Hysterectomy among women with HIV: Indications and incidence

OBJECTIVE: To describe hysterectomy rates and indications among women with HIV and to compare them with at-risk HIV-seronegative women. METHODS: Reports of hysterectomy were collected from 3752 participants in a prospective cohort study of women with HIV and comparison uninfected women. Available operative notes were retrieved and abstracted. Comparisons were made using the Fisher exact, χ, Wilcoxon 2-sample, and Student's t tests. RESULTS: Incident hysterectomy was performed for 106 (4.5%) of 2361 HIV-seropositive women, most often for cervical neoplasia, and for 24 (2.9%) of 837 HIV-seronegative women (P = 0.04). The incidence of hysterectomy was 7.7 per 1000 person-years for HIV-seropositive women and 5.3 per 1000 person-years for HIV-seronegative women (P = 0.09). HIV-seropositive and HIV-seronegative women undergoing incident hysterectomy were similar, except for a higher likelihood of an abnormal preoperative Papanicolaou test result in the former (P = 0.001). Surgical indications did not differ by serostatus. CONCLUSION: Women with HIV are more likely than uninfected women to require a hysterectomy, most often for cervical neoplasia.