Non-clearance of cervical precancerous lesions and associated factors among women living with HIV in Uganda, 2020-2023.

Authors

Bridget Ainembabazi, Kevin Ouma Ojiambo, Richard Migisha, Julius Ssempiira, Fatumah Nalubega, Daniel Kadobera, Joseph Kabanda, Estella Birabwa, Tamara Nsubuga-Nyombi, Mina Nakawuka, Alex Riolexus Ario, Julius N Kalamya

Published in

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. Pages 109184. Oct 14, 2026. Epub Oct 14, 2026.

Abstract

We assessed the proportion of women living with HIV (WLHIV) with non-clearance of cervical precancerous lesions following a positive visual inspection with acetic acid (VIA) test, and treatment in Uganda from October 2020 to September 2023, and examined associated factors.
Cervical precancerous lesions were defined by a positive VIA result. Non-clearance was defined as a positive VIA result one year after screening and treatment. Treatment modalities included thermocoagulation, loop electrosurgical excision procedure (LEEP), and cryotherapy. We used a two-stage stratified cluster sample design and applied sampling weights to account for differential selection probabilities. All reported percentages and statistical estimates are weighted unless otherwise specified. Factors associated with non-clearance were assessed using modified Poisson regression, with adjusted risk ratios (aRRs) and 95% confidence intervals (CIs). Treatment type was analyzed descriptively due to small numbers of women receiving cryotherapy and LEEP.
Mean age was 36.3 years (standard deviation [SD]=7.6), and mean duration on antiretroviral therapy (ART) was 7.5 (SD=4.9) years. Most participants 807 (95.5%) were on first-line ART, and 770 (91.1%) were virally suppressed. Non-clearance was 17.1% (95% CI:10.3%-27.01%). Non-clearance was associated with second line ART (aRR=3.54, 95% CI: 2.40-5.23), p<0.01) and urban residence (aRR=1.68, 95% CI:1.00-2.83, p=0.049).
Non-clearance occurred in 17.1% of WLHIV, a proportion consistent with rates reported in comparable studies among women living with HIV. Second-line ART was significantly associated with non-clearance, and urban residence showed a borderline association. These findings highlight the need to further explore these factors in order to optimize treatment outcomes in this population.

PMID:
42874850
Bibliographic data and abstract were imported from PubMed on 15 Oct 2026.

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