by Carolyn Chu, MD, MSc, AAHIVS, AAHIVM Chief Medical Officer
May 18, 2021
Massad LS, Xie X, Minkoff HL, et al. Frequency of high grade squamous cervical lesions among women over age 65 years living with the human immunodeficiency virus. Am J Obstet Gynecol. 2021 May 3; S0002-9378(21)00535-4. doi: 10.1016/j.ajog.2021.04.253. PMID: 33957115.
Author’s Commentary:
Optimal cancer screening for people aging with HIV remains an important topic of HIV medicine, and this analysis provides data that might help guide information-sharing and shared decision making for women with HIV who are 65+ years of age and their providers. Investigators found that most women with HIV who reach age 65 do not meet criteria for exiting screening. However, for those who do meet criteria, HSIL risk is similar to the risk observed among seronegative women. Thus, authors suggest ‘women living with HIV should be offered the option of screening cessation as part of an informed discussion of the risks and potential benefits of screening, recognizing that the 2% annual HSIL risk … may persuade many in good health to continue screening’. It is also worth noting that many patients have limited documentation of prior screening/testing results (which might be avoidable at times), often leading to challenges in confident decision making regarding ongoing screening.
The author has no conflicts of interest to disclose.
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