Cervical Abnormalities Common in HIV-Infected Girls
May 30, 2007
A new report is the largest cohort study of girls who have had HIV since birth, and the first to publish on rates of genital infections, cervical lesions, and pregnancy among them, said senior investigator Dr. Susan B. Brogly.
The study involved 638 girls infected during birth with HIV; they were ages 13 to 21 when they entered a pediatric AIDS study between 2000 and 2005. Brogly and colleagues estimate that 174 of the girls were sexually active. More than three-quarters were on HIV medication.
Pelvic exams revealed multiple cases of genital warts, and many participants had STDs including trichomoniasis, chlamydia, gonorrhea, and syphilis. Of the 101 sexually active girls who had Pap tests, 30 (29.7 percent) had abnormal results at the first examination, including squamous intraepithelial lesions (SIL), which could become cancerous.
"We were surprised at the high rates of SIL that were observed," Brogly said. "It is concerning to find such high rates in young adolescent girls."
The authors noted that "Pap smears were so infrequent among these girls identified as sexually active." During the course of the study, 38 girls became pregnant for the first time. Seven were pregnant more than once, resulting in 32 pregnancies that ended with live births. Of those, only one newborn was known to be HIV-positive.
The pregnancy rate was much lower in this cohort than among HIV-uninfected girls of similar ages in the U.S., the team found. Brogly attributed the low pregnancy rates to the fact that "some of these girls have severely compromised health and serious illness, making it difficult to become pregnant."
The full report, "Reproductive Health of Adolescent Girls Perinatally Infected With HIV," was published in the American Journal of Public Health (2007;97(6):1047-1052).
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.