IMPLEMENTATION OF A CERVICAL CANCER SCREENING PROGRAM FOR HIV-INFECTED WOMEN IN NAIROBI, KENYA.

Abstract

Purpose/Background Women in developing countries face some of the highest rates of cervical cancer in the world. Similarly, human immunodeficiency virus (HIV)-positive women are at much greater risk of cervical cancer than their HIV-negative counterparts. A cervical cancer screening program for HIV-positive African women was designed to address the intersection of these two public health concerns. Objective To implement a cervical cancer screening program for women receiving HIV care in a Nairobi clinic, as per guidelines outlined in previously conducted needs assessment. Methods Develop infrastructure clinic-wide to support a sustainable program, including training staff, acquiring necessary medical supplies and patient education materials, creating clinic forms and data tracking systems, and establishing a protocol for ongoing management of abnormal results. Results/Conclusions A cervical cancer screening program was established to screen HIV-positive women with an initial target patient population defined as women aged 30 to 39 who were currently on ARV therapy (approximately 550 women). Clinicians counseled and referred patients to a Pap smear procedure clinic conducted by nurses. Slides were read by an on-site pathologist with an estimated turnaround time of 1 week. Clinicians informed patients of results at follow-up appointments and made referrals to the national hospital for additional diagnostics and treatment as indicated. A special fund was established at the national hospital to subsidize care for patients referred from the program. Program monitoring and evaluation are ongoing.