{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:03:37Z","timestamp":1784300617345,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Adherence to cervical cancer screening reduces cervical cancer mortality, particularly in settings with high HIV prevalence. We conducted the first nationwide study examining adherence to cervical cancer screening following first HIV testing in Eswatini, a country with the highest HIV prevalence globally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed data of 18\u2009989 women between 2019 and 2023 who underwent first\u2010time HIV testing, with follow\u2010up for cervical cancer screening until 2024 using Eswatini Client Management Information System. Cervical cancer screening adherence was defined per national guidelines: undergoing screening within one year for HIV\u2010positive testers and within two years for HIV\u2010negative testers. Poisson regression with robust variance assessed crude and adjusted associations between HIV test status and screening adherence and evaluated predictors of screening adherence by HIV test status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HIV\u2010positive test status was associated with significantly lower screening adherence (adjusted risk ratio\u2009=\u20090.67, 95% CI: 0.65\u20130.70). When applying the screening guideline for HIV\u2010negative testers to HIV\u2010positive testers, the association was not significant (adjusted risk ratio\u2009=\u20090.98, 95% CI: 0.96\u20131.01). For women with either HIV test result, older age (\u226550\u2009years) and care at mission hospitals or private clinics were linked to lower adherence, whereas urban residence increased adherence. Marriage was associated with higher adherence only among HIV\u2010negative women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cervical cancer screening adherence remains suboptimal in Eswatini, particularly among HIV\u2010positive women. Strengthening integration of HIV testing and cervical cancer screening, alongside targeted interventions for low\u2010adherence subgroups, is needed to reduce screening disparities and improve cervical cancer prevention and prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70227","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:56:17Z","timestamp":1773924977000},"page":"1008-1017","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervical cancer screening adherence following initial\n                    <scp>HIV<\/scp>\n                    testing in\n                    <scp>Eswatini<\/scp>"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4329-8620","authenticated-orcid":false,"given":"Mpumelelo G.","family":"Ndlela","sequence":"first","affiliation":[{"name":"International Health Program National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8808-0999","authenticated-orcid":false,"given":"Lerato N.","family":"Vilakati","sequence":"additional","affiliation":[{"name":"School of Public Health Taipei Medical University  Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ntombifuthi M.","family":"Ginindza","sequence":"additional","affiliation":[{"name":"Non\u2010Communicable Disease Unit, Ministry of Health, Copper Centre SNAP  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nomalanga P.","family":"Hlophe","sequence":"additional","affiliation":[{"name":"Eswatini National Cancer Registry, Ministry of Health  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7379-5022","authenticated-orcid":false,"given":"Jason J.","family":"Liu","sequence":"additional","affiliation":[{"name":"International Health Program National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Institute of Public Health, National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jncc.2024.11.006"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4120-3"},{"key":"e_1_2_11_4_1","first-page":"1453","article-title":"The World Health Organization targets for cervical cancer control by 2030: a baseline assessment in six African countries\u2014part I","volume":"16","author":"Stefan DC","year":"2022","journal-title":"Ecancermedicalscience"},{"key":"e_1_2_11_5_1","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","author":"World Health Organization","year":"2020"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2016.03.011"},{"issue":"1","key":"e_1_2_11_7_1","article-title":"CDC activities for improving implementation of human papillomavirus vaccination, cervical cancer screening, and surveillance worldwide","volume":"23","author":"Senkomago V","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"e_1_2_11_8_1","volume-title":"Global HIV & AIDS Statistics\u20142020 Fact Sheet","author":"UNAIDS","year":"2025"},{"key":"e_1_2_11_9_1","volume-title":"GLOBOCAN 2020. 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