Cervical cancer screening and prevalence among older <scp>US</scp> Medicare beneficiaries with and without <scp>HIV</scp>

Females with HIV (FWH) are recommended to receive cervical cancer screening annually, with the interval extended to every 3 years after three sequential normal results. Lifelong screening is highly recommended due to their increased risk of human papillomavirus infection and cervical cancer. We assessed the trends in cervical cancer screening rates and cervical cancer/precancer prevalence among older FWH and females without HIV (FWOH) using 2007-2019 US Medicare data. We found that age-adjusted cervical cancer screening rates decreased similarly in both FWH and FWOH (average annual percentage change: -4.4 [95% CI: -5.2, -3.6] vs. -5.7 [95% CI: -6.8, -4.7], p = 0.11). However, the age-adjusted cervical cancer/precancer prevalence showed increasing rates among FWH (5.4, [2.9, 7.9]) while stable in FWOH (-0.6 [-1.4, 0.1]). These findings underscore the need for strict adherence to clinical practice guidelines for cervical cancer screening in older FWH.