HIV, HPV, and Cervical Cancer: A Deadly Nexus
New research aims to expand prevention and improve health outcomes for women in Indonesia
By Chael Needle
Regular cervical cancer screenings— Pap smears and testing for human papillomavirus (HPV), the primary cause of cervical cancer—help detect cancerous and precancerous cells early, when they are most treatable.
But uptake of cervical health screening has been low at Prof. Dr. Ngoerah Hospital in Bali, Indonesia, where Dr. Agus Somia heads up the HIV clinic and infectious diseases program.
Low uptake, combined with the fact that women living with HIV are susceptible to chronic, persistent high-risk HPV infection (strains more prone to lead to cancer) and are six times more likely to develop cervical cancer than women without HIV, prompted Dr. Somia to study the issue in more depth.
The study collected data via interviews and clinical exams at HIV outpatient clinics in Bali to determine the prevalence and risk factors of high-risk HPV and cervical dysplasia in women living with HIV. It was funded through International epidemiology Databases to Evaluate AIDS (IeDEA), a U.S. National Institutes of Health consortium whose Asia-Pacific component is co-led by amfAR’s TREAT Asia program and the Kirby Institute, University of New South Wales, Australia.
Based on its findings, the study recommends increasing HPV vaccination and cervical cancer screening, particularly for younger women, and screening all women living with HIV in Indonesia in order to improve health outcomes.
“We will be sharing the results of this study with the Bali Provincial Health Office to serve as input for developing policies on routine Pap smear screening and HPV vaccination programs for women living with HIV at HIV treatment clinics in Bali and across Indonesia,” Dr. Somia says about putting the recommendations into practice.
“IeDEA support also allows for peer assistants who are living with HIV to deliver education and assistance during screening.”
“Also, we will be expanding the integrated screening services currently implemented at research sites (our clinic and the Kerti Praja HIV Foundation in Denpasar) to serve as a model for integrated Pap smear screening and HPV vaccination services.”
In addition, the facility will establish referral pathways to gynecologic oncology specialists for more specific and advanced clinical management.
Funding from IeDEA benefits the hospital’s research and healthcare delivery needs in several ways, he notes. The IeDEA grant strengthens local research capacity and has helped them to develop an integrated model for cervical cancer screening within their HIV clinics.
“IeDEA support also allows for peer assistants who are living with HIV to deliver education and assistance during screening,” shares Dr. Somia.
“The cervical health needs of women in the Asia-Pacific region are underserved and under-researched,” says Annette Sohn, MD, PhD, amfAR VP and director of TREAT Asia. “Network sites like Prof. Dr. Ngoerah Hospital play a vital role in addressing the bi-directional and mutually reinforcing risks of HIV and cervical cancer.”
Chael Needle is amfAR’s senior staff writer.
Click Here to read more from the May 2025 issue of amfAR INNOVATIONS.
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