Table of Contents
ISRN Obstetrics and Gynecology
Volume 2011, Article ID 789106, 5 pages
http://dx.doi.org/10.5402/2011/789106
Research Article

Investigating Potential Associations between Cervical Procedures and HIV Acquisition

1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA
2Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA
3UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA 94143, USA
4Department of Obstetrics and Gynecology, University of Zimbabwe, Harare, Zimbabwe
5Department of Pathology, University of California San Francisco, San Francisco, CA 94143, USA
6Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
7Division of Adolescent Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA

Received 3 August 2011; Accepted 7 September 2011

Academic Editors: E. Petru and L. B. Twiggs

Copyright © 2011 Khady Diouf et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Cervical human papillomavirus (HPV) infection has been associated with human immunodeficiency virus (HIV) acquisition in populations with a high prevalence of both infections. Procedures performed in the management of cervical dysplasia may facilitate HIV entry via mechanical injury. We sought to investigate the association between cervical procedures and incident HIV. Methods. Data on cervical cancer screening and procedures were collected in a cohort study evaluating the diaphragm for HIV prevention in 2040 women. In this secondary analysis, we investigated the association between cervical procedures and HIV acquisition. Results. Out of 2027 HIV-negative women at baseline, 199 underwent cervical procedures. Cumulative risk of HIV was 4.3% over 21 months of median followup ( 𝑛 = 8 8 ). Compared with women without cervical procedures, we observed no difference in HIV incidence after a cervical biopsy (RR 0.92, 95% CI 0.39–2.16), endocervical curettage (RR 0.29, 95% CI 0.07–1.22), or loop electrosurgical excision procedure (RR 1.00, 95% CI 0.30–3.30). Conclusions. In this cohort, cervical procedures were not associated with HIV incidence. This lack of association could be due to the small number of events.