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首页> 外文期刊>The journal of family planning and reproductive health care >HIV testing in colposcopy and termination of pregnancy services: a missed opportunity?
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HIV testing in colposcopy and termination of pregnancy services: a missed opportunity?

机译：阴道镜检查中的艾滋病毒检测和终止妊娠服务：错失良机吗？

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INTRODUCTION: The 2008 National HIV testing guidelines produced jointly by the British Association of Sexual Health and HIV, British HIV Association and British Infection Society recommend HIV testing for patients attending termination of pregnancy (TOP) services and patients diagnosed with cervical intraepithelial neoplasia (CIN) Grade 2 or above. The aim is to reduce the time between acquisition and diagnosis of HIV by encouraging testing in settings where patients present with indicator diseases. Benefits of earlier HIV diagnosis include improved survival, prevention of onward transmission, and optimisation of maternal health when planning pregnancy. There is evidence that HIV reduces the effectiveness of standard treatment for CIN 2/3 and cervical cancer. The experience of antenatal screening indicates that the majority of women accept HIV screening if it is offered as part of a package of care. METHODS: This retrospective case notes review of 60 HIV-positive women, diagnosed between 1 January 2006 and 31 July 2009, collected data on age, ethnicity, length of time in the UK, timing of HIV diagnosis and possible timing of acquisition relative to attendance at colposcopy or TOP services, CD4 count and symptoms at diagnosis and cervical cytology history. RESULTS: The authors found that three (5%) women were diagnosed with CIN Grade 2 or above prior to HIV diagnosis; HIV testing at the time of TOP may have resulted in earlier diagnosis for three (5%) women. There was at least one missed opportunity for earlier diagnosis in five (8%) cases. CONCLUSIONS: The authors suggest further work should be undertaken to establish HIV prevalence in TOP and colposcopy services and that HIV testing should become standard practice in the management of CIN 2/3 and cervical cancer.
机译：简介：由英国性健康协会和HIV，英国HIV协会和英国感染协会联合制定的2008年国家HIV检测指南建议对参加终止妊娠（TOP）服务的患者和被诊断患有宫颈上皮内瘤变（CIN）的患者进行HIV检测2年级或以上。目的是通过鼓励在存在指示性疾病的患者中进行检测来减少从HIV感染到诊断的时间。早期诊断HIV的好处包括提高生存率，防止继续传播以及计划怀孕时优化孕产妇健康。有证据表明，HIV降低了CIN 2/3和宫颈癌的标准治疗效果。产前检查的经验表明，如果将其作为一揽子护理的一部分提供，则大多数妇女会接受HIV筛查。方法：该回顾性病例记录了2006年1月1日至2009年7月31日之间确诊的60例HIV阳性妇女的回顾，收集了有关年龄，种族，在英国的时间长短，HIV诊断的时间以及相对于出勤可能的获取时间的数据在阴道镜检查或TOP服务时，在诊断和宫颈细胞学史时应检查CD4计数和症状。结果：作者发现三名（5％）妇女在HIV诊断之前被诊断出CIN 2级或更高。 TOP时进行的HIV检测可能导致三名（5％）妇女的早期诊断。在五例（8％）的病例中，至少有一个错过早诊断的机会。结论：作者建议应进一步开展工作，以确定TOP和阴道镜检查服务中的HIV患病率，并且HIV检测应成为CIN 2/3和宫颈癌管理的标准做法。

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