Cervical Dysplasia In HIV-Seropositive women in Central Nigeria

Objective: To identify social, behavioural and epidemiologic predictors of cervical dysplasia in HIV- infected women in central Nigeria. Design: A cross sectional study. Setting: Jos University Teaching Hospital (JUTH), Nigeria. Patients: Cases were HIV- positive heterosexually active women diagnosed between January and April 2005 in JUTH. Controls were HIV- negative heterosexually active women recruited from HIV testing sites. Family and social history and cervical smears were obtained from the subjects. Results: Univariate analysis of 178 HIV- positive and 116 HIV- negative women showed that HIV-positive cases were more likely to be unemployed ( OR= 7.31, RR= 1.83, P< 0.0001), divorced ( OR= 3.69, P< 0.006, RR= 1.60), widowed (OR= 5.63, RR= 1.77, P< 0.0001), housewives ( OR= 2.19, RR= 1.83, P< 0.03), singles ( OR= 3.19, RR= 1.57, P < 0.0001), have had STDs (OR= 3.30, RR= 1.66, P< 0.0001) and more lifetime sexual partners (OR= 2.05, RR= 1.53, P< 0.0001). Inflammatory smears were more associated with HIV-positive cases (OR= 2.71, P< 0.0001). High grade dysplasia was more likely to be present in HIV-infected women (OR= 10.71, RR= 1.95, P< 0.003). The prevalence of cervical dysplasia was found to be 21% and 6% in HIV cases and controls respectively. Conclusion: We conclude that the prevalence of cervical dysplasia is two times higher in HIV- infected women than HIV- negative women in Jos. Socioeconomic factors such as poverty and social insecurity are risk factors for HIV infection as well are predictors of cervical dysplasia.