Cervical cancer is the leading cause of cancer-related deaths for women in Africa. Each year, worldwide, 270,000 women die needlessly from a disease that is 100 percent preventable. Approximately 80 percent of these deaths occur in low-resource countries, where less than 1 percent of HIV-positive women are screened for cervical cancer, which is one of the most dangerous opportunistic infections for women living with HIV/AIDS. The survival rate for cervical cancer in sub-Saharan Africa is 20 percent, compared to 80 percent in the United States—where the Pap test is widely available for screening.
Now, because of advances in treatment for HIV/AIDS, women in sub-Saharan Africa—the epicenter of the pandemic—are living with HIV, but are at risk for dying from cervical cancer because of the lack of screening. Traditionally, cervical cancer prevention efforts have targeted the general population, but Jhpiego is specifically focusing on HIV-positive women, which represents a new frontier.
Globally, an estimated 50 percent of adults infected with HIV are women, and these women have a higher incidence and greater prevalence of human papillomavirus (HPV) infection, which is responsible for nearly all cases of cervical cancer. Because HPV generally persists longer in women with HIV, this population has a higher risk of developing precancerous lesions. And these lesions may progress more rapidly to cancer in women with HIV.
Jhpiego has been a leader in establishing and scaling up innovative, low-tech cervical cancer prevention (CECAP) programs using the cost-effective, single visit approach (SVA) to screening and treatment. This approach combines visual inspection of the cervix after an application of acetic acid (VIA) to detect precancerous lesions, with an offer of immediate treatment with cryotherapy, when appropriate. Building on this experience, Jhpiego has pioneered the integration of this program with existing HIV care and treatment services. For example, with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), at 20 HIV care and treatment sites in Côte d’Ivoire, Jhpiego and partners screened more than 13,000 women, including 6,000 women living with HIV, and provided immediate cryotherapy to 76 percent of eligible women. Globally, Jhpiego has helped to screen more than 170,000 women, treat more than 10,000 women and train 700 providers to deliver CECAP services. By integrating cervical cancer screening and treatment with HIV services, Jhpiego is helping to save the lives of women in the developing world, many of whom are struggling with the added burden of HIV.