Human papillomavirus–associated cervical cytologic abnormalities among women with or at risk of infection with human immunodeficiency virus ☆ ☆☆

Abstract Objective: Correlates of abnormal human immunodeficiency virus cervical cytologic findings were examined among women infected with human immunodeficiency virus and uninfected women. Study Design: We performed a cross-sectional analysis of baseline data on demographically similar women with infection or risk factors for it. Results: Among 1050 women without hysterectomy, squamous intraepithelial lesions were more common among women infected with human immunodeficiency virus than among uninfected women (18.8% vs 5.3%; P + cell count. Adjusted prevalence ratios were 1.9 for CD4 + cell counts + cell counts between 200 and 500 (95% confidence intervals, 1.2-3.0 and 1.0-2.5, respectively). Adjusted attributable fractions calculated for this study population indicated that if both human immunodeficiency virus and human papillomavirus were removed, 47.6% of the observed lesions with atypical squamous cells of uncertain significance and 93.4% of the observed squamous intraepithelial lesions would be prevented. Conclusion: Squamous intraepithelial lesions are more common among human immunodeficiency virus–infected women and are associated most commonly with high- and intermediate-risk human papillomavirus types and secondarily with human immunodeficiency virus–associated immune compromise. (Am J Obstet Gynecol 2001;184:584-90.)