{"doi":"10.1371/journal.pgph.0000156","title":"Cervical Cancer Screening Cascade for women living with HIV: A cohort study from Zimbabwe","abstract":"Countries with high HIV prevalence, predominantly in sub-Sahahran Africa, have the highest cervical cancer rates globally. HIV care cascades successfully facilitated the scale-up of antiretroviral therapy. A cascade approach could similarly succeed to scale-up cervical cancer screening, supporting WHO's goal to eliminate cervical cancer. We defined a Cervical Cancer Screening Cascade for women living with HIV (WLHIV), evaluating the continuum of cervical cancer screening integrated into an HIV clinic in Zimbabwe. We included WLHIV aged ≥18 years enrolled at Newlands Clinic in Harare from June 2012-2017 and followed them until June 2018. We used a cascade approach to evaluate the full continuum of secondary prevention from screening to treatment of pre-cancer and follow-up. We report percentages, median time to reach cascade stages, and cumulative incidence at two years with 95% confidence intervals (CI). We used univariable Cox proportional hazard regressions to calculate cause-specific hazard ratios with 95% CIs for factors associated with completing the cascade stages. We included 1624 WLHIV in the study. The cumulative incidence of cervical screening was 85.4% (95% CI 83.5-87.1) at two years. Among the 396 WLHIV who received screen-positive tests in the study, the cumulative incidence of treatment after a positive screening test was 79.5% (95% CI 75.1-83.2) at two years. The cumulative incidence of testing negative at re-screening after treatment was 36.1% (95% CI 31.2-40.7) at two years. Using a cascade approach to evaluate the full continuum of cervical cancer screening, we found less-than 80% of WLHIV received treatment after screen-positive tests and less-than 40% were screen-negative at follow-up. Interventions to improve linkage to treatment for screen-positive WLHIV and studies to understand the clinical significance of screen-positive tests at follow-up among WLHIV are needed. These gaps in the continuum of care must be addressed in order to prevent cervical cancer.","journal":"PLOS Global Public Health","year":2022,"id":250968,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":25,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9601,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":769461,"name":"Ardele Mandiriri","orcid":"0000-0001-6095-6213","position":1,"is_corresponding":false},{"id":769460,"name":"Tinei Shamu","orcid":"0000-0001-8931-4484","position":2,"is_corresponding":false},{"id":340362,"name":"Eliane Rohner","orcid":"0000-0002-0554-2875","position":3,"is_corresponding":false},{"id":823602,"name":"Lukas Bütikofer","orcid":"0000-0002-0801-746X","position":4,"is_corresponding":false},{"id":823603,"name":"Serra Lem Asangbeh","orcid":"0000-0001-6426-2032","position":5,"is_corresponding":false},{"id":613608,"name":"Tsitsi Magure","orcid":null,"position":6,"is_corresponding":false},{"id":361253,"name":"Cleophas Chimbetete","orcid":"0000-0002-3756-3523","position":7,"is_corresponding":false},{"id":4469,"name":"Matthias Egger","orcid":"0000-0001-7462-5132","position":8,"is_corresponding":false},{"id":823604,"name":"Margaret Pascoe","orcid":"0000-0003-3066-3780","position":9,"is_corresponding":false},{"id":507049,"name":"Julia Bohlius","orcid":"0000-0003-1955-1585","position":10,"is_corresponding":false},{"id":507047,"name":"Katayoun Taghavi","orcid":"0000-0003-0812-0069","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T00:24:37.429628Z","pmid":"36860760","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}