Sensitivity of the Papanicolaou smear in human immunodeficiency virus-infected women.

OBJECTIVE: To determine the sensitivity of the Papanicolaou smear in human immunodeficiency virus (HIV)-infected women. METHODS: Fifty-two HIV-seropositive women underwent colposcopy and had cytologic and histologic specimens obtained. Eighty-five consecutive women seen in our colposcopy clinic who stated that they were HIV-seronegative formed the comparison group. Demographic features of the groups and cytology and histology findings were compared. RESULTS: In HIV-infected patients, the prevalence of cervical dysplasia was 50%. An additional 15% had vulvar lesions alone. The sensitivity of cytologic smears for cervical dysplasia was 63% and specificity was 84%. These findings were not significantly different from those of a control group of women undergoing colposcopy for standard indications (P > .05). Twelve of 38 seropositive women for whom future appointments were scheduled were lost to follow-up. CONCLUSIONS: The sensitivity of the Papanicolaou test does not appear to be diminished in HIV-seropositive women. Screening colposcopy may be justified in view of the high prevalence of cervical and vulvar dysplasia, as well as the high noncompliance rate observed in this patient population.

Current report--HIV. AIDS at the crossroads: a report from the 1990 International Conference on AIDS--San Francisco.

Major scientific and clinical breakthroughs in HIV disease are rarely saved for the International Conference on AIDS. Nevertheless, this conference provides an opportunity for experts, providers, and patients to gain new information, exchange ideas, and assess progress. The Conference is also a public forum for political and social discussion and serves as a barometer of scientific and social trends as well. This year's conference featured refinements in clinical care, a deeper understanding of the epidemiologic trends, and a public awareness of the many political aspects of the AIDS epidemic. Contributions from family physicians and other primary care providers about problems they face and the family aspects of HIV need still greater prominence and exposure. Hopefully family physicians will use their expertise and report at future international conferences.