Associations of HIV RNA Viral Load, CD4 Counts, HPV Detection, and Cytology Support Co-Testing for Cervical Cancer Screening Among Women Living with HIV

WLHIV demonstrate higher HPV prevalence and abnormal cytology rates, with persistence inversely related to CD4 counts. Viral suppression correlates with lower HPV prevalence and fewer cytologic abnormalities. Co-testing identified 34.8% of WLHIV with abnormal cytology and HPV-negative results. This study supports consideration of co-testing for cervical cancer screening in WLHIV, even among those with high ART uptake. Further prospective and multi-site studies are warranted to confirm these observations and inform policy or guideline changes.