Abstract B149: Prevalence of HPV vaccination and cervical cancer screening among women living with HIV in Puerto Rico: Findings from the 2023-2024 Medical Monitoring Project

Abstract

Women living with HIV (WLWH) have a more than fourfold higher risk of developing cervical cancer (CC) than HIV-negative women. Although HPV vaccination and routine CC screening prevent CC, updated data on the uptake of these strategies among WLWH in Puerto Rico (PR) are limited. This study estimated the prevalence of HPV vaccination and cervical Pap screening and factors associated with their uptake among WLWH in PR. We conducted a cross-sectional secondary analysis using data from the 2023-2024 cycles of the Medical Monitoring Project (MMP). The analysis included 109 women aged ≥18 years who completed the PR MMP survey and provided information on HPV vaccination and cervical cancer screening. Survey-weighted prevalence and 95% confidence intervals (CIs) were estimated for lifetime HPV vaccination and cervical Pap screening within the past 3 years (defined as up-to-date screening), overall and by demographic, behavioral, and psychosocial characteristics. Differences in HPV vaccination and cervical Pap screening prevalence across participant characteristics were assessed using the design-based Rao-Scott adjusted Pearson chi-square test. All analyses were conducted using Stata survey procedures. Generative artificial intelligence was used solely to improve grammar and language. Most participants were aged > 45 years (80.4%; mean age, 56.3 ±13.8 years), 59.6% had a high school education or less, 74.1% reported an annual income < $20,000, and 62.7% were covered by Medicaid, another public insurance program, or the Ryan White HIV/AIDS Program. About 7.6% had both received HPV vaccination and undergone cervical Pap screening, 66.1% had undergone cervical Pap screening only, 0.8% had received HPV vaccination only, and 25.5% had received neither prevention strategy. HPV vaccination was more commong among WLWH aged ≤ 45 than those aged > 45 years (22.5% vs. 5.0%, p=0.017). Up-to-date cervical Pap screening was more prevalent among WLWH with a regular healthcare provider (79.5% vs. 52.0%, p=0.024) and those currently receiving antiretroviral therapy (76.1% vs. 26.0%, p=0.044) than their counterparts. No significant differences in both CC prevention strategies were observed by education, income, employment, insurance type, HIV stigma score, time since HIV diagnosis, alcohol use, smoking status, or number of sexual partners. Cervical Pap screening (73.7%) and especially HPV vaccination (8.4%) remain suboptimal among WLWH in PR, with few women receiving both recommended prevention strategies. Compared with previous MMP findings from PR, the prevalence of up-to-date cervical Pap screening appears to have declined, highlighting the need to strengthen CC prevention efforts within HIV care seetings. Daniela López-Vallejo, Lorena González-Sepúlveda, Maritza Cruz-Cortés, Gilbert A. Encarnación-Cortés, Ana P. Ortiz, Vivian Colón-López, Sharee Umpierre, Jane Montealegre, Marievelisse Soto-Salgado. Prevalence of HPV vaccination and cervical cancer screening among women living with HIV in Puerto Rico: Findings from the 2023-2024 Medical Monitoring Project [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B149.