Cervical screening for HIV positive women

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1 Women s & Children s Cervical screening for HIV positive women Information for patients This leaflet explains cervical screening (smear tests) and why we recommend you have a test every year. 1

2 What is cervical screening? It is a test also known as a cervical smear to check the health of your cervix, which is the lower part of your womb (often called the neck of the womb). For many women, the test results show that everything is fine. However, for about 1 in 20, they show changes in cells. These changes (abnormalities) can be caused by many things, but they are mostly caused by the wart virus (Human Papilloma Virus HPV). This virus can cause cervical cancer if it is left untreated for a long period of time. Most of these changes will not lead to cervical cancer. Cervical screening is not a test for cervical cancer. What is Human Papilloma Virus (HPV)? It is a very common infection and most women get it at some time in their life. There are many types of HPV, and some can cause abnormalities in the cervix. If these abnormalities are not treated, they can sometimes develop into cervical cancer. However, not all abnormalities develop into cancer and in many cases HPV clears up by itself. HPV is easily transmitted during intimate sexual contact between partners. This includes intimate contact between men and women, and between partners of the same sex. There are no symptoms. This means you or a partner could have had the virus for many months or years from a previous relationship without knowing it. Why are HIV positive women offered cervical screening every year? All women aged are offered cervical screening tests every three years. However, if you are HIV positive, we recommend you have a cervical smear test every year. 2

3 This is because women with HIV are more likely to be infected with HPV and more likely to have more cervical abnormalities, especially if they have a low CD4 cell count. Cervical cancer can often be prevented. The signs that it may develop can be spotted early and treated to prevent it from becoming cancer. About 750 women die of cervical cancer in England each year, but many of these will not have had regular smear tests. Not going for cervical screening is one of the biggest risk factors for developing cervical cancer. Should all HIV positive women have the test? Yes. We offer a yearly test to all HIV positive women aged from 25 to 64, but cervical cancer is more common if you: are HIV positive have a low CD4 cell count smoke first had sex at an early age have had several sexual partners or have had a sexual partner who has had several other partners. What happens during the test? The doctor or nurse will ask you to lie down on a couch. They will gently put a small plastic instrument, called a speculum, into your vagina to hold it open. Then, they will wipe a small brush-like device over your cervix to pick up some cells. They will put these cells into a small container of liquid and send it away to be examined under a microscope. 3

4 Does the test hurt? You may have some discomfort or pain. Try to relax by taking slow, deep breaths as it may be more uncomfortable if you are tense. If it is painful, tell the doctor or nurse straight away as they may be able to make you more comfortable. When should I have my smear test? The best time is in the middle of your menstrual cycle. You should not be tested during your period, so try to make sure you get an appointment before or after your period is due. Can I have sex before the test? Yes, but do not use a spermicide, a barrier method of contraception or a lubricant jelly for 24 hours before the test as the chemicals they contain may affect the test. Can I be tested for sexually transmitted infections (STIs)? We routinely offer you screening for gonorrhoea and chlamydia at the Caldecot Centre while you have your smear test. We will discuss this with you before your test. The Caldecot Clinic may contact you directly about your STI test results. When do I get my results? You usually get them within two weeks. If you have given us permission, the laboratory will send a copy of your smear results to your home address and your GP surgery. If you decide to have your screening done at your GP surgery, please bring a copy of your results to the clinic at your next appointment. 4

5 How reliable is cervical screening? Early detection and treatment can prevent about 75% of cancers developing but, like other screening tests, cervical screening is not perfect. It may not always detect early cell changes that may lead to cancer. Sometimes, abnormal cells do not look much different from normal cells, so they are difficult to recognise on your test sample. There may be very few abnormal cells on your sample; or the person reading your sample may miss the abnormality (this happens occasionally, no matter how experienced the reader is). About 1 in 20 tests have to be done again because: you may have an infection that needs treating before we can give you a clear result your cervical cells may have been hidden by blood or mucus there may not have been enough cervical cells to give an accurate assessment your sample may not have been prepared properly the container with your sample may have leaked. What does it mean if you ask me to come back for another screening test? It may mean that: your cell sample did not show up clearly so we may need to take another one screening found some small changes in the cells of your cervix. We may refer you for a colposcopy so we can take a closer look at your cervix and these cells. What is a colposcopy? It is a minor procedure and you usually have it in an outpatient clinic. It allows us to take a closer look at any abnormal areas on your cervix and to take more cell samples, if necessary. 5

6 If we find changes on your first smear test, we may also treat these areas when you have your colposcopy. We will fully explain this if we ask you to come in for the procedure. How do I book a smear test? To book an appointment at the Caldecot Centre, call Where can I get more information? You can ask your GP for more information or contact your local health clinic. You can also contact NHS 111. You may find NHS Choices useful This leaflet is based on the NHS Cancer Screening Programmes NHS cervical screening brochure. PALS The Patient Advice and Liaison Service (PALS) is a service that offers support, information and assistance to patients, relatives and visitors. They can also provide help and advice if you have a concern or complaint that staff have not been able to resolve for you. The PALS office is located on the ground floor of the Hambleden Wing, near the main entrance on Bessemer Road - staff will be happy to direct you. Tel: Fax: You can also contact us by using our online form at 6

7 If you would like the information in this leaflet in a different language or format, please contact PALS on

8 Corporate Comms: 0958 PL651.1 December 2014 Review date December 2017

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