Table 4. Model 2—Coordination between co-located clinics/specialists.
| Study | Study design | Setting | Model of care | Integration | Screening n (% of those offered) |
HIV positive | Treatment coverage | Selection bias |
|---|---|---|---|---|---|---|---|---|
| Odafe 2013 | Cross-sectional | Secondary healthcare urban public hospital, Nigeria | All women attending ART were counselled on CaCx screening, those accepting were referred to the reproductive health unit for same-day VIA screening. Referred for colposcopy and treatment. | Coordination between ART unit and reproductive health unit with bi-directional referral and patient tracking system. | 834 (96.5%) | 100% | NA: Screening only | N/A |
| Horo 2012 | Case -control with sub-cohort | Three ART clinics and a blood donor clinic, Cote d’Ivoire | Screening by mobile staff, referred for colposcopy if positive or inconclusive at ART clinic, follow-up and treatment at ART clinic. | Coordination between mobile staff and the ART clinic to provide screening and treatment for CaCx. | 4,046 | 74% | 414 referred for colposcopy, 36.5% (n = 151) did not attend. A systematic mobile phone tracking system reduced the loss to follow up from 36.5% to 19.8%. | N/A |
| Fink 2012 | Cross-sectional | A hospital HIV clinic, Argentina | Screening: Pap smear and colposcopy | New weekly specific clinic for women living with HIV; care provided by HIV and gynecological specialists. | 96 | 100% | NA: Screening only | N/A |
| Mwanahamuntu 2013 | Cross-sectional | 17 clinics and an outpatient surgery care center housing a Gynecologic Cancer Prevention Clinic, Zambia | ‘See and Treat’: VIA and cryotherapy, refer cryotherapy-ineligible for evaluation and treatment to an outpatient surgery clinic located in a tertiary hospital. |
Physical co-location of CaCx program clinics with HIV/AIDS clinics. | 56,427 |
26.7% | Not reported | N/A |
| Ramogola-Masire 2012 | Cross-sectional | Community and hospital-based HIV clinics, Botswana | “See and Treat”: VIA and EDI and cryotherapy. Cryotherapy ineligible referred for colposcopy/LEEP to local hospital. Complex lesions referred to specialized clinic, advanced cases referred to tertiary hospital. | Coordination between HIV clinic and CaCx screening community clinic in the same facility. |
2,175 | 100% | 253 received same-day cryotherapy. 575 were referred for further evaluation and treatment. 61.3% women received appropriate same-day screening and treatment without the need for recall or referral. | N/A |
| Parham 2010 |
Cohort | 11 urban and four rural public health clinics, Zambia | “See and Treat”: VIA and cryotherapy, referred for histologic evaluation and clinical management. Follow-up visits for those undergoing cryotherapy or LEEP are encouraged at 6 weeks and 6 and 12 months. | Specialist nurses coordinate care independently in rooms co-located within 15 public health clinics. | 21,010 | 31.3% | Of the women eligible for ablative treatment by cryotherapy, 78% (1603/2061) actually underwent treatment. A total of 75% (1095/1462) of HIV-infected women referred for evaluation complied. Less than 20% of women ever returned for their recommended follow-up visit. | High |
Abbreviations: CaCx: cervical cancer, VIA: visual inspection with acetic acid, NA: not applicable, EDI: enhanced digital imaging, LEEP: loop electrosurgical excision procedure