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Cervical Screening in HIV — RACP Adult Medicine MCQ

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HardGeneral Internal MedicineCervical Screening in HIVRACP Adult Medicine

A 50-year-old woman living with HIV has an undetectable viral load, CD4 count 650 cells/microlitre and a negative oncogenic HPV screening test. Which principle applies to her Australian cervical screening?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Continue the immunocompromised screening pathway rather than extending as the default to the routine five-year interval

The best answer is “Continue the immunocompromised screening pathway rather than extending as the default to the routine five-year interval”. Women living with HIV remain at higher risk of persistent HPV infection and cervical neoplasia even with viral suppression, so the Australian immunocompromised pathway uses more frequent surveillance than routine five-year primary HPV screening. The exact follow-up depends on prior results and treatment history; symptoms still require assessment independently of screening.

Reference: Australian Government: National Cervical Screening Program: https://www.health.gov.au/our-work/national-cervical-screening-program?language=en ASHM: National HIV testing policy and clinical resources: https://testingportal.ashm.org.au/national-hiv-testing-policy/