{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T02:54:50Z","timestamp":1784602490261,"version":"3.55.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Department of Family Medicine"},{"DOI":"10.13039\/501100001336","name":"University of the Witwatersrand, Johannesburg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["93093"],"award-info":[{"award-number":["93093"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Cervical cancer is the second most common malignancy among South African women and the load of abnormal cervical smears has clinical, programmatic and policy implications. This cross-sectional study of women who presented for cervical cancer screening aimed to determine the prevalence of abnormal cervical smears and associated factors in primary health care (PHC) facilities in Gauteng\u2014the most densely populated province in South Africa. A questionnaire collected data on socio-demography, tobacco use, sexual behaviours, HIV status, past treatment for sexually transmitted infections (STI) and cervical cancer screening in the past 10 years. Cytology reports were extracted from the laboratory reports. Of 749 participants, most were black (89.7%), aged 30\u201349 years (62.2%), single (57.5%) and attained high school education (76.8%). About 43.9% were HIV positive with almost all (97.2%) on antiretroviral therapy. Cytology results were available for 612 (81.9%) participants. Of these, 25.8% (159) were abnormal: 13.2% low-grade squamous intraepithelial lesion; 5.7% atypical squamous cells of undetermined significance and 4.9% high-grade squamous intraepithelial lesion. In bivariate and multivariable analysis, abnormal cervical cytology was not associated with any sociodemographic characteristics, HIV status, tobacco use status, sexual behaviours or past treatment for STI. In conclusion, the prevalence of abnormal cervical smears is high across all demographic groups and irrespective of HIV status and highlights the need to increase screening uptake, including advocacy for self-sampling. It also calls for capacity building to allow for the devolution of some downstream clinical care from specialist to district hospitals and large PHC facilities.<\/jats:p>","DOI":"10.1093\/heapro\/daae162","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T15:10:16Z","timestamp":1738249816000},"source":"Crossref","is-referenced-by-count":3,"title":["High burden of abnormal cervical smears in South African primary health care: health programmes implications"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4621-1378","authenticated-orcid":false,"given":"Olufemi B","family":"Omole","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Primary Care, University of the Witwatersrand , 4th Floor, Phillip Tobias Building, 29 Princess of Wales Street, Parktown, Johannesburg 2193 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1902-2683","authenticated-orcid":false,"given":"Joel M","family":"Francis","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, University of the Witwatersrand , 4th Floor, Phillip Tobias Building, 29 Princess of Wales Street, Parktown, Johannesburg 2193 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Musonda","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, University of the Witwatersrand , 4th Floor, Phillip Tobias Building, 29 Princess of Wales Street, Parktown, Johannesburg 2193 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2542-6038","authenticated-orcid":false,"given":"Pumla P","family":"Sodo","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, University of the Witwatersrand , 4th Floor, Phillip Tobias Building, 29 Princess of Wales Street, Parktown, Johannesburg 2193 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Reji","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Free State , Universitas Academic Hospital,1 Logeman Street, Bloemfontein 9301 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyundu S J","family":"Phukuta","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Sefako Makgatho Health Sciences University , Molotlegi Street, Ga-Rankuwa, Pretoria, Medunsa 0204 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honey L M","family":"Mabuza","sequence":"additional","affiliation":[{"name":"Deans Office, Faculty of Health Sciences, Sefako Makgatho Health Sciences University , Molotlegi Street, Ga-Rankuwa, Pretoria 0204 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce S","family":"Musonda","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Pretoria , Bophelo Road, Prinshof 349-Jr, Pretoria 0084 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Akii","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, University of the Witwatersrand , 4th Floor, Phillip Tobias Building, 29 Princess of Wales Street, Parktown, Johannesburg 2193 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John V","family":"Ndimande","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Sefako Makgatho Health Sciences University , Molotlegi Street, Ga-Rankuwa, Pretoria, Medunsa 0204 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olalekan A","family":"Ayo-Yusuf","sequence":"additional","affiliation":[{"name":"School of Health Systems and Public Health, University of Pretoria , HW Snyman Building, Bophelo Road, Pretoria 0084 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"2025013015100496500_CIT0001","doi-asserted-by":"crossref","first-page":"34","DOI":"10.7196\/SAMJ.6124","article-title":"Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa","volume":"103","author":"Adam","year":"2012","journal-title":"South African Medical Journal"},{"key":"2025013015100496500_CIT0002","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s12905-019-0804-4","article-title":"Female perspectives on male involvement in a human-papillomavirus-based cervical 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