Do HIV-Positive Women Need Routine Pap Tests After Hysterectomy?

Routine Pap testing is not recommended in women without histories of cervical dysplasia who undergo hysterectomy for benign indications. Does this guidance also apply to HIV-positive women? Investigators in Texas reviewed post-hysterectomy Pap test records of 238 HIV-positive women with no prior histories of abnormal cervical cytology.

At a median follow-up of 16 years, 31% of the women had abnormal Pap tests (5% atypical cells of undetermined significance and human papillomavirus [HPV] positive, 23% low-grade squamous intraepithelial lesions, and 3% high-grade squamous intraepithelial lesions). Among women with abnormal Pap tests who underwent vaginal biopsies, 23 had vaginal intraepithelial neoplasia (VAIN) 1, 9 had VAIN 2, 7 had VAIN 3, a…