While the pap smear has traditionally been a once-a-year annoyance, new guidelines say that healthy women who have normal results and also test negative for human papillomavirus (HPV), the virus that causes cervical cancer, can go for three years between tests. The same is true for women who aren't tested for the virus but have three normal pap results in a row. But women with HIV are still told to get a pap smear every single year. According to a new study, that may not be necessary for all HIV-positive women.

What the researchers wanted to know: How often do women with HIV need to get pap smears to check for cervical cancer?

What they did: The researchers looked at 855 HIV-positive women and 343 HIV-negative women who were in a larger study on women and HIV. The women joined the study in 1994 and 1995. At a clinical visit every six months, each woman had a pap smear to look for abnormal cells on the cervix. Samples were also taken from each woman to look for HPV.

What they found: HIV-positive women who had high CD4 counts (500 cells per microliter or higher) and weren't infected with human papillomavirus when the study started were unlikely to develop cervical lesions in three years—just like women without HIV. CD4 count is the number of T-cells, a type of immune cell attacked by HIV, in the blood; AIDS is defined as a CD4 count below 200.

What the study means to you: These results suggest that, like HIV-negative women, some women with HIV could go longer between pap smears than the guidelines currently recommend.

Caveats: This absolutely doesn't mean that women with HIV should cancel their dates with the gynecologist; these results were true only for women whose CD4 counts were 500 or higher, and women in this study were tested for human papillomavirus at the beginning of the study, helping predict their risk of cervical cancer. Anyway, the guidelines won't be changed without more research on HIV and cervical cancer.

Find out more: Check out information about human papillomavirus from the U.S. Centers for Disease Control and Prevention.

Read the National Library of Medicine's medical encyclopedia entry on cervical cancer.

Read the article: Harris, T.G., et al. "Incidence of Cervical Squamous Intraepithelial Lesions Associated With HIV Serostatus, CD4 Cell Counts, and Human Papillomavirus Test Results." Journal of the American Medical Association. March 23/30, 2005, Vol. 293, No. 12, pp. 1471-1476.

Abstract online: http://jama.ama-assn.org