{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T06:41:35Z","timestamp":1740120095777,"version":"3.37.3"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T00:00:00Z","timestamp":1491350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Swedish Physicians Against AIDS Research Foundation"},{"name":"Centre for Clinical Research"},{"DOI":"10.13039\/501100009612","name":"V\u00e4stmanland County Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009612","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,10]]},"abstract":"Objectives<\/jats:title>To analyse whether the prevalence of undiagnosed HIV<\/jats:styled-content> among (1) all women in Sweden and (2) migrant women, diagnosed with cervical intraepithelial neoplasia grade 2 or worse CIN<\/jats:styled-content>2+<\/jats:sup> reaches the threshold of 0.1%, which has been suggested to be cost\u2010effective for HIV<\/jats:styled-content> testing.<\/jats:p><\/jats:sec>Design<\/jats:title>Population\u2010based register study.<\/jats:p><\/jats:sec>Setting<\/jats:title>Counties of Stockholm and Gothenburg, Sweden, 1990\u20132014.<\/jats:p><\/jats:sec>Population<\/jats:title>All women, born between 1940 and 1990, with at least one cervical cytology or histology registered in the Swedish National Cervical Screening Register (NKC<\/jats:styled-content>x).<\/jats:p><\/jats:sec>Methods<\/jats:title>Data were collected from the NKC<\/jats:styled-content>x and the Swedish National HIV<\/jats:styled-content> register. The proportion of women with undiagnosed HIV<\/jats:styled-content> among women with CIN<\/jats:styled-content>2+<\/jats:sup> compared with women with a normal\/mildly abnormal cytology\/histology was assessed.<\/jats:p><\/jats:sec>Main outcome measures<\/jats:title>Proportion of women with undiagnosed HIV<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>The proportion of undiagnosed HIV<\/jats:styled-content> was higher among all women with CIN<\/jats:styled-content>2+<\/jats:sup> than among those without CIN<\/jats:styled-content>2+<\/jats:sup>: 0.06% (95% CI<\/jats:styled-content> 0.04\u20130.08) versus 0.04% (95% CI<\/jats:styled-content> 0.04\u20130.04); P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.017). Among migrant women, the proportion of undiagnosed HIV<\/jats:styled-content> was higher among those with CIN<\/jats:styled-content>2+<\/jats:sup> than among those without [0.30% (95% CI<\/jats:styled-content> 0.20\u20130.43) versus 0.08% (95% CI<\/jats:styled-content> 0.07\u20130.10); P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001] and exceeded 0.1%, suggesting the cost\u2010effectiveness of HIV<\/jats:styled-content> testing. Women with undiagnosed HIV<\/jats:styled-content> at the time of CIN<\/jats:styled-content>2+<\/jats:sup> had a significantly lower nadir CD<\/jats:styled-content>4+<\/jats:sup> T\u2010cell count, as a measure of immunosuppression, compared with women without CIN<\/jats:styled-content>2+<\/jats:sup> before HIV<\/jats:styled-content> diagnosis (median nadir CD<\/jats:styled-content>4, 95\u00a0cells\/mm3<\/jats:sup> versus 210 cells\/mm3<\/jats:sup>; P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.01).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>HIV<\/jats:styled-content> testing should be performed in migrant women with unknown HIV<\/jats:styled-content> status diagnosed with CIN<\/jats:styled-content>2+<\/jats:sup>.<\/jats:p><\/jats:sec>Tweetable abstract<\/jats:title>HIV<\/jats:styled-content> testing should be performed in migrant women with unknown HIV<\/jats:styled-content> status diagnosed with CIN<\/jats:styled-content>2+<\/jats:sup>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14614","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T23:36:54Z","timestamp":1487979414000},"page":"1680-1687","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessing cervical intraepithelial neoplasia as an indicator disease for HIV<\/scp> in a low endemic setting: a population\u2010based register study"],"prefix":"10.1111","volume":"124","author":[{"given":"C","family":"Carlander","sequence":"first","affiliation":[{"name":"Unit of Infectious Diseases Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden"},{"name":"Centre for Clinical Research V\u00e4stmanland County Hospital V\u00e4ster\u00e5s Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Marrone","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Br\u00e4nnstr\u00f6m","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden"},{"name":"Department of Infectious Diseases Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Institute of Biomedicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Elfgren","sequence":"additional","affiliation":[{"name":"CLINTEC Department of Obstetrics and Gynaecology Karolinska University Hospital Huddinge Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Spar\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"S\u00f6nnerborg","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden"},{"name":"Division of Clinical Microbiology Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP1523"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000233579.79714.8d"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001510"},{"key":"e_1_2_6_5_1","first-page":"1","article-title":"Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013","volume":"20","author":"Mocroft A","year":"2015","journal-title":"Euro Surveillance: Bull Eur Maladies Transmiss\/Eur Communicable Dis Bull"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12321"},{"key":"e_1_2_6_7_1","unstructured":"ECDC press releases. 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