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Cervical Cancer and
Women Living with HIV:
A Call to Action
Sethembiso Promise Mthembu
ICWSA
[email protected]
Introduction
 Linkages between Cervical Cancer and HIV
 What are some of our concerns?
 Some recommendations: Call to Action
Cervical Cancer and HIV
 Linkages scientifically proven
 Women with HIV between 5-9 times more likely to
have CAC ( Denny et al, (Chirenje, 2005), (Franceschi
& Ronco, 2010)
 Higher rates of HIV infection in CAC patients
(Schoeman, Van Wyngardt, Horn, Goedhals &
Jourbert, 2006)
 Defined as HIV related OI by CDC and later WHO (CDC
1993)
Cervical Cancer and HIV
 Cervical Cancer one of the biggest killers of women in
Southern Africa
 Research suggests that CAC deaths might be greater
than maternal mortality (Hale, 2009)
o DoH estimates about 3,000 in CAC and 1,600 per
annum in maternal mortality (NDoH, RSA)
 Stats on CAC are hard to find as you would not have
these unless you diagnose cancer
 Anecdotal reports: Women in communities and
hospices
Cervical Cancer and HIV
 Previously a disease of older women;
o NOW Younger Women in their 20’s
 Women living with HIV will still die of cancer even if
AIDS treatment is available
What are some of the concerns?
 Marginalised disease (Arnolu, 2008)
 Traditionally older women
 Outside reproductive brackets – out of women as
mothers framing of women’s health
 STIs
 About women’s private parts - essentially an STI.
What are some of the concerns?
 Defined as AIDS OI through court action – resistance?
 Missed by HIV/AIDS SRH Integration (contraceptives
integration really)
 Not covered by AIDS Policy and AIDS money – missed
by Global Targets
What are some of the concerns?
 Piece-meal Pap Smears and Screening – not coupled
with treatment of abnormal smears; not coupled with
treatment of cancer
 Alternatives to Pap Smears not speedily explored by
some countries
 Palliative care not integrated in AIDS care/home care
 Positive women excluded in vaccine research
 Vaccines replacing integrated CAC care programmesprevention is the cure?
Call To Action
Policy
 Integration of Cervical Cancer in Global AIDS Policy
 Global policies should be translated into national AIDS
and Cancer Policies
 AIDS Money should be leveraged to resource cervical
cancer – as a must
 Integration and involvement of HIV (Women Living
with HIV) in Global Cancer Policy
Call To Action
Resourcing
 Health systems strengthening agenda – need to
resource cervical cancer
 It is possible to resource cervical cancer
 Resource women’s health
Call To Action
Programming
 Cancer research and programming should include
women living with HIV
 Full integration of Sexual and Reproductive Health in
AIDS – not just piece-meal (which as been pap
smears, in some instances VIA)
Call To Action
 Cancer programming should explore using models
/methods for greater outreach to women, with
particular focus on cervical cancer and HIV integration
 Quality assurance in service delivery should be of
utmost priority, loss to follow-up should be reduced
Call to Action
 Raising awareness on policy and community level is
also critically important
 Training of health care workers in this integration
area for nationwide scale-up is also essential
 Systems strengthening for delivering this critical
service are also important
Call To Action
 HPV Vaccine is not cancer treatment or cure
 There is a need to programme and scale up treatment
of abnormal smears - and also cervical
o Curing cervical cancer should be part of this agenda
 Community Care for HIV should take care of cancer:
there should be collaboration and upscale of palliative
care and AIDS home based care
Call To Action
Programme
 Cervical cancer is painful, AIDS care should be able to
provide pain relief to the women who have HIV and
cancer
 Public and community awareness on HIV and cervical
cancer is essential and critical
Appreciation
 Thank you very much for your audience!
 Let us all work towards reducing the incidence, pain,
loss of life due to cervical cancer in women living with
HIV now!
 It is possible!