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将宫颈癌预防策略纳入艾滋病护理项目的有效性:一项混合方法系统评价方案。

Effectiveness of integrating cervical cancer prevention strategies into HIV care programmes: A mixed-methods systematic review protocol.

作者信息

Govindsamy Kimeshnee, Noll Susanne, Blose Ntombifuthi, Amponsah-Dacosta Edina

机构信息

Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Western Cape, South Africa.

Vaccines for Africa Initiative (VACFA), Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.

出版信息

PLoS One. 2025 May 19;20(5):e0306496. doi: 10.1371/journal.pone.0306496. eCollection 2025.

Abstract

INTRODUCTION

Cervical cancer, which is the fourth most frequently diagnosed cancer among women globally, remains a significant health burden despite being preventable and treatable, exposing gaps in accessing prevention and control services. Adolescent girls and young women (AGYW) living with HIV face heightened risk of persistent HPV infection, a primary cause of cervical cancer, making this population the ideal target for preventing cervical cancer before HPV exposure or disease progression. The overlap of cervical cancer and HIV exacerbates public health challenges, urging intensified efforts in bolstering prevention and control measures. Integration of cervical cancer prevention strategies into HIV care programs shows promise in effectively addressing this dual burden.

METHODS

To evaluate the effectiveness of integrating cervical cancer prevention strategies within HIV care programs, a mixed-methods systematic review will be conducted. A comprehensive Boolean search for literature published and indexed in PubMed, Cochrane Library, EBSCO Host, Web of Science, Scopus, and Google Scholar will be conducted, without imposing any language restrictions. This review will be conducted in alignment with the Joanna Briggs guidelines on systematic reviews together with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data from eligible studies will be extracted and synthesized, and their quality assessed.

DISCUSSION

There is limited understanding of the effectiveness of integrating cervical cancer prevention and HIV care in the real-world setting. While some studies touch on integration, focus tends to be on cervical cancer screening alone, neglecting vaccination, treatment of precancerous lesions, and education programs. Previous reviews on this focus are outdated, surpassing six years. This systematic review aims to fill these evidence gaps by thoroughly evaluating the challenges and opportunities associated with integrating the full complement of HPV prevention strategies and HIV care programs. The anticipated findings could enhance service delivery models aimed at reducing cervical cancer incidence and mortality among AGYW living with HIV.

TRIAL REGISTRATION

Systematic review registration: PROSPERO registration number: CRD42024535821.

摘要

引言

宫颈癌是全球女性中第四大最常被诊断出的癌症,尽管可预防且可治疗,但仍是一项重大的健康负担,这暴露了在获得预防和控制服务方面存在的差距。感染艾滋病毒的少女和年轻女性面临持续性人乳头瘤病毒(HPV)感染的风险增加,而HPV感染是宫颈癌的主要病因,这使得该人群成为在HPV暴露或疾病进展之前预防宫颈癌的理想目标人群。宫颈癌和艾滋病毒的重叠加剧了公共卫生挑战,促使加大力度加强预防和控制措施。将宫颈癌预防策略纳入艾滋病毒护理项目有望有效应对这一双重负担。

方法

为评估将宫颈癌预防策略纳入艾滋病毒护理项目的有效性,将进行一项混合方法的系统评价。将在PubMed、Cochrane图书馆、EBSCO主机、科学网、Scopus和谷歌学术搜索中对已发表和编入索引的文献进行全面的布尔搜索,不设任何语言限制。本评价将按照乔安娜·布里格斯系统评价指南以及系统评价和元分析的首选报告项目(PRISMA)指南进行。将提取和综合符合条件的研究的数据,并评估其质量。

讨论

在现实环境中对将宫颈癌预防与艾滋病毒护理相结合的有效性了解有限。虽然一些研究涉及整合,但往往只关注宫颈癌筛查,而忽视了疫苗接种、癌前病变的治疗和教育项目。以前关于这一重点的综述已经过时,超过了六年。本系统评价旨在通过全面评估与整合HPV预防策略和艾滋病毒护理项目的全部内容相关的挑战和机遇来填补这些证据空白。预期的研究结果可能会改进旨在降低感染艾滋病毒的少女和年轻女性宫颈癌发病率和死亡率的服务提供模式。

试验注册

系统评价注册:PROSPERO注册号:CRD42024535821。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cfd/12088019/f9f92b2adb3a/pone.0306496.g001.jpg

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