Women
Contraception and Preconception Care
ÎÎAll HIV-infected women of childbearing age should be asked about
their plans and desires regarding pregnancy upon initiation of care
and routinely thereafter (A-III).
Pregnancy Testing
ÎPregnancy testing should be considered in the following situations (B-III):
Î
>> Missed menses (unless using etonorgestrel implants or depot medroxyprogesterone
acetate);
>> Irregular bleeding (unless using etonorgestrel implants or depot
medroxyprogesterone acetate);
>> New onset of irregular bleeding after prolonged amenorrhea while using
etonorgestrel implants or depot medroxyprogesterone acetate;
>> New onset pelvic pain;
>> Enlarged uterus or adnexal mass on examination;
>> Before institution of new medications with potential adverse effects for the
pregnant woman or fetus;
>> Or at the patient's request.
Gynecological Evaluation for Cervical Cancer Screening and
Prevention
ÎÎHIV-infected women should have a cervical Pap smear performed upon
initiation of care, and this test should be repeated at 6 months and, if
normal, annually thereafter (A-I).
ÎÎWomen with atypical squamous cells or ASCs (both ASC-US [atypical
squamous cells of unknown significance] and ASC-H [ASC cannot
rule out high-grade squamous intraepithelial lesion or SIL]), atypical
glandular cells, low-grade or high-grade SIL (squamous intraepithelial
lesion), or squamous carcinoma noted by Pap testing should undergo
colposcopy and directed biopsy, with further treatment as indicated by
results of evaluation (A-II).
Breast Cancer Screening
ÎÎMammography should be performed annually in women after the age
of 50 years (A-I).
ÎÎIn women 40 to 49 years of age, providers should perform
individualized assessment of risk for breast cancer and inform them of
the potential benefits and risks of screening mammography (B-II).
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