PROJECT SUMMARY/ABSTRACT
Women living with HIV (WLWH) have a substantially increased risk for cervical cancer when compared to women
without HIV infection (1). Georgia has the second largest population of people living with HIV in the US, with a
prevalence of 1.9 times the national rate (2). Simultaneously, Georgia’s rates of cervical cancer are notably
higher than the national average with 8.0 per 100,000 women diagnosed between 2015-2019 (3). Black women
are disproportionately impacted by HIV(4) and cervical cancer in Georgia (5) and have significantly higher rates
of being lost to follow-up and not undergoing colposcopy or treatment after an abnormal cervical cancer screen
when compared to white women (6). It is thus imperative that Georgia is a focal point of pragmatic clinical trials
to address cervical cancer screening and treatment among WLWH who face health disparities. The Georgia
Consortium to Eliminate Cervical Cancer in Women Living with HIV (GaCECC) encompasses established, well-
funded programs in Georgia that service WLWH and are primed to conduct the ‘CASCADE’ Network clinical
trials. The GaCECC includes Emory University HIV research and clinical networks, urban and rural Ryan White
funded clinics, Morehouse School of Medicine’s (MSM’s) extensive community networks, Georgia Cancer Center
for Excellence at Grady Health System (GCCE), and respected HIV and women’s health community-based
organizations in Georgia. The GaCECC has access to thousands of WLWH through various clinical sites that
served over 9,000 WLWH and performed over 5,000 cervical cancer screenings between 2020-2021 in both
urban and rural settings across Georgia. These sites serve high proportions of Black women who are
disproportionately affected by social determinants of health. The GaCECC’s experienced client navigation
services will work to optimize participant access to and completion of recommended screening and treatment
sequences. The GaCECC recruitment and retention team will assure seamless linkage of care between positive
screens at community clinics and colposcopy at the GCCE. Grady Memorial Hospital will provide its Grady Mobile
Health Center Vehicle to bring colposcopy to women who are unable to travel to the GCCE. Emory University,
MSM, and AAPHC partner gynecologists will deliver ‘CASCADE’ Network protocol-based treatment at the
GCCE, Ponce Infectious Disease Clinic, and rural gynecology offices associated with AAPHC. Experienced
investigators and research staff in HIV and HPV clinical trials will proficiently implement clinical trials protocols
and ensure optimal retention. The GaCECC will use the strengths and resources leveraged by each collaborator
in this consortium to address cervical cancer prevention for WLWH. In sum, the GaCECC will harness its clinical
and research leadership in HIV care and cervical cancer prevention (Aim 1) to advance research in cervical
cancer prevention among WLWH through the ‘CASCADE’ Network clinical trial, (Aim 2) to implement pragmatic
clinical trials in cervical cancer prevention across all four scientific focus areas (Aim 3) and to utilize its network
of community partnerships to enroll and retain WLWH with an emphasis on equity and diversity.