{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:57:40Z","timestamp":1789001860488,"version":"build-2803163510"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011541","name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute","doi-asserted-by":"publisher","award":["U01 CA199334; U01 CA253912"],"award-info":[{"award-number":["U01 CA199334; U01 CA253912"]}],"id":[{"id":"10.13039\/100011541","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR002317"],"award-info":[{"award-number":["KL2 TR002317"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["P2C HD042828"],"award-info":[{"award-number":["P2C HD042828"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Women living with HIV experience heightened risk of cervical cancer, and over 50% of cases in Southern Africa are attributed to HIV co-infection. Cervical cancer interventions tailored by HIV status delivered with HIV antiretroviral therapy (ART) for treatment can decrease cancer incidence, but impact on HIV-related disparities remains understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a dynamic model calibrated to KwaZulu-Natal, South Africa, we projected HIV prevalence, cervical cancer incidence, and proportion of cancer cases among women living with HIV between 2021\u20132071. Relative to the status quo of moderate intervention coverage, we modeled three additive scenarios: 1) ART scale-up only; 2) expanded human papillomavirus (HPV) vaccination, screening, and treatment; and 3) catch-up HPV vaccination and enhanced screening for women living with HIV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Under the status quo, HIV prevalence among women aged 15+ decreased from a median of 35% [Uncertainty Range (UR): 26\u201342%] in 2021 to 25% [19\u201334%] in 2071. The proportion of cervical cancer cases that were women living with HIV declined from 73% [63\u201386%] to 58% [47\u201374%], but incidence remained 4.3-fold [3.3\u20135.7] that of women without HIV. ART scale-up reduced HIV prevalence in 2071, but increased the incidence rate ratio to 5.2 [3.7\u20137.3]. Disparities remained after expanding cancer interventions for all women (incidence rate ratio: 4.8 [3.6\u20137.6]), while additional catch-up HPV vaccination and screening for women living with HIV decreased the incidence rate ratio to 2.7 [1.9\u20133.4] in 2071.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tailored cervical cancer interventions for women living with HIV can counteract rising cancer incidence incurred by extended life expectancy on ART and reduce disparate cancer burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0301997","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T13:47:17Z","timestamp":1716472037000},"page":"e0301997","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Enhanced cervical cancer and HIV interventions reduce the disproportionate burden of cervical cancer cases among women living with HIV: A modeling analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5627-8250","authenticated-orcid":true,"given":"Cara J.","family":"Broshkevitch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1793-6003","authenticated-orcid":true,"given":"Ruanne V.","family":"Barnabas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thesla","family":"Palanee-Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darcy White","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"issue":"6","key":"pone.0301997.ref001","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"F Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"issue":"2","key":"pone.0301997.ref002","doi-asserted-by":"crossref","first-page":"e161","DOI":"10.1016\/S2214-109X(20)30459-9","article-title":"Estimates of the global burden of cervical cancer associated with HIV","volume":"9","author":"D Stelzle","year":"2021","journal-title":"Lancet Glob Health"},{"key":"pone.0301997.ref003","article-title":"The Fifth South African National HIV Prevalence, Incidence, Behaviour and Communications Survey, 2017","author":"LC Simbayi","year":"2019","journal-title":"Cape Town"},{"issue":"2","key":"pone.0301997.ref004","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1016\/S2214-109X(19)30482-6","article-title":"Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis","volume":"8","author":"M Arbyn","year":"2020","journal-title":"Lancet Glob Health"},{"issue":"1","key":"pone.0301997.ref005","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/S2352-3018(17)30149-2","article-title":"Association of antiretroviral therapy with high-risk human papillomavirus, cervical intraepithelial neoplasia, and invasive cervical cancer in women living with HIV: a systematic review and meta-analysis","volume":"5","author":"H Kelly","year":"2018","journal-title":"Lancet HIV"},{"issue":"8","key":"pone.0301997.ref006","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1002\/ijc.33716","article-title":"Modelling the impact of prevention strategies on cervical cancer incidence in South Africa","volume":"149","author":"C van Schalkwyk","year":"2021","journal-title":"Int J Cancer"},{"issue":"5","key":"pone.0301997.ref007","doi-asserted-by":"crossref","first-page":"e0231388","DOI":"10.1371\/journal.pone.0231388","article-title":"The past, present and future impact of HIV prevention and control on HPV and cervical disease in Tanzania: A modelling study","volume":"15","author":"MT Hall","year":"2020","journal-title":"PLoS One"},{"key":"pone.0301997.ref008","unstructured":"Rohner E, B\u00fctikofer L, Maskew M, Chen YMA, Friedman R, D\u2019Souza G, et al. 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