Objective: To determine the sensitivity of the Papanicolaou smear in human immunodeficiency virus (HIV)-infected women.
Methods: Fifty-two HIV-seropositive women underwent colposcopy and had cytologic and histologic specimens obtained. Eighty-five consecutive women seen in our colposcopy clinic who stated that they were HIV-seronegative formed the comparison group. Demographic features of the groups and cytology and histology findings were compared.
Results: In HIV-infected patients, the prevalence of cervical dysplasia was 50%. An additional 15% had vulvar lesions alone. The sensitivity of cytologic smears for cervical dysplasia was 63% and specificity was 84%. These findings were not significantly different from those of a control group of women undergoing colposcopy for standard indications (P > .05). Twelve of 38 seropositive women for whom future appointments were scheduled were lost to follow-up.
Conclusions: The sensitivity of the Papanicolaou test does not appear to be diminished in HIV-seropositive women. Screening colposcopy may be justified in view of the high prevalence of cervical and vulvar dysplasia, as well as the high noncompliance rate observed in this patient population.