2023-09-28 14:46:10 +00:00
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abstract: 'Introduction: HIV and cervical cancer are intersecting epidemics that
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disproportionately affect one of the most vulnerable populations in the
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world: women in low-and middle-income countries (LMICs). Historically,
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the disparity in cervical cancer risk for women in LMICs has been due to
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the lack of organized screening and prevention programmes. In recent
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years, this risk has been augmented by the severity of the HIV epidemic
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in LMICs. HIV-positive women are at increased risk for developing
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cervical precancer and cancer, and while the introduction of
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antiretroviral therapy has dramatically improved life expectancies among
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HIV-positive women it has not been shown to improve cancer-related
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outcomes. Therefore, an increasing number of HIV-positive women are
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living in LMICs with limited or no access to cervical cancer screening
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programmes. In this commentary, we describe the gaps in cervical cancer
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prevention, the state of evidence for integrating cervical cancer
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prevention into HIV programmes and future directions for programme
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implementation and research.
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Discussion: Despite the biologic, behavioural and demographic overlap
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between HIV and cervical cancer, cervical cancer prevention has for the
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most part been left out of sexual and reproductive health (SRH) services
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for HIV-positive women. Lower cost primary and secondary prevention
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strategies for cervical cancer are becoming more widely available in
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LMICs, with increasing evidence for their efficacy and
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cost-effectiveness. Going forward, cervical cancer prevention must be
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considered a part of the essential package of SRH services for
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HIV-positive women. Effective cervical cancer prevention programmes will
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require a coordinated response from international policymakers and
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funders, national governments and community leaders. Leveraging the
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improvements in healthcare infrastructure created by the response to the
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global HIV epidemic through integration of services may be an effective
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way to make an impact to prevent cervical cancer among HIV-positive
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women, but more work remains to determine optimal approaches.
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Conclusions: Cervical cancer prevention is an essential part of
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comprehensive HIV care. In order to ensure maximal impact and
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cost-effectiveness, implementation strategies for screening programmes
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must be adapted and rigorously evaluated through a framework that
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includes equal participation with policymakers, programme planners and
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key stakeholders in the target communities.'
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affiliation: 'Huchko, MJ (Corresponding Author), Mission Hall,550 16th St,Box 1224,
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San Francisco, CA 94158 USA.
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Huchko, Megan J.; Cohen, Craig R., Univ Calif San Francisco, Dept Obstet Gynecol
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\& Reprod Sci, San Francisco, CA 94143 USA.
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Maloba, May, Kenya Govt Med Res Ctr, Family AIDS Care \& Educ Serv, Kisumu, Kenya.
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Nakalembe, Miriam, Makerere Univ, Dept Obstet \& Gynaecol, Kampala, Uganda.
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Nakalembe, Miriam, Makerere Univ, Infect Dis Inst, Kampala, Uganda.'
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author: Huchko, Megan J. and Maloba, May and Nakalembe, Miriam and Cohen, Craig R.
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author-email: megan.huchko@ucsf.edu
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author_list:
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- family: Huchko
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given: Megan J.
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- family: Maloba
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given: May
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- family: Nakalembe
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given: Miriam
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- family: Cohen
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given: Craig R.
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da: '2023-09-28'
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doi: 10.7448/IAS.18.6.20282
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eissn: 1758-2652
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files: []
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journal: JOURNAL OF THE INTERNATIONAL AIDS SOCIETY
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keywords: 'cervical cancer prevention; HIV; integration; low- and middle-income
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countries'
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keywords-plus: 'RANDOMIZED CONTROLLED-TRIAL; SUB-SAHARAN AFRICA; ANTIRETROVIRAL THERAPY;
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COST-EFFECTIVENESS; VISUAL INSPECTION; KENYA; INTEGRATION; INFECTION;
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INDIA; CARE'
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language: English
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month: DEC
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number: '5'
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number-of-cited-references: '48'
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pages: 39-43
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papis_id: 83658330c46ffb293390fb56cefbcb43
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ref: Huchko2015timehas
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researcherid-numbers: Huchko, Megan/S-6063-2019
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times-cited: '3'
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title: The time has come to make cervical cancer prevention an essential part of comprehensive
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sexual and reproductive health services for HIV-positive women in low-income countries
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000365969900006
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usage-count-last-180-days: '0'
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usage-count-since-2013: '11'
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volume: '18'
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web-of-science-categories: Immunology; Infectious Diseases
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year: '2015'
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