Figure 1.

(A) HPV natural history model and (B) outline of the options of care evaluated for scale-up. (A) Transition probabilities and rates vary by age and HIV status, as shown in blue and red annotations, respectively. Spontaneous recovery is possible from HPV and CIN stages. (B) Losses to follow-up (LTFU) are shown in red and occur when another visit to a health facility is necessary (ie, during HPV-DNA testing and from screening to LEEP). For definition and values of model parameters, see table 1. *Represents screening with either digitally enhanced VIA or same-day HPV-DNA. **Rescreening carried out yearly from 2023 onwards (phase II), with pool of age-eligible WHIV in care being sampled each year at random for 70% coverage. ART, antiretroviral therapy; CC, cervical cancer; CIN, cervical intraepithelial neoplasia; CIS, carcinoma in situ; Cryo, cryotherapy; HPV, human papillomavirus; LEEP, loop excision electrical procedure; LTFU, loss to follow-up; VIA, visual inspection with acetic acid; WHIV, women living with HIV.