Availability of Cancer Screening Across <scp>HIV</scp> Treatment Sites in the <scp>IeDEA</scp> Consortium
Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increases as this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continents within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening availability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit link function to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reported cervical cancer screening by cytology or human papillomavirus (HPV) testing on-site, and 88% (194/220) reported cervical cancer screening by any method, including visual inspection. At sites serving predominantly rural populations, 62% (29/47) exclusively performed screening by visual inspection. Overall, 23% (50/220) of sites performed cytology-based anal cancer screening on-site, and 16% (35/220) had availability of high-resolution anoscopy, either on-site or by referral. Screening for cancer of the liver, colon, lung, prostate, or breast (by imaging) were each available at less than 43% of sites. The odds of cervical cancer screening availability increased by 16% annually from 2017 through 2023 (aOR = 1.16, 95% CI: 1.07-1.27, p = 0.001), while the relative odds of anal cancer screening availability decreased by 9% annually (aOR = 0.91, 95% CI: 0.84-0.99, p = 0.023). Lack of trained staff was the most frequently reported barrier, followed by lack of equipment. Understanding current practices and capacity is essential for the continued integration of cancer prevention in HIV care.
Authors
- Aggrey Semeere (ORCID: https://orcid.org/0000-0003-1826-2239)
- Miriam Nakalembe (ORCID: https://orcid.org/0000-0001-7569-8173)
- Fernanda Maruri (ORCID: https://orcid.org/0000-0001-9533-8239)
- Jonathan Euvrard (ORCID: https://orcid.org/0000-0002-3937-7855)
- Valeria Fink (ORCID: https://orcid.org/0000-0003-3994-4781)
- Rachael Pellegrino (ORCID: https://orcid.org/0000-0002-7111-3040)
- Adebola Adedimeji (ORCID: https://orcid.org/0000-0002-8012-9124)
- Simon Boni (ORCID: https://orcid.org/0000-0002-0630-9135)
- Sally B. Coburn (ORCID: https://orcid.org/0000-0002-6423-1137)
- Eliane Rohner (ORCID: https://orcid.org/0000-0002-0554-2875)
- Helen Byakwaga (ORCID: https://orcid.org/0000-0002-4799-1564)
- Michael Jonah Silverberg (ORCID: https://orcid.org/0000-0001-9322-1395)
- Lesley S. Park (ORCID: https://orcid.org/0000-0002-3848-7753)
- Bryan E. Shepherd (ORCID: https://orcid.org/0000-0002-3758-5992)
- Antoine Jaquet (ORCID: https://orcid.org/0000-0002-3426-9492)
- Kathryn Anastos
- Gad Murenzi (ORCID: https://orcid.org/0000-0002-5513-5522)
- Chad J. Achenbach (ORCID: https://orcid.org/0000-0003-4847-7249)
- Eugène Messou
- Emilia M. Jalil
- Oliver Ezechi
- Limpho Mokone
- Brenda Crabtree Ramírez
- I Ketut Agus Somia
- Caroline Lade
- Sanjay Pujari
- Jessica L. Castilho
- Jeremy Ross
- International epidemiology Databases to Evaluate AIDS (IeDEA)
- Omenge Orang'o
- Eduardo Gotuzzo
- Patricia Lelo
- Kumbirai Pise Quarter
Institutions
- Northwestern University (US)
- Great Zimbabwe University (ZW)
- University of Bern (CH)
- Udayana University (ID)
- Albert Einstein College of Medicine (US)
- Kaiser Permanente (US)
- Mbarara University of Science and Technology (UG)
- Johns Hopkins University (US)
- Université de Bordeaux (FR)
- Inserm (FR)
- University of Cape Town (ZA)
- Universidad Peruana Cayetano Heredia (PE)
- Asia Foundation (US)
- Gold Coast Hospital (AU)
- Reformed Church University (ZW)
- Kinshasa General Hospital (CD)
- Serum Institute of India (India) (IN)
- University of Rwanda (RW)
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX)
- Bordeaux Population Health (FR)
- Fundación Huésped (AR)
- Aga Khan University Nairobi (KE)
- Goodlife (Netherlands) (NL)
- Société de Développement des Forêts (CI)
- Institute of Social and Preventive Medicine (CH)
- Programme PAC-CI (CI)
- Instituto Evandro Chagas (BR)
- Gold Coast Health (AU)
- Touching Tiny Lives (LS)
- Institut de Recherche pour le Développement (FR)
- Wake Forest University (US)
- Nigerian Institute of Medical Research (NG)
- Makerere University (UG)
- Vanderbilt University Medical Center (US)
- Stanford University (US)
Publication Details
- Journal
- International Journal of Cancer
- Published
- 2026-04-16
- DOI
- https://doi.org/10.1002/ijc.70503
- Primary Topic
- Cervical Cancer and HPV Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Vanderbilt University
- Vanderbilt Institute for Clinical and Translational Research
- National Institutes of Health
- National Heart, Lung, and Blood Institute
- National Institute of Mental Health
- National Cancer Institute
- National Institute of Allergy and Infectious Diseases
- Fogarty International Center
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute of Child Health and Human Development
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development