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Women living with HIV have 6-times the risk of cervical cancer compared to women in the general population, and we harnessed a model platform (\u2018Policy1-Cervix-HIV\u2019) to evaluate the benefits and harms of a range of screening strategies for women living with HIV in Tanzania, a country with endemic HIV. Assuming 70% coverage, we found that 3-yearly primary HPV screening without triage would reduce age-standardised cervical cancer mortality rates by 72%, with a number needed to treat (NNT) of 38.7, to prevent a cervical cancer death. Triaging HPV positive women before treatment resulted in minimal loss of effectiveness and had more favorable NNTs (19.7\u201333.0). Screening using visual inspection with acetic acid (VIA) or cytology was less effective than primary HPV and, in the case of VIA, generated a far higher NNT of 107.5. These findings support the WHO 2021 recommendation that women living with HIV are screened with primary HPV testing in a screen-triage-and-treat approach starting at 25 years, with regular screening every 3\u20135 years.<\/jats:p>","DOI":"10.1038\/s41591-023-02601-3","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T06:03:12Z","timestamp":1702360992000},"page":"3059-3066","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Benefits and harms of cervical screening, triage and treatment strategies in women living with HIV"],"prefix":"10.1038","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8989-1449","authenticated-orcid":false,"given":"Michaela T.","family":"Hall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2568-7956","authenticated-orcid":false,"given":"Kate T.","family":"Simms","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Murray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Keane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diep T. 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CDF1004). M.A. was supported by the Horizon 2020 Framework Program for Research and Innovation of the European Commission, through the Risk-based Screening for Cervical Cancer (RISCC) Network (grant no. 847845). K.C. receives salary support from the National Health and Medical Research Council (Australia, grant no. APP1135172). K.C. is co-principal investigator and M.C. is an investigator on an investigator-initiated trial of cytology and primary HPV screening in Australia (\u2018COMPASS\u2019) (ACTRN12613001207707 and\n                      \n                      ), which is conducted and funded by the Australian Centre for the Prevention of Cervical Cancer, a government-funded health promotion charity. The Australian Centre for the Prevention of Cervical Cancer has received equipment and a funding contribution for the COMPASS trial from Roche Molecular Systems and operational support from the Australian Government. K.C. is also co-principal investigator on a major implementation program, \u2018Elimination of Cervical Cancer in the Western Pacific\u2019, which receives support from the Minderoo Foundation and equipment donations from Cepheid, Inc. All declared funders had no role in the study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the manuscript for publication.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}