Integrating Cervical Cancer Screening with HIV Care in a District Hospital in Abuja; Nigeria

Human immunodeficiency virus positive (HIV+) women have a higher risk of developing invasive cervical cancer compared with uninfected women. This study aims to document programmatic experience of integrating cervical cancer screening using Visual Inspection and Acetic Acid (VIA) into HIV care as well as to describe patients' characteristics associated with positive VIA findings amongst HIV+ women. Materials and Methods: A cross-sectional study analysed routine service data collected at the antiretroviral therapy (ART) and cervical cancer screening services. Our program integrated screening for cervical cancer using VIA technique to HIV care and treatment services through a combination of stakeholder engagement; capacity building for health workers; creating a bi-directional referral between HIV and reproductive health (RH) services and provider initiated counselling and screening for cervical cancer. Information on patients' baseline and clinical characteristics were captured using an electronic medical records system and then exported to Statistical Package for the Social Sciences (SPSS). Logistic regression model was used to estimate factors that influence VIA results. Results: A total of 834 HIV+ women were offered VIA screening between April 2010 and April 2011; and 805 (96.5) accepted it. Complete data was available for 802 (96.2) women. The mean age at screening and first sexual contact were 32.0 (SD 6.6) and 18.8 (SD 3.5) years; respectively. VIA was positive in 52 (6.5) women while 199 (24.8) women while 199 (24.8) had a sexually transmitted infection (STI). Of the 199 who had a STI; eight (4.0) had genital ulcer syndrome; 30 (15.1) had lower abdominal pain syndrome and 161 (80.9) had vaginal discharge syndrome. Presence of lower abdominal pain syndrome was found to be a significant predictor of a positive VIA result ( P = 0.001). Women with lower abdominal pain syndrome appeared to be more likely (OR 47.9; 95 CI: 4.8-480.4; P = 0.001) to have a positive VIA result. Conclusion: The high burden of both HIV and cervical cancer in developing countries makes it a necessity for integrating services that offer early detection and treatment for both diseases. The findings from our study suggest that integrating VIA screening into the package of care offered to HIV+ women is feasible and acceptable

Using HIVetAIDS Statistics in Pre-service Mathematics Education to Integrate HIVetAIDS Education

In South Africa; the HIVetAIDS education policy documents indicate opportunities for integration across disciplines/subjects. There are different interpretations of integration/inclusion and mainstreaming HIVetAIDS education; and numerous levels of integration. Integration ensures that learners experience the disciplines/subjects as being linked and related; and integration is required to support and expand the learners' opportunities to attain skills; acquire knowledge and develop attitudes and values across the curriculum. This study makes use of self-study methodology where I; a teacher educator; aim to improve my practice through including HIVetAIDS statistics in Mathematics Education. This article focuses on how I used HIVetAIDS statistics to facilitate pre-service teacher reflection and introduce them to integration of HIVetAIDS education across the curriculum. After pre-service teachers were provided with HIV statistics; they drew a pie chart which graphically illustrated the situation and reflected on issues relating to HIVetAIDS. Three themes emerged from the analysis of their reflections. The themes relate to the need for further HIVetAIDS education; the changing pastoral role of teachers and the changing context of teaching. This information indicates that the use of statistics is an appropriate means of initiating the integration of HIVetAIDS education into the academic curriculum