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Excisional treatment was offered as indicated. Histopathology was the reference standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Persistence, clearance and incidence of high\u2010risk HPV infection; and persistence, progression, regression, cure and incidence of cervical dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 300 women screened at baseline, 237 attended follow up (79%). High\u2010risk HPV positivity significantly decreased from 28% at baseline to 20% at 1\u00a0year (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). High\u2010risk HPV persistence was 46% and clearance was 54%; incidence was high at 9%. Prevalence of cervical intraepithelial neoplasia Grade 2 (CIN2) or higher was most common in participants with incident high\u2010risk HPV (53%). CIN2 or higher was also common in those with persistent high\u2010risk HPV (32%) and even in those who cleared high\u2010risk HPV (30%). Of the high\u2010risk HPV\u2010positive participants at baseline with &lt;CIN2, 40% progressed to CIN2 or higher at follow up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The high incidence of high\u2010risk HPV and high\u2010grade cervical dysplasia in women living with HIV after one round of high\u2010risk HPV\u2010based screening and treatment raises concern about the rate of progression of high\u2010risk HPV infection to dysplasia. Persistent disease is common. Caution in spacing cervical cancer screening intervals using high\u2010risk HPV testing in women living with HIV is warranted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>High incidence and persistence of HPV and CIN2+ in women living with HIV 1\u00a0year after screening and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16758","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T04:01:46Z","timestamp":1621396906000},"page":"1986-1996","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Persistence and clearance of high\u2010risk human papillomavirus and cervical dysplasia at 1\u00a0year in women living with human immunodeficiency virus: a prospective cohort study"],"prefix":"10.1111","volume":"128","author":[{"given":"R","family":"Luckett","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Beth Israel Deaconess Medical Center Boston MA USA"},{"name":"Botswana Harvard AIDS Institute Partnership Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Painter","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MR","family":"Hacker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Beth Israel Deaconess Medical Center Boston MA USA"},{"name":"Harvard T.H. Chan School of Public Health Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Simon","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Seiphetlheng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Princess Marina Hospital Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Erlinger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Beth Israel Deaconess Medical Center Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Eakin","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership Gaborone Botswana"},{"name":"Department of Obstetrics and Gynecology Creighton University School of Medicine\u2010Phoenix Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Moyo","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership Gaborone Botswana"},{"name":"Harvard T.H. 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