A comparison of risk factors for atypical squamous cells and squamous intraepithelial lesions in a sample of US- and African-born HIV-positive women

• Published in: AIDS care 2010-09, Vol.22 (9), p.1115-1122
• Main Authors: Wilkerson, Michael, Prosser, Rachel
• Format: Article
• Language: English
• Subjects: Adult; Africa; Africa - epidemiology; African; Africans; Aged; AIDS/HIV; Analysis of Variance; Biological and medical sciences; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - virology; CD4 Lymphocyte Count; cervical cancer screening; Cervical Intraepithelial Neoplasia - diagnosis; Cervical Intraepithelial Neoplasia - epidemiology; Cervical Intraepithelial Neoplasia - virology; Cross-Sectional Studies; Diagnosis; Female; Female genital diseases; Fundamental and applied biological sciences. Psychology; Gynecology and obstetrics; Gynecology. Andrology. Obstetrics; Health care; HIV; HIV Infections - complications; human immunodeficiency virus (HIV); human papillomavirus (HPV) infection; Human viral diseases; Humans; Immune response system; Infectious diseases; Medical sciences; Medical treatment; Middle Aged; Odds Ratio; Papillomavirus Infections - complications; Prescriptions; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Risk; Risk Factors; Tumors; U.S.A; United States - epidemiology; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - virology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Women; Young Adult
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121003599240

Previous research conducted in the USA and Africa has identified human immunodeficiency virus (HIV) infection as a risk factor for women developing squamous intraepithelial lesion (SIL) diagnosis. This study was conducted to compare the odds of a diagnosis of atypical squamous cells (ASCUS) or SIL in a sample of mostly African-born and US-born women (n=275). A greater proportion of US-born women had an ASCUS (68.9%) or SIL (81.3%) diagnosis than African-born women (29.5% ASCUS, 15.6% SIL). After adjusting for age, smoking status, absolute CD4, and a prescription for HIV-antiviral medications, the US-born women had a greater odds of a SIL diagnosis than the African-born women (OR=0.22, 95% CI: 0.06-0.79); no significant differences in ASCUS remained after adjustment. In this sample, proportionately more African-American (55.3%) and white American (51.1%) women smoke tobacco than African-born women (1.9%), explaining, perhaps, some of the difference. We found that an absolute CD4 less than 200, when compared to an absolute CD4 above 500, was highly predictive of a SIL diagnosis (OR=6.31, 95% CI: 2.10-18.93, p-trend