Comparing Visual Inspection With Acetic Acid to Cytology in Detection of Precancerous Lesions of the Cervix in HIV-Infected Cambodian Women

Purpose: To compare Papanicolaou (Pap) smear readings to visual inspection with acetic acid (VIA) findings among HIV-infected women in Phnom Penh, Cambodia. Methods: A total of 304 HIV-infected women presenting to the women’s clinic at the Community Resource Center in Phnom Penh, Cambodia, were screened for cervical cancer by both Pap smear and VIA. The results of the 2 tests were compared. Results: Complete data were available on 293 women. In all, 55 (19%) women screened positive on VIA; 25 (8.5%) women screened positive by Pap. Visual inspection with acetic acid detected 18 of the 25 patients with abnormal cytology and was normal in 7 women with abnormal cytology. A total of 37 (67%) women with positive VIA were negative by cytology. Conclusions: Our study shows a reasonable correlation between VIA and Pap smear, with VIA detecting more abnormalities than cytology. In the absence of Pap smear availability, VIA may be a reasonable cervical cancer screening method for HIV-infected women in Cambodia.