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Cervical Cancer and Women Living with HIV: A Call to Action

Cervical Cancer and Women Living with HIV: A Call to Action. Sethembiso Promise Mthembu ICWSA smthembu@icwsa.org. Introduction. Linkages between Cervical Cancer and HIV What are some of our concerns? Some recommendations : Call to Action. Cervical Cancer and HIV.

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Cervical Cancer and Women Living with HIV: A Call to Action

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  1. Cervical Cancer and Women Living with HIV: A Call to Action Sethembiso Promise Mthembu ICWSA smthembu@icwsa.org

  2. Introduction Linkages between Cervical Cancer and HIV What are some of our concerns? Some recommendations: Call to Action

  3. 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)

  4. 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) • DoHestimates 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

  5. Cervical Cancer and HIV • Previously a disease of older women; • NOWYounger Women in their 20’s • Women living with HIV will still die of cancer even if AIDS treatment is available

  6. 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.

  7. 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

  8. 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 programmes- prevention is the cure?

  9. 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

  10. Call To Action Resourcing Health systems strengthening agenda – need to resource cervical cancer It is possible to resource cervical cancer Resource women’s health

  11. 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)

  12. 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

  13. 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

  14. 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 • 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

  15. 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

  16. 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!

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