Women with HIV four times more likely to develop cancerous lesions from HPV

With over 23 percent of adults in Lesotho living with HIV, PIH recognizes women living here are at far greater risk of developing cervical cancer. HIV accelerates the progression of pre-cancerous lesions in the cervix — a process that usually takes 10-20 years often takes as little as two. This in a country with less than 1 physician per 10,000 people.

In response, PIH’s sister project in Lesotho has stepped up efforts to identify and treat at-risk women, a necessary step to preventing unnecessary deaths.

Clinicians at PIH-Lesotho’s rural clinics perform pap-smears during routine checkups, three months after giving birth and during menopause — all in an effort to detect cervical cancer. The pap-smear is then analyzed at a lab in Maseru, Lesotho’s capital. 

If a woman tests positive for cervical cancer, she is sent to the main referral hospital in Maseru. Women who require further care would be referred to a hospital in Bloemfontein, South Africa, for services such as radiation treatment and chemotherapy.

The double burden of living with HIV

Women living with HIV are four-times more likely to develop cancerous lesions from HPV. While enrollment on antiretroviral drugs decreases the likelihood that a HIV-positive woman will develop cervical cancer, she is still at greater risk than her HIV-negative peers.

This double burden of communicable and non-communicable diseases (NCDs) impacts poor countries hardest — especially those places that lack universal primary care. While a global consensus to treat diseases like HIV has emerged, we must also treat unrelated NCDs.

PIH-Lesotho provides comprehensive health care to all patients at each of its 7 facilities. For people living with HIV, this includes monitoring for and treating any number of conditions that might result from a weakened immune system — including cervical cancer.

One of the world’s highest rates of cervical cancer

At 179 deaths per 100,000 women each year, Lesotho’s mortality rate from cervical cancer is one of the highest in the world, according to the World Health Organization. Of those 179 deaths, 31 women are between 15 and 44. This highlights the need of a comprehensive screening and treatment program. In comparison, the cervical cancer incidence in North America is only 7.7 per 100,000.

In Lesotho, access to specialized care and oncological expertise is limited. In most cases, patients need to be referred to South Africa to get adequate cancer care; this is out of reach for the majority of Lesotho’s rural women — both geographically and financially. 

Learn more about PIH's work in Lesotho.