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A high proportion of HIV-positive women in the United States are living in poverty, are Hispanic, or have other disadvantages that typically are negative correlates of mammography use. Because these characteristics have been shown to relate to lower screening rates, it would be logical to expect low mammography use among women with HIV. However, HIV diagnosis usually leads to regular contact with health professionals, and HIV-positive women may, therefore, be more likely than HIV-negative women to receive screening recommendations from their physicians.
Since life expectancy for many of these women has been prolonged due to new antiretroviral therapies, it is important to understand cancer screening practices among HIV-positive women and to ensure that they receive recommended early detection tests, suggests Susan Preston-Martin, Ph.D., of the University of Southern California. Dr. Preston-Martin and her colleagues used data from the Women's Interagency HIV Study (WIHS) to examine mammography use among 2,059 HIV-positive and 569 HIV-negative socioeconomically disadvantaged women who were enrolled in the study between October 1994 and November 1995. The WIHS is jointly funded by the Agency for Healthcare Research and Quality, the National Institutes of Health, and the Centers for Disease Control and Prevention.
The researchers used WIHS data on women who were at least 40 years old in 1994 and 1995 to compare HIV-positive women with demographically similar HIV-negative women on use of mammography through September 2000. They also compared mammography use between WIHS women and U.S. women in general using National Health Interview Survey (NHIS) data.
Results revealed that fewer WIHS women, regardless of HIV status, reported mammography than U.S. women (67 percent HIV-positive, 62 percent HIV-negative, 79 percent NHIS). However, HIV-positive women were 60 percent more likely than HIV-negative women to be screened for the first time while in the study, probably due to their greater health care access and use. For example, despite similar education and income, more HIV-positive than HIV-negative women reported having health insurance (82 vs. 59 percent), having a primary care provider (93 vs. 67 percent), or having seen a doctor in the past 2 months (84 vs. 54 percent). This finding supports prior research that increased use of health care, in general, is related to increased screening.
See "Use of mammographic screening by HIV-infected women in the Women's Interagency HIV Study (WIHS)," by Dr. Preston-Martin, Lynn M. Kirstein, M.S., Janice M. Pogoda, Ph.D., and others, in the March 2002 Preventive Medicine 34, pp. 386-392.
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