Precancerous cervical lesions and associated factors among HIV-positive women in Southern and Eastern African countries: A systematic review and meta-analysis

Gebrie Getu Alemu, Astewil Moges Bazezew, Amlaku Nigusie Yirsaw, Wubet Tazeb Wondie, Berihun Agegn Mengistie, Tenagnework Eseyneh Dagnaw, Mekuriaw Nibret Aweke, Nebebe Demis Baykemagn, Gebeyehu Lakew and Bisrat Tewelde Gebretsadkan

PLOS ONE, 2026, vol. 21, issue 10, 1-22

Abstract: Background: Women living with HIV (WLHIV) face a sixfold increased risk of cervical cancer compared to HIV-negative women. Most WLHIV residing in the Southern and Eastern African regions have a substantial HIV-related cervical cancer burden. Studies on precancerous cervical lesions (PCCL) and associated factors in WLHIV from these regions have inconsistent and inconclusive findings. Therefore, we aimed to synthesize the pooled prevalence of PCCL and associated factors among WLHIV in Southern and Eastern Africa. Methods: This study was registered under PROSPERO (CRD420251123583) and conducted in accordance with PRISMA 2020 standards. Primary studies published from inception to 2025 in Southern and Eastern Africa were included. The methodological quality of studies was assessed using the Newcastle-Ottawa scale. Data extraction and statistical analyses were done in Microsoft Excel and STATA 17, respectively. Pooled prevalence, publication bias, subgroup, and sensitivity analysis were conducted. Associations were expressed as odds ratios (OR), and a p-value of less than 0.05 was considered statistically significant. Results: 44 studies met the inclusion criteria, with a sample size of 47,009. The pooled prevalence of PCCL was 22.25% (95% CI: 19.57, 24.93). Age at first sexual intercourse (

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0361185

DOI: 10.1371/journal.pone.0361185

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