Cervical Cancer screening for Women living with HIV in Andhra

Author : Dr.Mahalingam Periasamy
WHO recommends 7 different options for cervical cancer screening among HIV infected women (screen, triage and treat or screen and treat), based on the availability of resources.In public health facilities as HPV screening is not available we can either go ahead with VIA(Visual inspection with Acetic acid) or pap. In Andhra we have currently undertaken a pilot initiative to screen using VIA and treat women living with HIV and Female sex workers from Jan 2023. WHO stats shows every 20 women out of 1 lakh will have either a precancerous or cancerous lesion which needs treatment. HIV infected women are 6 times at higher risk, which means 120/ 1lakh (0.12 %). Our data from Andhra from 4 secondary care govt hospitals shows that 49/ 2700 women above 25 yrs mobilised from the ART centre or NGO, have pre cancerous or cancerous lesions (1.8%) which is more than 10 times higher. Cryo was not available in these facilities. Through Indian Association of STD and AIDS we mobilised funds from private donors and donated a hand held thermocoagulator worth 3 lakhs and it is circulated among the hospitals for treating precancerous lesions. Frank cases of malignancy were referred to Tertiary care facilities .This pilot helped in early detection and treatment of cervical cancer among HIV infected women. Planning to scale it up across the country.