Even though they are at increased risk of cervical cancer, nearly one in four HIV-positive women in the U.S. who were recently interviewed had not had a Pap test to look for cervical cancer in the previous year, investigators found.

The risk of cervical cancer has not decreased since the introduction of highly active antiretroviral) therapy for HIV infection, "highlighting the continued importance of cervical cancer screening in this population," health officials from the U.S. Centers for Disease Control and Prevention note in the Journal of Acquired Immune Deficiency Syndromes for August 1.

To see if guidelines for annual cervical cancer screening for HIV-infected women were being performed, Dr. Alexandra M. Oster and associates analyzed information on 2417 HIV-infected women from 18 states.

Records showed that 23 percent of those interviewed had not undergone a Pap test during the year before the interview.

Older age was an independent predictor of not being tested, as was poor immune system function, as evidenced by low numbers of infection-fighting CD4 T cells.

"Because of competing priorities," the investigators suspect that preventive care for sicker women "may be given lower priority than in other HIV-infected women."

"However, it is important to remember," they note, that these women are at higher risk of infection with human papillomavirus (HPV), a cause of cervical cancer. They are also at higher risk for abnormal Pap test findings. "Thus, cervical cancer screening should be a high priority," the investigators conclude.