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Rates and Correlates of Self-Reported Pap Testing in African-Caribbean-Black HIV-Positive Women in Ontario, Canada

Abstract

Nisha Andany, Juan Liu, Robert Remis, Rupert Kaul, Wangari Esther Tharao and Mona R Loutfy

Cervical dysplasia and cancer are more common and aggressive in HIV-positive women and Papanicolaou (Pap) testing allows for their earlier identification and treatment. Guidelines recommend annual screening for this population. This cross-sectional study assessed prevalence and correlates of self-reported Pap testing among African-Caribbean HIV-positive women who completed an ACASI-administered questionnaire. Participants were recruited through a community health centre in Toronto, Canada. Pap testing history was assessed by a single question asking when the last test was done. Logistic regression examined correlates of Pap testing in the previous year. The 126 participating women’s median age was 40 years (IQR=34-46); 53.2% were East African and 16.7% Caribbean.69.9% and 82.1% of women had received a Pap test in the previous year and three years, respectively; 10.6% had never been tested. Age: 35-49 vs. >50 years (OR=6.7,95%,CI=1.7-25.1), being in Canada for >2 years (OR=4.6,95%,CI=1.6-13.5), having >2 sexual partners (OR=3.4,95%,CI=1.1-10.7) or having seen a family doctor within 6 months (OR=2.6,95%,CI=1.1-6.2) were significantly associated with Pap testing in the past year. In conclusion, 70% of participating women did have Pap screening in the past year. Program development to reach the 30% unscreened women should be sought; especially for the 10% who never received screening.

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