{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:53:25Z","timestamp":1781870005127,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U01 CA199334"],"award-info":[{"award-number":["U01 CA199334"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["P2C HD042828"],"award-info":[{"award-number":["P2C HD042828"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In settings with high HIV prevalence, cervical cancer incidence rates are up to six\u2010fold higher than the global average of 13.1 cases per 100,000 women\u2010years. To inform strategies for global cervical cancer elimination, we used a dynamic transmission model to evaluate scalable screening and treatment strategies, accounting for HIV\u2010associated cancer risks and weighing prevention gains against overtreatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed a dynamic model of HIV\u2010HPV co\u2010infection and disease progression, which we calibrated to KwaZulu\u2010Natal, South Africa. Our baseline scenario reflects the current practice of HPV vaccination with a multi\u2010visit screening and treatment strategy involving cytology and colposcopy triage. We evaluated 13 comparator scenarios with increased vaccination coverage and one\u2010time, two\u2010time or repeat HIV\u2010targeted cervical cancer screening with the following single\u2010visit strategies: HPV DNA testing, HPV genotyping, automated visual evaluation (AVE) and HPV DNA with AVE triage. In all scenarios, HIV antiretroviral therapy, condom use and voluntary male medical circumcision continue at baseline levels. We simulated cancer incidence under each scenario from 2020 to 2120 using the 25 best\u2010fitting parameter sets. We present the median and range of model output from these simulations to account for parameter uncertainty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We estimate that cervical cancer incidence will decrease by 87% with the continuation of current cervical cancer and HIV prevention strategies, from an age\u2010standardized rate per 100,000 women of 80.4 (range 58.2, 112.1) in 2020 to 10.7 (4.2, 29.9) in 2120. Scenarios scaling up vaccination and single\u2010visit strategies resulted in near\u2010 and long\u2010term gains. With repeat HIV\u2010targeted screening, incidence rates were projected to be 29\u201334% lower in 2030 relative to the baseline scenario, and elimination (incidence &lt;4\/100,000) was achieved with HPV DNA testing in 2095 and with AVE in 2114. A strategy of HPV DNA with AVE triage optimized the tradeoff between cancer cases averted and overtreatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Single\u2010visit screening strategies could avert a substantial burden of cervical cancer and accelerate progress towards elimination in settings with a high burden of HIV. Increasing the screening frequency among women with HIV and reducing loss\u2010to\u2010follow\u2010up for treatment will be key components of a successful elimination strategy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26021","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T05:43:35Z","timestamp":1665639815000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Modelling cervical cancer elimination using single\u2010visit screening and treatment strategies in the context of high HIV prevalence: estimates for KwaZulu\u2010Natal, South Africa"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0058-8513","authenticated-orcid":false,"given":"Darcy White","family":"Rao","sequence":"first","affiliation":[{"name":"Bill &amp; Melinda Gates Foundation  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara J.","family":"Bayer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of North Carolina\u2010Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-7073","authenticated-orcid":false,"given":"Gui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Admire","family":"Chikandiwa","sequence":"additional","affiliation":[{"name":"Wits RHI, Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7599-1561","authenticated-orcid":false,"given":"Monisha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine L.","family":"Hathaway","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Tan","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly","family":"Mugo","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle Washington USA"},{"name":"Kenya Medical Research Institute  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruanne V.","family":"Barnabas","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30482-6"},{"key":"e_1_2_12_3_1","unstructured":"International Agency for Research on Cancer. IARC Handbooks of Cancer Prevention Volume 10: Cervix Cancer Screening.International Agency for Research on Cancer;2005."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coviro.2019.06.006"},{"key":"e_1_2_12_5_1","volume-title":"Global strategy to accelerate the elimination of cervical cancer as a public health problem","author":"World Health Organization","year":"2020"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.5306\/wjco.v6.i6.281"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1123"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30459-9"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30149-2"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32260"},{"key":"e_1_2_12_11_1","volume-title":"South Africa Demographic and Health Survey 2016","author":"National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), ICF","year":"2019"},{"key":"e_1_2_12_12_1","unstructured":"Republic of South Africa National Department of Health. 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