References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Women living with HIV have a higher risk of persistent HPV infection and cervical cell changes that can lead to cancer if not caught and treated. This is true even when HIV is well-controlled on treatment. The good news is that with the right screening schedule, most problems can be detected early and treated before they become serious.
UK guidance recommends more frequent cervical screening for women with HIV than for the general population.
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Why More Frequent Screening?
HPV (human papillomavirus) is the main cause of cervical cancer. The immune system normally clears HPV infections over time, but in people with HIV — especially those with lower CD4 counts — the virus can persist longer and cause cell changes to progress faster.
UK Screening Schedule for Women with HIV
| When | What Happens |
|---|---|
| At HIV diagnosis | Baseline cervical screening regardless of age |
| Annually thereafter | Yearly cervical screening (more frequent than the general population) |
| If any abnormal result | Colposcopy referral following standard pathways |
This differs from the general NHS cervical screening programme, which tests women every 3 to 5 years depending on age.
What Happens at Screening
The test itself is the same as for any woman. A speculum is used to see the cervix, and a small soft brush collects cells from the surface. These are sent to the lab to check for HPV and, if HPV is present, abnormal cell changes.
If Results Are Abnormal
An abnormal result doesn’t mean cancer. Most changes are minor and resolve on their own. If follow-up is needed, you’ll usually be invited for a colposcopy — a closer look at the cervix with a magnifying camera. Treatment for precancerous changes is quick and usually done as a day case.
HPV Vaccination
The HPV vaccine is offered routinely in UK schools. If you were not vaccinated in school and are living with HIV, you may be eligible for catch-up vaccination. Ask your HIV clinic — the vaccine doesn’t treat existing infections but can protect against other HPV types you haven’t yet encountered.
Other Things That Help
- Stay on your HIV treatment — an undetectable viral load reduces cell change progression
- Don’t smoke — smoking significantly increases cervical cancer risk
- Attend every screening appointment
- Report any unusual bleeding, pain or discharge promptly
Read more: What is HIV? | What is HPV? | HIV and the immune system
Frequently Asked Questions
Do I really need a smear every year with HIV?
Yes. UK guidelines from BHIVA and BASHH recommend annual cervical screening for women with HIV because HPV-related cell changes are more common and can progress faster.
Does HIV medication protect against cervical cancer?
Being on effective HIV treatment with an undetectable viral load lowers the risk of cell change progression, but it doesn’t remove the need for regular screening. Screening stays the best way to catch problems early.
Can I have the HPV vaccine if I’m HIV positive?
Yes. The vaccine is safe for people with HIV. Speak to your HIV clinic about catch-up vaccination if you didn’t receive it in school.
Related reading
- HPV Testing: How It Works
- How Accurate Are Rapid HIV Tests?
- Anonymous STI Testing: What It Means
- Are Genital Warts Clearable?
- Are HIV Tests Accurate If You're on PrEP, PEP or ART?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
