Abstract
INTRODUCTION:Human papillomavirus (HPV) 16 and 18 cause approximately 70% of invasive and preinvasive lesions of the cervix and vagina. As detection of HPV-related disease advances, many of these patients will access the health care system for treatment. Both HPV and human immunodeficiency virus (HIV) are transmitted through sexual exposure; thus, screening for other sexually transmitted infections (STIs) including HIV is warranted in women undergoing treatment for cervical dysplasia. Human immunodeficiency virus infection is undiagnosed in an estimated one in five individuals with HIV infection in the United States; other STIs increase the risk of HIV transmission.
METHODS:A retrospective chart review of women who underwent loop electrosurgical excision procedure (LEEP) in a large urban university clinic between January 1, 2010, and December 31, 2012. The review was conducted to determine if HIV and STI (syphilis, chlamydia, and gonorrhea) screening was performed within 12 months of their LEEP or between their LEEP date and the date of their most recent Pap test before performed LEEP. All LEEPs were performed by an obstetrics and gynecology provider.
RESULTS:Sixty-three percent (n=66) of the 105 who had a LEEP procedure were not tested for STIs or HIV.
CONCLUSIONS:Appropriate screening is critical for sexually active women who are at risk for HIV and other STIs. Obstetrician–gynecologists have a unique opportunity to recommend STI screening to women with HPV and cervical dysplasia at the time of a LEEP procedure.
