Sociodemographic determinants of abnormal cervical cytology among HIV positive women in Nnewi, Nigeria

Abstract

Women living with human immunodeficiency virus (HIV) infection have a higher burden of premalignant lesion of the cervix. This may be influenced by their sociodemographic profile. To study the sociodemographic determinants of abnormal cervical cytology among HIV-positive women attending the adult HIV clinic in Nnamdi Azikiwe University Teaching Hospital Nnewi (NAUTH), Nnewi, Nigeria, the Pap smears of 110 HIV-positive women attending the adult HIV clinic at the hospital were evaluated for cytological abnormalities using the Bethesda system of classification.  Data on sociodemographic factors were obtained with the aid of semi structured questionnaires. Epi info statistical package was used to analyze the data. Majority of the women were married (61.8%; n=68), traders (67.3%; n=74) and who had attained at least secondary education (85.5%; n=94). All of them were Christians. The mean age and parity were 37.7±9.5 years and 2.8±2.3, respectively. The mean CD4 count was 557.1± 26 cells/ml and 89.1% (n= 98) of the women were on highly active antiretroviral therapy (HAART). The prevalence of cervical cytological abnormalities among the studied women was 28.2% (n=31). The mean age (35.4 vs. 38.9 years; p<0.05) was significantly lower among women with positive cervical cytological abnormalities and the prevalence of cytological abnormalities was significantly high among women aged 25 to 29 years (c2=9.30, p=0.05), traders (c2=10.7, p=0.03) and the Anglicans (c2=6.7, p=0.04).  The prevalence rate was also the highest among women who were para 0-1 (36.6%), unemployed (100.0%), with no formal education (33.3%), and those who were separated from their husbands (100.0%), but these were not statistically significant. The prevalence of cervical cytological abnormalities among the HIV positive women attending the HIV clinic in NAUTH was high. Younger age, being a trader and Anglican Christian denomination were significantly associated with increased risk of premalignant lesions of the cervix.   Key words: Cervical, cytological, premalignant lesions, human immunodeficiency virus (HIV) positive.