Background: Cervical cancer remains as the leading cause of morbidity and mortality globally and in India as second leading cancer cause among women. Women living with HIV (WLHIV) in India face a 6-10-fold higher risk of cervical cancer due to elevated high-risk HPV prevalence and persistence, yet very few studies from India have explored integration of HPV screening into HIV care, and no national policy currently embeds routine screening within the National AIDS Control Programme's (NACP) 2500+ ART centres. ART centres provide essential HIV treatment, however cervical screening lags due to untrained nurses, poor WLHIV awareness of HIV-HPV-cancer risks, and missing colposcopy referral pathways & missing vital early detection chances. This capacity-building initiative from The Gujarat Cancer Research Institute (GCRI), Ahmedabad, piloted HPV DNA-based screening at an ART centre to address this gap.

Objective: To identify high-risk HPV infections among PLHA women through HPV DNA testing. To ensure early diagnosis of pre-cancerous and cancerous cervical lesions. To build the capacity of ART centre nursing staff for cervical sample collection. To establish a referral linkage for colposcopy and further management at GCRI.
Methods: This capacity-building initiative at an ART centre in Ahmedabad screened 1384 women living with HIV/AIDS (WLHA) aged >25 years using HPV DNA testing, and liquid-based cytology (LBC). HPV-positive cases and abnormal LBC underwent portable colposcopy. Training modules for ART nurses covered sample collection, referral pathways, and patient education.

Result: A total of 1384 samples underwent HPV DNA testing, with 289 (21.14%) positive for high-risk types: HPV 16 (n=76), HPV 18 (n=45), and other high-risk types (n=168). Liquid-based cytology (LBC) revealed abnormalities in 143 women living with HIV/AIDS (WLHA): ASCUS (n=86), LSIL/ASC-H (n=43), HSIL (n=14). Colposcopy was performed in 94 women, identifying CIN1 (n=34), CIN2 (n=21), and CIN1/2 (n=1), alongside cancer (n=1).

Conclusion: This study validates the substantial prevalence of HPV infection among WLHIV and proves the practicality of embedding HPV screening at ART centres and GCRI for timely colposcopy, biopsy and treatment. It presents a strategic pathway for statewide adoption across Gujarat's ART centres under NACO, building nurse capacity, for conducting periodic training, strengthening digital data tracking for HPV testing, LBC results, and leveraging portable tools to drive equitable scale-up, and advance national cervical cancer elimination in this vulnerable group.

Data Details for this study