{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:35:12Z","timestamp":1790872512667,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,4,20]],"date-time":"2011-04-20T00:00:00Z","timestamp":1303257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Human immunodeficiency virus (HIV)\u2010infected women in India and other developing country settings are living longer on antiretroviral therapy, yet their risk for human papillomavirus (HPV)\u2010induced cervical cancer remains unabated because of lack of cost\u2010effective and accurate secondary prevention methods. Visual inspection after application of dilute acetic acid on the cervix (VIA) has not been adequately studied against the current standard: conventional cervical cytology (Pap smears) among HIV\u2010infected women. We evaluated 303 nonpregnant HIV\u2010infected women in Pune, India, by simultaneous and independent screening with VIA and cervical cytology with disease ascertainment by colposcopy and histopathology. At the cervical intraepithelial neoplasia (CIN2+) disease threshold, the sensitivity, specificity and positive and negative predictive value estimates of VIA were 80, 82.6, 47.6 and 95.4% respectively, compared to 60.5, 59.6, 22.4 and 88.7% for the atypical squamous cells of undetermined significance or severe (ASCUS+) cutoff on cytology, 60.5, 64.6, 24.8 and 89.4% for the low\u2010grade squamous intraepithelial cells or severe (LSIL+) cutoff on cytology and 20.9, 96.0, 50.0 and 86.3% for high\u2010grade squamous intraepithelial lesion or severe (HSIL+) cutoff on cytology. A similar pattern of results was found for women with the presence of carcinogenic HPV\u2010positive CIN2+ disease, as well as for women with CD4+ cell counts &lt;200 and &lt;350 \u03bcL<jats:sup>\u22121<\/jats:sup>. Overall, VIA performed better than cytology in this study with biologically rigorous endpoints and without verification bias, suggesting that VIA is a practical and useful alternative or adjunctive screening test for HIV\u2010infected women. Implementing VIA\u2010based screening within HIV\/acquired immunodeficiency syndrome care programs may provide an easy and practical means of complementing the highly anticipated low\u2010cost HPV\u2010based rapid screening tests in the near future, thereby contributing to improve program effectiveness of screening.<\/jats:p>","DOI":"10.1002\/ijc.25971","type":"journal-article","created":{"date-parts":[[2011,2,3]],"date-time":"2011-02-03T21:23:09Z","timestamp":1296768189000},"page":"234-240","source":"Crossref","is-referenced-by-count":42,"title":["Comparison of visual inspection with acetic acid and cervical cytology to detect high\u2010grade cervical neoplasia among HIV\u2010infected women in India"],"prefix":"10.1002","volume":"130","author":[{"given":"Vikrant V.","family":"Sahasrabuddhe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh 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