Risk factors for cervical squamous intraepithelial lesions among HIV-1 seropositive women in Dar es Salaam, Tanzania

Int J Gynaecol Obstet. 1999 Nov;67(2):87-94. doi: 10.1016/s0020-7292(99)00125-3.

Abstract

Objectives: To determine the prevalence and risk factors for cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Dar es Salaam, Tanzania.

Methods: Between July 1996 and December 1997 we interviewed 691 HIV-infected women to obtain information about risk factors for SIL. Cervical smears and samples for lymphocyte subsets and sexually transmitted diseases (STD) diagnosis were collected.

Results: The prevalence of SIL was 2.9% (20/686) (95% CI = 1.7-4.2%). Eleven women had low-grade SIL while nine women had high-grade SIL. The number of lifetime sexual partners and live births was associated with a marginally non-significant increased risk of SIL. The risk of SIL was significantly increased among women with CD4+ cell count < 200/mm3 (multivariate odds ratio (OR) = 6.15, 95% CI = 1.19-41.37) and decreased by 68% for each 5-cm increase in mid-upper arm circumference (multivariate OR = 0.32, 95% CI = 0.10-0.93).

Conclusions: HIV-related immunosuppression and wasting and long-term sexual behavior were the major determinants of SIL in this population. Federation of Gynecology and Obstetrics.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • HIV Seropositivity*
  • HIV-1 / immunology*
  • Humans
  • Lymphocyte Count
  • Middle Aged
  • Risk Factors
  • T-Lymphocyte Subsets
  • Tanzania / epidemiology
  • Uterine Cervical Dysplasia / epidemiology*
  • Uterine Cervical Neoplasms / epidemiology*