Integrating Cervical Cancer Prevention into HIV Services in Sub-Saharan Africa: A Narrative Review Addressing the Dual Burden Among Women

Abstract

Abstract Background Women with HIV face a higher risk of cervical cancer. This review synthesizes evidence on precancerous cervical lesions among women with HIV in sub-Saharan Africa (SSA), regional differences, risk factors, and approaches to integrating cervical cancer prevention into HIV services. Methods We conducted a comprehensive literature search across PubMed, Embase, Scopus, and Web of Science databases through December 2025 and identified studies evaluating the prevalence of precancerous cervical lesions among women with HIV in SSA. It highlights prevalence, ongoing global efforts, and integration strategies specific to SSA. Results The prevalence of precancerous cervical lesions among women with HIV in SSA is higher in Tanzania (71.8%), and Kenya (42%), eastern countries than from western (Nigeria, 26.6%) or southern countries (South Africa, 23.2%), influenced by the distribution of human papillomavirus (HPV) genotypes, including higher-risk HPV (HR-HPV) such as HPV 35, which is not targeted by the HPV vaccine. Conclusions Given the increased risk among women with HIV and the substantial burden in SSA, evidence suggests that integrating HPV-based cervical cancer screening and vaccination into HIV care platforms could help close the prevention gap and reduce the dual burden among women with HIV in SSA.