DETERMINANT FACTORS OF VISUAL INSPECTION WITH ACETIC ACID (VIA) POSITIVE LESIONS AMONG HIV POSITIVE WOMEN IN MEKELLE HOSPITAL, NORTHERN ETHIOPIA: A CASE CONTROL STUDY.

Background: Cervical cancer is the second commonest type and third cause of cancer death among women in low-income countries. Women living with HIV/AIDS are at greater risk of developing cervical cancer. The study aimed to identify the determinant factors forsuspected precancerous cervical lesions among HIV- positive women in Mekelle hospital, Ethiopia.

Methods: Anunmatched case-control study was conducted among randomly selected HIV positive women in Mekelle hospital in 2014. In Mekelle Hospital, routine screening for lesions of the cervix uteri by visual inspection with acetic acid (VIA) is done in HIV positive women by trained nurses. Suspicious findings are treated by cryotherapy or referred to the Gynaecologist. A number of 116 cases, who had suspicious findings on VIA, and 232 HIV-positive controls without suspicious findings on VIA were randomly selected and enrolled into the study The determinant factors for precancerous cervical lesion were analyzed using multiple logistic regression and described as adjusted odds ratio (AOR).

Results: HIV positive women who had CD4 cells less than 350/mm3 were two times more likely to have precancerous cervical lesion compared to those with CD4 cells above 350/mm3. Women with two (AOR = 3.6; 95% CI: 1.7, 7.7) and three (AOR = 2.5; 95% CI: 1.2, 5.4) sexual partners were four and three times more likely to have precancerous cervical lesion, respectively, as compared to those who had one sexual partner. Age, History of STI and duration of ART had no influence on presence of VIA positive lesions in HIV positive women.

Conclusion: CD4 count cells and number of sexual partners were predictors of VIA positive cervical lesion among HIV positive women.