Research Article Women Living with HIV over Age of 65: Cervical Cancer Screening in a Unique and Growing Population Alexandra Aserlind, Karla Maguire, Lunthita Duthely, Stefan Wennin, and JoNell Potter University of Miami Miller School of Medicine, Department of Obstetrics & Gynecology, Miami, FL, USA Correspondence should be addressed to Alexandra Aserlind; a.aserlind@med.miami.edu Received 22 March 2017; Revised 11 May 2017; Accepted 30 July 2017; Published 17 September 2017 Academic Editor: Janet S. Rader Copyright © 2017 Alexandra Aserlind et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. Women living with HIV are at increased risk of human papillomavirus (HPV) infection, which can lead to cervical cancer. New guidelines recommend indefnite screening. Te objective of this study is to describe cervical cancer screening practices and colposcopy results in a cohort of women living with HIV over age of 65 who were followed before the new guidelines. Comorbidities, sexually transmitted infections (STIs), and other risk factors were evaluated. Methods. We conducted a retrospective chart review on 75 women aged 65 or older living with HIV with at least one Pap smear. Results. Te mean age of the cohort was 66.5 and at HIV diagnosis was 56. Te majority of women were immunocompetent. 80% had serial Pap smears. Of these, 86% of 238 were negative or ASCUS. No women progressed to HSIL. 92% of colposcopies had negative or CIN I results. Tree women were treated successfully for high-grade dysplasia. More than half of women had other STIs. 72% were screened for HPV; 50% were positive. Conclusion. Te majority of women had negative and low-grade Pap smears. Questions remain regarding the utility of continued Pap screening and the added value of HPV testing in this unique population of older women living with HIV. 1. Introduction Te number of older people living with Human Immunodef- ciency Virus (HIV) in the United States is increasing [1]. From 2008 to 2011, the prevalence of HIV infection in people aged 65 and older grew by 41%, making the rate of increase higher than in any other age group [2]. Tis is due to increased rates of HIV transmission in the elderly and the prolongation of life with the advent of combined antiretroviral therapy three decades ago [3]. Te population of postmenopausal women living with HIV (WLWH) has grown steadily. Te median survival time afer diagnosis in women over 50 years of age increased by 11 years from 1996 to 2014, reaching an average of 22.8 years. With the prevalence of elderly WLWH expected to double over the next 10 years, there will be an increasing need for expert gynecological care for these women [4]. WLWH are at an increased risk of coinfection with high- risk human papillomavirus (HPV) and have higher rates of developing precursor lesions that may potentially lead to cervical cancer. Te rates of high-grade cervical dysplasia and HPV coinfection are directly related to HIV viral load and inversely related to CD4 count. Multiple studies suggest a decrease progression of neoplasia with use of antiretroviral therapy [5, 6]. As CD4 counts drop below 200 cells/L, there is a 2-fold increase in the incidence and prevalence of cervical preinvasive lesions such as cervical intraepithelial neoplasia (CIN) and low-grade squamous intraepithelial lesion (LSIL), when compared to those with CD4 counts > 500 cells/L [7, 8]. Cervical screening and management guidelines for this aging population continue to evolve. Previous guidelines recommended cervical cytology twice in the frst year afer HIV diagnosis and annually thereafer, with no guidance on stopping [6]. Te latest cervical screening guidelines for WLWH over 65 years of age, published in 2016, recommend cervical cancer screening to be continued for the duration of a woman’s life [9]. Tis is in contrast to guidelines in place for women without HIV, which support cessation of screening afer 65 years of age, subsequent to three consecutive negative cytology results. Alternately, women not living with HIV can suspend cervical cancer screening with two consecutive Hindawi Infectious Diseases in Obstetrics and Gynecology Volume 2017, Article ID 2105061, 5 pages https://doi.org/10.1155/2017/2105061