{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:06:47Z","timestamp":1784120807660,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","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","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Primary human papillomavirus (HPV) screening (PHS) utilizes oncogenic human papillomavirus (oncHPV) testing as the initial cervical cancer screening method and typically, if positive, additional reflex-triage (eg, HPV16\/18-genotyping, Pap testing). While US guidelines support PHS usage in the general population, PHS has been little studied in women living with HIV (WLWH).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We enrolled n = 865 WLWH (323 from the Women\u2019s Interagency HIV Study [WIHS] and 542 from WIHS-affiliated colposcopy clinics). All participants underwent Pap and oncHPV testing, including HPV16\/18-genotyping. WIHS WLWH who tested oncHPV[+] or had cytologic atypical squamous cells of undetermined significance or worse (ASC-US+) underwent colposcopy, as did a random 21% of WLWH who were oncHPV[\u2212]\/Pap[\u2212] (controls). Most participants additionally underwent p16\/Ki-67 immunocytochemistry.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Mean age was 46 years, median CD4 was 592 cells\/\u00b5L, 95% used antiretroviral therapy. Seventy WLWH had histologically-determined cervical intraepithelial neoplasia grade 2 or greater (CIN-2+), of which 33 were defined as precancer (ie, [i] CIN-3+ or [ii] CIN-2 if concurrent with cytologic high grade squamous intraepithelial lesions [HSILs]). PHS had 87% sensitivity (Se) for precancer, 9% positive predictive value (PPV), and a 35% colposcopy referral rate (Colpo). \u201cPHS with reflex HPV16\/18-genotyping and Pap testing\u201d had 84% Se, 16% PPV, 30% Colpo. PHS with only HPV16\/18-genotyping had 24% Colpo. \u201cConcurrent oncHPV and Pap Testing\u201d (Co-Testing) had 91% Se, 12% PPV, 40% Colpo. p16\/Ki-67 immunochemistry had the highest PPV, 20%, but 13% specimen inadequacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PHS with reflex HPV16\/18-genotyping had fewer unnecessary colposcopies and (if confirmed) could be a potential alternative to Co-Testing in WLWH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1317","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T19:41:03Z","timestamp":1598989263000},"page":"1529-1537","source":"Crossref","is-referenced-by-count":14,"title":["Primary HPV and Molecular Cervical Cancer Screening in US Women Living With Human Immunodeficiency Virus"],"prefix":"10.1093","volume":"72","author":[{"given":"Howard D","family":"Strickler","sequence":"first","affiliation":[{"name":"Albert Einstein College of Medicine\/Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla J","family":"Keller","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine\/Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A","family":"Hessol","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isam-Eldin","family":"Eltoum","sequence":"additional","affiliation":[{"name":"University of Alabama, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H","family":"Einstein","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School, Newark, New Jersey, 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M","family":"Atrio","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine\/Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalina","family":"Ramirez","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Minkoff","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Brooklyn, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adaora A","family":"Adimora","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igho","family":"Ofotokun","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, Georgia, 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