{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:37:40Z","timestamp":1777927060397,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2014,6,13]],"date-time":"2014-06-13T00:00:00Z","timestamp":1402617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:p>\n                    Rates of abnormal visual inspection with acetic acid and prevalence of high-risk human papillomavirus (HPV) subtypes have not been well characterized in HIV-infected women in Malawi. We performed a prospective cohort study of visual inspection with acetic acid (N\u2009=\u2009440) in HIV-infected women aged 25--59 years, with a nested study of HPV subtypes in first 300 women enrolled. Of 440 women screened, 9.5% (N\u2009=\u200942) had abnormal visual inspection with acetic acid with 69.0% (N\u2009=\u200929) having advanced disease not amenable to cryotherapy. Of 294 women with HPV results, 39% (N\u2009=\u2009114) of women were positive for high-risk HPV infection. Only lower CD4 count (287 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    versus 339 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    , p\u2009=\u20090.03) and high-risk HPV (66.7% versus 35.6%, p\u2009&lt;\u20090.01) were associated with abnormal visual inspection with acetic acid. The most common high-risk HPV subtypes in women with abnormal visual inspection with acetic acid were 35 (33.3%), 16 (26.7%), and 58 (23.3%). Low CD4 cell count was associated with abnormal visual inspection with acetic acid and raises the importance of early antiretroviral therapy and expanded availability of visual inspection with acetic acid. HPV vaccines targeting additional non-16\/18 high-risk HPV subtypes may have greater protective advantages in countries such as Malawi.\n                  <\/jats:p>","DOI":"10.1177\/0956462414539149","type":"journal-article","created":{"date-parts":[[2014,6,16]],"date-time":"2014-06-16T10:51:03Z","timestamp":1402915863000},"page":"379-387","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["High-risk human papillomavirus in HIV-infected women undergoing cervical cancer screening in Lilongwe, Malawi: a pilot study"],"prefix":"10.1177","volume":"26","author":[{"given":"Deepa","family":"Reddy","sequence":"first","affiliation":[{"name":"David Geffen School of Medicine at the University of California, Los Angeles, Center for Clinical AIDS Research and Education and the UCLA AIDS Institute, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Njala","sequence":"additional","affiliation":[{"name":"International Training and Education Centre on Health (I-TECH), Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penny","family":"Stocker","sequence":"additional","affiliation":[{"name":"Partners in Hope, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Schooley","sequence":"additional","affiliation":[{"name":"Partners in Hope, Lilongwe, Malawi"},{"name":"David Geffen School of Medicine at the University of California, Los Angeles, Department of Medicine, Division of Infectious Diseases, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martiniano","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Hong","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Pfaff","sequence":"additional","affiliation":[{"name":"Partners in Hope, Lilongwe, Malawi"},{"name":"David Geffen School of Medicine at the University of California, Los Angeles, Department of Medicine, Division of Infectious Diseases, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perry","family":"Jansen","sequence":"additional","affiliation":[{"name":"Partners in Hope, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald T","family":"Mitsuyasu","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at the University of California, Los Angeles, Center for Clinical AIDS Research and Education and the UCLA AIDS Institute, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Risa M","family":"Hoffman","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at the University of California, Los Angeles, Center for Clinical AIDS Research and Education and the UCLA AIDS Institute, Los Angeles, CA, USA"},{"name":"David Geffen School of Medicine at the University of California, Los Angeles, Department of Medicine, Division of Infectious Diseases, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,6,13]]},"reference":[{"key":"bibr1-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-5-149"},{"key":"bibr2-0956462414539149","unstructured":"World Health Organization and Institut Catala d\u2019Oncologia. Human papillomavirus and related cancers: Malawi, summary report update. Barcelona: Institut Catalia d Oncologia (ICO) Information Centre on HPV and Cancer (HPV Information Centre), http:\/\/www.hpvcentre.net\/statistics\/reports\/MWI.pdf (2010, accessed 14 February 2014)."},{"key":"bibr3-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1086\/424466"},{"key":"bibr4-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.8.1031"},{"key":"bibr5-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji072"},{"key":"bibr6-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200203290-00014"},{"key":"bibr7-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/92.18.1500"},{"key":"bibr8-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.05.121"},{"key":"bibr9-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00713.x"},{"key":"bibr10-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.06.035"},{"key":"bibr11-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603633"},{"key":"bibr12-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.17.2173"},{"key":"bibr13-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.12.031"},{"key":"bibr14-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3182426227"},{"key":"bibr15-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32833e163e"},{"key":"bibr16-0956462414539149","unstructured":"World Health Organization International Agency for Research on Cancer. Prevention of cervical cancer through screening using visual inspection with acetic acid (VIA) and treatment with cryotherapy: A demonstration project in six African countries. Geneva: African Population and Health Research Center, 2012, http:\/\/apps.who.int\/iris\/bitstream\/10665\/75250\/1\/9789241503860_eng.pdf (accessed 14 February 2014)."},{"key":"bibr17-0956462414539149","unstructured":"World Health Organization. Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Geneva: World Health Organization, http:\/\/www.who.int\/reproductivehealth\/publications\/cancers\/screening_and_treatment_of_precancerous_lesions\/en\/index.html (2013, accessed 14 February 2014)."},{"key":"bibr18-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1086\/514194"},{"key":"bibr19-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.30.10.2539-2543.1992"},{"key":"bibr20-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0053494"},{"key":"bibr21-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e3182320f0c"},{"key":"bibr22-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1159\/000325079"},{"key":"bibr23-0956462414539149","unstructured":"Anderson J, Lu E, Harris M, et\u00a0al. Initial results from a multi-country cervical cancer screening program for HIV+ women. In:\n                      18th Conference on Retroviruses and Opportunistic Infections\n                      . Abstract 783. Boston, MA, 27 February\u20132 March 2011."},{"key":"bibr24-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181743327"},{"key":"bibr25-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603737"},{"key":"bibr26-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2006.06.015"},{"key":"bibr27-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.22178"},{"key":"bibr28-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2007.027318"},{"key":"bibr29-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1086\/526792"},{"key":"bibr30-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/173.3.714"},{"key":"bibr31-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1186\/1750-9378-5-8"},{"key":"bibr32-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1086\/650467"},{"key":"bibr33-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31819225cb"},{"key":"bibr34-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1086\/421467"},{"key":"bibr35-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1086\/323081"},{"key":"bibr36-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70210-9"},{"key":"bibr37-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.26470"},{"key":"bibr38-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70187-1"},{"key":"bibr39-0956462414539149","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djs395"},{"key":"bibr40-0956462414539149","unstructured":"GAVI Alliance. GAVI funds vaccines to protect girls against cervical cancer. http:\/\/www.gavialliance.org\/library\/news\/press-releases\/2013\/gavi-funds-vaccines-to-protect-girls-against-cervical-cancer\/ (2013, accessed 14 February 2014)."},{"key":"bibr41-0956462414539149","doi-asserted-by":"crossref","unstructured":"Financing HPV vaccination in developing countries.\n                      Lancet\n                      2011; 377: 1544.","DOI":"10.1016\/S0140-6736(11)60622-3"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462414539149","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0956462414539149","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462414539149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:34:00Z","timestamp":1777674840000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0956462414539149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,13]]},"references-count":41,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.1177\/0956462414539149"],"URL":"https:\/\/doi.org\/10.1177\/0956462414539149","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,13]]}}}