(An improvement of Pap Smear Screening Service in HIVs women at Sanpatong Hospital, Chiang Mai Province, 2005-2010)

Abstract

Background: Incidence of cervical cancer is high in HIV- reactive women. Cervical cancer screening and follow-up continuous can decrease the incidence of invasive cancer. The Thailand National AIDs policy require high quality service for HIV- reactive, which is at least 50% of HIV reactive women has to receive Pap smear annually. Methods: This experimental development research: one group pre-test post-test time series design aimed to improve Pap smear screening services among HIV- reactive women attending at Sanpatong Hospital by prospective data recording. The pre-test (baseline data) utilized 2004 data; duration for experiment was between January 2005 and December 2010; experiment measurement was done annually to be the post-test data. The samples were 306 HIV-reactive women living in Sanpatong District, Chiang Mai Province during the experiment. Descriptive statistics such as percentage were employed. Results: Pap smear uptakes increased from 18.5% in 2004 to42.5%, 53.0%, 68.1%, 82.0%, 82.9% and 84.1% in 2005-2010 respectively. Follow - up rate for diagnosis and treatment within 3 months after screening were changed from 30.0% in 2004 to 52.0%, 44.5%, 71.4%, 77.8%, 81.8% and 85.7% in 2005-2010. Follow-up rate after treatment increased to 100% in 2010 indicating every target person received quality services continuously. Abnormal Pap smear were 24.5% and follow-up cytology showed 77.3% were cancer. The improved Pap smear screening services were convenience and simple computer programs for data recording of HIV-reactive women and services received; data linkage between service provider units; and warm counseling on disease, preventive behaviors, treatment and follow-up. Conclusion: HIV- reactive women need quality Pap smear screening services every year. It can do by the commitment of concerning groups working together by patient focused using our existing resources.