancer (CC), access to and quality of prevention and care services must be monitored, particularly for women living with HIV (WLHIV). We assessed implementation practices in HIV clinics across sub-Saharan Africa (SSA) to identify gaps in the care cascade and used aggregated patient data to populate cascades for WLHIV attending HIV clinics.
Our facility-based survey was administered between November 2020 and July 2021 in 30 HIV clinics across SSA that participate in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We performed a qualitative site-level assessment of CC prevention and care services and analysed data from routine care of WLHIV in SSA.
Human papillomavirus (HPV) vaccination was offered in 33% of sites. Referral for CC diagnosis (42%) and treatment (70%) was common, but not free at about 50% of sites. Most sites had electronic health information systems (90%), but data to inform indicators to monitor global targets for CC elimination in WLHIV were not routinely collected in these sites. Data were collected routinely in only 36% of sites that offered HPV vaccination, 33% of sites that offered cervical screening and 20% of sites that offered pre-cancer and CC treatment.
Though CC prevention and care services have long been available in some HIV clinics across SSA, patient and programme monitoring need to be improved. Countries should consider leveraging their existing health information systems and use monitoring tools provided by the World Health Organization to improve CC prevention programmes and access, and to track their progress towards the goal of eliminating CC.
为了消除宫颈癌（CC），必须监测预防和护理服务的可及性和质量，特别是对艾滋病毒感染者（WLHIV）。我们评估了撒哈拉以南非洲（SSA）各地艾滋病毒诊所的实施情况，以确定护理级联中的差距，并使用汇总患者数据为参加艾滋病毒诊所的 WLHIV 填补级联。
我们的基于设施的调查于 2020 年 11 月至 2021 年 7 月在 SSA 参与国际艾滋病流行病学数据库评估（IeDEA）联盟的 30 个艾滋病毒诊所进行。我们对 CC 预防和护理服务进行了定性的现场评估，并分析了 SSA 中 WLHIV 常规护理的数据。
33%的地点提供人乳头瘤病毒（HPV）疫苗接种。转诊进行 CC 诊断（42%）和治疗（70%）很常见，但在大约 50%的地点并非免费。大多数地点都有电子健康信息系统（90%），但这些地点没有常规收集用于监测 WLHIV 消除宫颈癌全球目标的指标数据。只有 36%提供 HPV 疫苗接种的地点、33%提供宫颈筛查的地点和 20%提供癌前病变和 CC 治疗的地点定期收集数据。
尽管宫颈癌预防和护理服务在 SSA 一些艾滋病毒诊所早已提供，但仍需改进患者和方案监测。各国应考虑利用现有的卫生信息系统，并使用世界卫生组织提供的监测工具，以改善宫颈癌预防方案的可及性，并跟踪其在消除宫颈癌目标方面的进展。
