Authors (including presenting author) :
Kwong TS (2), Lee MP (1), Wu TC (2), Yu P (1), Chan S (1), Chan SN (1), Au SM (1), Chan KL (1), Chan YT (1)
Affiliation :
(1) HIV Clinical Service, Department of Medicine, Queen Elizabeth Hospital
(2) Infectious Disease Unit, Department of Medicine, Queen Elizabeth Hospital
Introduction :
In addition to the morbidities caused by HIV, women living with HIV also face with gender-specific challenges, including reproductive health, pregnancy, contraception, gynecological problems like HPV-related cervical disease, and social problems. Owing to the success of anti-retroviral treatment in controlling HIV, patients now enjoy a near-normal life expectancy and are entitled to enjoy healthy family life.
Objectives :
In view of the growing demands of care for women-specific health issues, women-oriented services are established in the QEH HIV Clinic to provide holistic care for female patients.
Methodology :
Since June 2010, Cervical Cancer Screening Program (CCSP) was started in QEH HIV clinic, whose nursing staffs had received training for pap smear taking. Since July 2016, Women Clinic (SMCF) was launched, which ran on weekly basis by a doctor and nurses who are committed to provide counselling on pregnancy planning, contraception, sexual health, as well as comprehensive care for pregnant women to prevent perinatal transmission of HIV. Close collaboration with Obstetricians & Gynaecologists, Paediatric HIV Specialists, Psychologists, Social Workers and NGOs are undertaken to ensure a holistic approach of care to the female patients.
Retrospective review of both the CCSP and SMCF were carried out. The period reviewed for CCSP was between 1st June 2010 and 31st December 2018, and that for SMCF was between 1st July 2016 and 31st December 2019.
Result & Outcome :
Among the 280+ female patients of the HIV clinic, 76 were ever referred to SMCF for assessment. There were 18 pregnancies with resultant 12 live births (none was HIV-infected), 4 miscarriages and 2 pregnancy terminations. 38 women received advice on contraception, 12 of whom started on hormonal contraception. 23 couples were counselled about pregnancy planning (4 sero-condordant, 19 sero-discordant), with subsequent 4 successful pregnancies. Women were also seen for gynaecological problems including abnormal pap smear results and breast diseases.
For CCSP, 287 women were ever screened. 30.7% had abnormalities that required colposcopic investigations, among whom 10.2% were diagnosed to have high grade CIN (pre-cancerous lesion) requiring treatment, 27.3% low grade CIN, while none was diagnosed to have cervical carcinoma.
Conclusion: Women-oriented service comprising both the Women Clinic and Cervical Cancer Screening Program succeed in promoting good health among women living with HIV.
