Foumban

Cervical cancer is a leading cause of death among women living with HIV in resource-limited settings. Researchers are evaluating different cervical cancer screening strategies to improve screening completeness and reduce dropouts. The study compares a single-visit screen and treat approach with a differentiated approach that offers more flexibility and centers on patient preferences, aiming to adapt the screening process to local constraints while maintaining effectiveness. The study also includes sub-studies assessing urinary HPV testing, methods to identify women needing treatment, and the risk of post-treatment cervical disease. The study has two main periods: the first uses a single-visit screening and treatment approach where all screening steps and treatment occur in one visit when possible. The second period implements a differentiated screening delivery, which offers more flexible options for screening and includes a decision aid to help participants choose between approaches. The study combines intervention and implementation research to assess both effectiveness and how well each strategy is carried out. Participants will be women living with HIV aged 25 to 49 who are eligible for cervical cancer screening. Researchers will collect quantitative and qualitative data, including biomedical data, monitoring data, surveys, interviews, and observations. They will measure screening completeness within 60 days after screening initiation, assess participants' stress levels, and document the experiences of women and health workers throughout the screening and post-treatment process. The study also evaluates the performance of HPV testing methods and treatment efficacy for cervical lesions.