HIV prevalence and its association with cervical cancer risk in southern Africa: a systematic review and meta-analysis.

Abstract

Southern Africa is characterized by exceptionally high rates of HIV prevalence and incidence of cervical cancer, exceeding those observed in other regions of the continent. This situation highlights the urgent need for targeted and coordinated public health action. In this context, this review aims to clarify the links between these two diseases, to understand their interaction better, and to guide prevention and treatment strategies adapted to this high-risk region. This study, conducted according to the PRISMA 2020 guidelines, explored the impact of HIV on the risk of cervical cancer and the prevalence of HIV among cervical cancer patients in southern Africa. Eighteen original studies, covering six countries in the Southern Africa region and published between 2003 and 2022, were included. The prevalence of HIV in patients with cervical cancer was 5.30% (95% confidence interval [CI]: 4.21-6.67; and p = 0.001). In addition, the analysis revealed a significant association between HIV infection and an increased risk of cervical cancer, with an overall odds ratio of 2.29 (95% CI: 1.62-3.23; p = 0.001). Tests for publication bias showed no significant bias, and trim-and-fill analysis did not reveal any missing studies. In conclusion, this study highlights a high prevalence of HIV among cervical cancer patients in southern Africa, with a strong association between HIV infection and an increased risk of this form of cancer. These findings underline the importance of integrated prevention strategies, including human papillomavirus vaccination, cervical cancer screening, and improved access to antiretrovirals, to reduce the combined burden of HIV and cervical cancer in this high-risk region.