Susan Donlon
Education Co-ordinator, HIV Ireland
In Ireland, women account for around a quarter of all new HIV diagnoses notified annually.
An HIV diagnosis is a life-changing event, but thanks to treatment advances, HIV is now a manageable chronic illness. Women with HIV can live healthy lives, have babies without passing on HIV, work, study, and have fulfilling emotional and sexual relationships.
Once diagnosed with HIV, the health of a person’s immune system will be regularly monitored at a HIV clinic. By strengthening the immune system, HIV treatment helps prevent certain illnesses developing, such as some serious infections and types of cancer.
Cervical Cancer is the second most common type of cancer in women worldwide, and the most common cause of cancer-related deaths in the developing world.
Women living with HIV are more at risk of cervical cancer and are up to five times more likely to develop cervical cancer than women who do not have the virus. Cervical cancer is considered to be an AIDS-defining illness.
While HPV infections are very common in the general population and most women with healthy immune systems will clear these infections over time, women with compromised immune systems (such as women with HIV) are far less likely to clear an HPV infection. This means that once they have been infected with HPV, women living with HIV are more likely to develop pre-invasive lesions that can, if left untreated, quickly progress to invasive life-threatening cervical cancer.
The World Health Organisation (WHO) recommends screening and providing adequate treatment to all women living with HIV as soon as they know their status.
Cervical Screening for Women living with HIV
It is recommended that women living with HIV have a smear test every year.
This can be provided at your HIV clinic, or you can have the test at your GP practice. Some GPs may not be aware that annual screening is required for women living with HIV, so it is important to be pro-active about this. Don’t wait for a reminder. Cervical cancer is curable if detected and treated early.
Talk to someone at your HIV clinic about annual screening if you are concerned that your GP doesn’t know about your HIV status.
As people with HIV are now living longer, there is an increased chance of developing cancers generally associated with older age which are not linked to having HIV.
If you are a woman living with HIV, you can make small changes to your lifestyle to help reduce your risk of developing cancer such as improving your diet, getting enough exercise, stopping smoking, cutting down on alcohol, staying at a healthy weight, and avoiding sun damage to your skin.
Make sure to take up routine testing such as screening for cervical or breast cancer. Starting antiretroviral treatment as soon as you are diagnosed can also be preventative. Taking effective HIV treatment will help strengthen your immune system and lower your risk of developing cancer.
The HPV Vaccine
Cervical cancer is preventable with the HPV vaccine. In July 2018, the National Immunisation Committee (NIAC) recommended the HPV vaccine for men and women living with HIV up to and including 26 years of age and for all men who have sex with men (MSM), including MSM living with HIV, up to and including 45 years of age. The vaccine is available through many STI and HIV clinics. Ask a nurse or doctor at your clinic for more information.