Reports on HIV/AIDS: 1990

NOVEMBER 30, 1990, MMWR, Vol. 39, No. 47, pp. 846-849
may also increase their risk for cervical carcinoma and of acquiring viral infections
that may be associated with cervical carcinoma. Therefore, epidemiologic studies that
can adjust for potential confounding variables, such as sexual behavior, are needed
to determine whether HIV infection places women at additional risk for cervical
disease.
In 1988, a consensus recommendation for cervical cancer screening was adopted
by the American Cancer Society, the National Cancer Institute, the American College
of Obstetricians and Gynecologists, the American Medical Association, the American
Nurses' Association, the American Academy of Family Physicians, and the American
Medical Women's Association (16). The recommendation suggests that all women
who are or who have been sexually active or who have reached age 18 years should
have an annual Pap test and pelvic examination. After a woman has had three or
more consecutive satisfactory normal annual examinations, the Pap test may be
performed less frequently at the discretion of her physician. Another advisory group,
the U.S. Preventive Services Task Force, recommended in 1989 that Pap smears
should begin with the onset of sexual activity and should be repeated every 1-3 years
at the physician's discretion (17). The time interval between Pap tests recommended
by the physician should be based on the presence of risk factors for cervical cancer.
In accordance with these recommendations and information suggesting that HIVinfected women may be at increased risk for cervical disease, HIV-infected women
should have a Pap smear annually.
References
1. Bradbeer C. Is infection with HIV a risk factor for cervical intraepithelial neoplasia? [Letter].
Lancet 1987;2:1277-8.
2. Maiman M, Fruchter RG, Serur E, Boyce JG. Prevalence of human immunodeficiency virus
in a colposcopy clinic [Letter]. JAMA 1988;260:2214.
3. Provencher D, Valme B, Averette HE, et al. HIV status and positive Papanicolaou screening:
identification of a high-risk population. Gynecol Oncol 1988;31:184-8.
4. Henry MJ, Stanley MW, Cruikshank S, Carson L. Association of human immunodeficiency
virus-induced immunosuppression with human papillomavirus infection and cervical intraepithelial neoplasia. Am J Obstet Gynecol 1989;160:352-3.
5. Schrager LK, Friedland GH, Maude D, et al. Cervical and vaginal squamous cell abnormalities in women infected with human immunodeficiency virus. J Acquir Immune Defic Syndr
1989;2:570-5.
6. Marte C, Cohen M, Fruchter R, Kelly P. Pap test and STD finding in HIV+ women at
ambulatory care sites [Abstract]. VI International Conference on AIDS. Vol 2. San Francisco,
June 20-24, 1990:211.
7. Feingold AR, Vermund SH, Burk RD, et al. Cervical cytologic abnormalities and P;pillomavirus in women infected with human immunodeficiency virus. J Acquir Immune Defic Syndr
1990;3:896-903.
8. Vermund S, Kelley KF, Burk RD, et al. Risk of human papillomavirus (HPV) and cervical
squamous intraepithelial lesions (SIL) highest among women with advanceo HIV disease
[Abstract]. VI International Conference on AIDS. Vol 3. San Francisco, June 20-24, 1990:215.
9. Maiman M, Fruchter RG, Serur E, et al. Human immunodeficiency virus infection and
cervical neoplasia. Gynecol Oncol 1990;38:377-82.
10. Tarricone NJ, Maiman M, Vieira J. Colposcopic evaluation of HIV seropositive women
[Abstract]. VI International Conference on AIDS. Vol 2. San Francisco, June 20-24, 1990:378.
11. National Cancer Institute Workshop. The 1988 Bethesda system for reporting cervical/
vaginal cytological diagnoses. JAMA 1989;262:931-4.
12. Novick LF, Berns D, Stricof R, Stevens R, Pass K, Wethers J. HIV seroprevalence in newborns
in New York state. JAMA 1989;261:1745-50.
13. New York State Department of Health. Time trends in cancer incidence: 1977-1986. Albany,
New York: New York State Cancer Registry, 1990.

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