Why is it that HIV positive women seem to have a lot of abnormal pap smears? And once the coloposcopy (spelling, oops!) is performed everything is found normal? What causes my paps to be abnormal when really, they end up being o.k.? Please shed some light on this for me, as I am still confused by this. Thanks in advance.

These are good questions. It is thought that the colonscopy is a more sensitive test for abnormalities than the Pap smear so that sometimes it will be normal when the Pap is abnormal. It also depends on what you mean by an abnormal Pap smear, some types of changes on the Pap smear may be due to an ongoing infection and if that is treated the Pap smear improves. Women with HIV are thought to be at increased risk for getting an abnormal Papa smear due to the effects of HIV on the immune system- when the immune system is not working other viruses, like HPV ( which can cause cervical dysplasia)are able to casue more problems. For this reason Pap smears are followed more closely in women with HIV. I hope this helps.

-JC