Exploring inclusion of rapid HPV DNA testing in primary cervical cancer screening in Tanzania – role of HIV status

Objective: HPV DNA testing is currently used as primary cervical cancer screening method in most of high income countries and was shown to improve quality of screening services. However, this is not yet the case in low income countries. In this study, we investigate whether the value of HPV DNA testing in primary cervical cancer screening with VIA as triage test is the same among HIV positive and negative women. Subjects and Methods: This cohort study included women attending routine cervical cancer screening clinics at Ocean Road Cancer Institute and Kilimanjaro Christian Medical Centre. At enrolment eligible women were interviewed tested for HIV, had a cervical sample taken, and finally VIA was performed. After 14 months, they were invited for follow-up visit and VIA was repeated. Results: At enrolment, 938 women tested careHPV positive, of those 101 were VIA positive and were referred to further diagnostic work up and treatment. Among 837 careHPV positive but VIA negative women, 333 attended follow-up as scheduled and 4.2 this was not distributed equally according to HIV status. In 109 HIV positive women (hrHPV positive and VIA negative at enrolment), 9.24 months follow-up whereas this only applied 1.8up. Conclusions: The study shows that when HPV DNA testing is integrated in cervical cancer screening using triage with VIA, HIV status should be considered when considering further follow-up.