Correlates and risk factors for abnormal papanicolaou smear among HIV infected and HIV non infected women in Northeastern Nigeria

Abstract

Background: Universal access to antiretroviral therapy has resulted in increased life expectancy among 
HIV infected women clients, however the risk of certain clinical conditions including premalignant lesion 
of the cervix may remain or enhanced compared with HIV negative control. Objectives: To compare the 
prevalence and the risk factors of abnormal Pap smear among HIV positive and HIV negative women 
attending clinics of two tertiary hospitals in Northeastern Nigeria. Methodology: This was a hospital 
based case control cross sectional study involving three hundred and sixty-five consecutive consenting 
HIV infected women and three hundred and sixty-five HIV non- infected women. Socioeconomic and 
clinical variables, abnormal Pap smear and CD4 cell count of all the HIV positive women were recorded. 
Results: Abnormal Pap smear among HIV infected women of 47.94 % (18.1% epithelial and 29.8% benign 
cells abnormalities) in this report was higher than 31.78% (8.0% epithelial and 23.78% benign cells 
abnormalities) among HIV non-infected women. A negative correlation was observed between CD4 cell 
count and the abnormal Pap smear.  Other correlates of abnormal Pap smear include early coitache, 
multiple sexual partners and low social class. Conclusion: HIV infection is associated with increased risk 
of abnormal Pap smear in women. Other risk factors associated with abnormal Pap smear, include early 
coitache, multiple sexual partners and low social class. Recommendation: Cervical screening should be 
included among investigations in evaluating HIV infected women.