Is there a link between Cervical Cancer and HIV? Experts reveal

January is cervical awareness month and looking at the state of HIV positive women in Kenya, we find this disease is threatening to turn the clock backward on health gains made.

Just when 46-year-old Sally Kwenda had come to terms with her HIV status that had pushed her to two unsuccessful suicide attempts, another unexpected blow hit her.

The energetic activist for persons living with HIV/Aids, who lost two babies to the disease, came face to face with the fresh blow in 2007 when staff members at her work place were requested to take a routine test for cervical cancer.

Sally, who works for a humanitarian organization in Nairobi’s Kibra area, readily went for it expecting nothing out of the ordinary.

“Despite having HIV, I was physically strong and felt okay. This changed after the screening when it was discovered I had stage two cervical cancer. I was shocked beyond words,” she recalls.

At this stage, cancer cells are found to have extended beyond the cervix to nearby tissues making it more life-threatening and more challenging to treat.

“The news were a really big blow for me. After dealing with HIV, here I was again dealing with another terminal illness,” she says.

Sally had to undergo multiple surgeries to prevent the disease from spreading further. As a result, doctors removed her womb and cervix to contain the virulent disease.

However, three years later, it emerged that the cancer had in fact spread to her colon and rectum and further surgery was needed. A large section of the colon (42 cms) was excised and fortunately, she survived to tell her tale.

But many others have not be so lucky. Like Sally, many women living with HIV in Kenya are increasingly falling victim to cervical cancer even after surviving the shackles of HIV. While anti-retroviral treatments have gifted such women with longer and more quality lives, cervical cancer comes in — rearing its ugly head and affecting their quality of life.

As Kenya joins the world this month to mark cervical health awareness month, cervical cancer incidences and deaths among women with HIV are expected to rise significantly in the country in the near future if the disease is not addressed decisively.

Of the 1.6 million Kenyans living with HIV, a sizeable fraction are women, whose risk of developing cervical cancer are high.

A recent study on HIV positive women in Nairobi’s Korogocho informal settlement revealed high incidences of cervical pre-cancer and cancer, possibly reflecting the overall situation in the country.

The three-year study by researchers from the Kenya Medical Research Institute (Kemri) and Kenyatta National Hospital involving 350 participants, found the prevalence of abnormal growths associated with cervical cancer were up to seven times higher in women with HIV.

According to Dr. Fredrick Kairithia, a Consultant Obstetrician-Gynaecologist practising in Nairobi, women with HIV are far more likely to develop cervical cancer than those who do not. They are also more likely to have a recurrence of the disease, even after treatment, and to die sooner.

“It appears HIV positive women in Kenya are not losing their lives or suffering health complications due to HIV, thanks to anti-retrovirals. Instead, it is cervical cancer that is hitting them really hard and urgent action is needed to save them,” he says.

In a recent joint article with other researchers in the Journal of the International Aids Society, Kemri researcher May Maloba, wrote that the implementation of cervical screening programmes for HIV-positive women should be an urgent public health priority.

“The health community is failing women in a crucial way. It has neglected prevention, screening and treatment for cervical cancer among the highest risk population, HIV-positive women in low-income countries,” she wrote.

HIV positive women need to be screened for cervical cancer every six months in the first year then yearly if the results are normal compared to HIV negative ones who are screened every five years.