A Comparison of the Predictors of Abnormal Cervical Cytology among HIV-Positive and HIV-Negative Women Attending Lagos University Teaching Hospital, Nigeria

Abstract

Background: Women living with Human Immunodeficiency Virus (HIV) are at increased risk of developing premalignant cervical lesions compared with the general population. This study assessed and compared the prevalence and predictors of abnormal cervical cytology among HIV-positive and HIV-negative women attending Lagos University Teaching Hospital, Nigeria. Methods: A comparative cross-sectional study was conducted among asymptomatic HIV-positive women attending the AIDS Prevention Initiative in Nigeria Clinic and HIV-negative women attending the General Out-Patient Department Clinic. Cervical cytology samples from 441 participants (232 HIV-positive and 209 HIV-negative), selected using systematic random sampling, were evaluated using the Bethesda Classification System. Data were collected using interviewer-administered questionnaires and analyzed with SPSS version 26. Associations were assessed using chi-square tests and multivariable logistic regression at a 5% significance level. Results: The prevalence of abnormal cervical cytology was significantly higher among HIV-positive women (27.6%) compared to HIV-negative women (5.7%) (p<0.001). A significant difference was observed in the mean ages at sexual initiation among these two groups of women with abnormal cytology. HIV-negative status (adjusted Odds Ratio [aOR]=0.15; 95% Confidence Interval [CI]: 0.07–0.30; p<0.001) and age 30–39 years (aOR=0.38; 95% CI: 0.16–0.92; p=0.032) were associated with lower odds of abnormal cytology, while high parity (≥3) increased the odds (aOR=2.54; 95% CI: 1.41–4.58; p=0.002). Conclusion: Abnormal cervical cytology was significantly more prevalent among women living with HIV. HIV status, age, and parity were key predictors. Strengthened and targeted cervical cancer screening strategies are recommended for HIV-positive women to facilitate early detection and timely intervention.