{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:08:41Z","timestamp":1790968121678,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"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\/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","award":["UM1CA121947"],"award-info":[{"award-number":["UM1CA121947"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Women living with human immunodeficiency virus (WLHIV) have disproportionately high rates of squamous cell carcinoma of the anus compared with the general population of women. Anal high-grade squamous intraepithelial lesions (HSILs) precede anal cancer, and accurate studies of HSIL prevalence among WLHIV in the United States are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The AIDS Malignancy Consortium 084 study was a multicenter national trial to evaluate the prevalence of and risk factors for anal HSIL in a US cohort. Eligible participants were WLHIV aged \u226518 years with no history of anal HSIL. Study participants had an examination including collection of cervical\/vaginal and anal specimens, followed by high-resolution anoscopy with biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 256 women with evaluable anal pathology. The mean age was 49.4 years, 64% women were non-Hispanic black, 67% were former or current smokers, and 56% reported ever having anal sex with a man. The median CD4 T-cell count was 664 cells\/\u03bcL. The prevalence of anal histologic HSIL (hHSIL) was 27% (95% confidence interval [CI], 22%\u201333%). There was a strong concordance (240\/254) between local and consensus pathologists for hHSIL vs less than hHSIL (\u03ba = 0.86 [95% CI, .79\u2013.93]). Current CD4 count of \u2264200 cells\/\u03bcL was the strongest predictor of consensus anal hHSIL diagnosis (adjusted odds ratio [aOR], 10.34 [95% CI, 3.47\u201330.87]). History of anoreceptive intercourse was also associated with hHSIL (aOR, 2.44 [95% CI, 1.22\u20134.76]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence of anal hHSIL in WLHIV in the United States was 27% in this study where all participants received high-resolution anoscopy and biopsy.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciz408","type":"journal-article","created":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T11:08:16Z","timestamp":1559214496000},"page":"1701-1707","source":"Crossref","is-referenced-by-count":41,"title":["Prevalence of and Risk Factors for Anal High-grade Squamous Intraepithelial Lesions in Women Living with Human Immunodeficiency Virus"],"prefix":"10.1093","volume":"70","author":[{"given":"Elizabeth A","family":"Stier","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Boston University School of Medicine, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly Y","family":"Lensing","sequence":"first","affiliation":[{"name":"Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa M","family":"Darragh","sequence":"first","affiliation":[{"name":"Department of Pathology, Mount Zion Medical Center, University of California, San Francisco (UCSF)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish A","family":"Deshmukh","sequence":"first","affiliation":[{"name":"Department of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H","family":"Einstein","sequence":"first","affiliation":[{"name":"Department of Obstetrics\/Gynecology and Women\u2019s Health, Rutgers\u2013New Jersey Medical School, Newark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel M","family":"Palefsky","sequence":"first","affiliation":[{"name":"Department of Medicine, UCSF"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Jay","sequence":"first","affiliation":[{"name":"Anal Neoplasia Clinic, Research, and Education Center, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Michael","family":"Berry-Lawhorn","sequence":"first","affiliation":[{"name":"Anal Neoplasia Clinic, Research, and Education Center, San Francisco, California"},{"name":"Division of Hematology Oncology, UCSF"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Wilkin","sequence":"first","affiliation":[{"name":"Clinical Trials Unit, Department of Medicine, Cornell University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy J","family":"Wiley","sequence":"first","affiliation":[{"name":"School of Nursing, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis F","family":"Barroso","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Infectious Diseases, Wake Forest University Health Sciences, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross D","family":"Cranston","sequence":"first","affiliation":[{"name":"University of Vic, Hospital Germans Trias i Pujol, Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Levine","sequence":"first","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humberto M","family":"Guiot","sequence":"first","affiliation":[{"name":"Department of Medicine and Department of Microbiology and Medical Zoology, University of Puerto Rico School of Medicine, San Juan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey L","family":"French","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, CORE Center\/Stroger Hospital of Cook County, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Citron","sequence":"first","affiliation":[{"name":"Department of Pathology, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Katayoon","family":"Rezaei","sequence":"first","affiliation":[{"name":"Department of Pathology, George Washington University, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E","family":"Goldstone","sequence":"first","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Chiao","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine"},{"name":"Center for Innovations in Quality, Effectiveness, and Safety, Michael E. 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