{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:48:22Z","timestamp":1791499702649,"version":"4.3.4"},"reference-count":21,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Global Oncology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> The WHO now recommends thermal ablation as an alternative to cryotherapy within \u201cscreen-and-treat\u201d cervical cancer programs in low- and middle-income countries (LMICs). We conducted a safety and acceptability clinical trial of thermal ablation in a Kenyan Ministry of Health hospital among women living with HIV (WLWH; ClinicalTrials.gov identifier: NCT04191967 ). <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> Between August 2019 and February 2020, WLWH age 25-65 years underwent human papillomavirus (HPV) self-collection in western Kenya. HPV-positive women underwent visual inspection with acetic acid, biopsy, and treatment with thermal ablation performed by a nonphysician clinician, if eligible by standard guidelines. A questionnaire was administered after treatment to assess for pain and treatment acceptability. Adverse events (AEs) were evaluated 4-6 weeks after treatment with a standardized grading tool. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> A total of 293 HPV-positive WLWH underwent thermal ablation in the study period. The mean age was 40.4 years (standard deviation, 8.7 years). After treatment, 15 (5.1%), 231 (78.8%), 42 (14.3%), and 5 (1.8%) reported none, mild, moderate, and severe pain with treatment, respectively. At follow-up, spotting, vaginal discharge, and pelvic pain were reported by 99 (37.8%), 258 (98.5%), and 46 (17.6%), respectively, for a median of 3.3 (interquartile range [IQR], 2-3), 14 (IQR, 7-21), and 7 (IQR, 3-7) days, respectively. Most participants graded their AEs as mild (grade 1): 94 (95.0%) for bleeding, 125 (48.5%) for vaginal discharge, and 37 (80.4%) for pelvic pain. No grade 3 or 4 AEs were reported. The vast majority (99.2%) were satisfied with the treatment and would recommend it to a friend. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Thermal ablation performed by nonphysicians in the public health sector in Kenya proved safe and highly acceptable in treating HPV-positive WLWH. <\/jats:p><\/jats:sec>","DOI":"10.1200\/go.20.00035","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T19:55:17Z","timestamp":1594151717000},"page":"1024-1033","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":18,"title":["Safety and Acceptability of Thermal Ablation for Treatment of Human Papillomavirus Among Women Living With HIV in Western Kenya"],"prefix":"10.1200","author":[{"given":"Chemtai","family":"Mungo","sequence":"first","affiliation":[{"name":"Division of Prevention Science, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cirilus Ogollah","family":"Osongo","sequence":"additional","affiliation":[{"name":"FACES Lumumba Clinic, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeniffer","family":"Ambaka","sequence":"additional","affiliation":[{"name":"FACES Lumumba Clinic, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalene A.","family":"Randa","sequence":"additional","affiliation":[{"name":"FACES Lumumba Clinic, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackton","family":"Omoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maseno University School of Medicine, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig R.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Huchko","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835b1041"},{"key":"B3","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1097\/00002030-200309050-00015","volume":"17","author":"Gichangi PB","year":"2003","journal-title":"AIDS"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603633"},{"key":"B7","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.ijgo.2008.07.016","volume":"103","author":"Nene BM","year":"2008","journal-title":"Int J Gynaecol Obstet"},{"key":"B8","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ijgo.2012.01.029","volume":"118","author":"Santesso N","year":"2012","journal-title":"Int J Gynaecol Obstet"},{"key":"B9","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/ijgo.12191","volume":"138","author":"Castle PE","year":"2017","journal-title":"Int J Gynaecol Obstet"},{"key":"B10","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1186\/s12889-016-3530-y","volume":"16","author":"Msyamboza KP","year":"2016","journal-title":"BMC Public Health"},{"key":"B11","author":"Binagwaho A","journal-title":"J Glob Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12655"},{"key":"B15","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ypmed.2018.10.006","volume":"118","author":"Randall TC","year":"2019","journal-title":"Prev Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1993.tb15273.x"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1089\/gyn.1988.4.211"},{"key":"B18","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1111\/j.1471-0528.1991.tb15372.x","volume":"98","author":"Goodman JD","year":"1991","journal-title":"Br J Obstet Gynaecol"},{"key":"B19","doi-asserted-by":"crossref","first-page":"62","DOI":"10.3109\/01443618509079143","volume":"6","author":"Hussein IY","year":"1985","journal-title":"J Obstet Gynaecol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-016-0355-x"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.09.035"},{"key":"B23","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S1470-2045(19)30635-7","volume":"21","author":"Pinder LF","year":"2020","journal-title":"Lancet Oncol"},{"key":"B24","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s12905-017-0469-9","volume":"17","author":"Tiruneh FN","year":"2017","journal-title":"BMC Womens Health"},{"key":"B26","unstructured":"Sellors JW, Sankaranarayanan R (eds): Colposcopy and Treatment of Cervical Intraepithelial Neoplasia: A Beginner\u2019s Manual. 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