Abstract C069: Experienced delays in cervical cancer care among women living with HIV in Puerto Rico

Abstract Background and Objectives: Women living with HIV (WLWH) are at an increased risk of developing cervical cancer compared to women without HIV. It has been reported that due to delayed diagnosis and healthcare system inequities, WLWH often experience disparities in access to cervical cancer care. Limited information is available on access to cervical cancer care among WLWH in Puerto Rico (PR). Our study aimed to evaluate whether HIV status affects cancer diagnosis and treatment delays among WLWH in PR. Methods: We conducted a retrospective cohort study of women ≥ 21 years diagnosed with cervical cancer from 2010 to 2021 using merged data from the PR Central Cancer Registry, the PR HIV/AIDS Surveillance System, and medical claims. To estimate the adjusted odds ratio (aOR) for the association between HIV status and delays in cancer diagnosis (≥ 60 days) and first course of cancer treatment (≥ 60 days), we performed multivariate logistic regression models adjusting for sociodemographic and clinical characteristics. Results: A total of 1,603 cervical cancer cases were included in the analysis 29 HIV+ (1.8%) and 1,574 HIV- (98.2%). Compared to HIV- women, WLWH were younger (51.41±15.90 vs 46.10± 10.35, p=0.25), a higher proportion had Medicaid (55.2% vs 93.1%, p0.001), and were more likely to be diagnosed with a squamous carcinoma (74.7% vs 89.7%, p=0.02). WLWH have higher odds of experiencing delays in cancer diagnosis (aOR: 2.24, 95%CI: 0.80-6.24, p=0.12) compared to HIV- women, after adjusting for covariates. Similarly, WLWH had higher odds of experiencing cancer treatment delays (aOR: 2.01, 95%CI: 0.88-4.60, p=0.097) compared to HIV- women, after adjusting for covariates. Conclusions: Our findings document disparities in timely access to cervical cancer care among WLWH in PR. Further studies should focus on identifying factors associated with delays in cancer diagnosis and treatment in this underserved population. Acknowledgements: This study was supported by the National Institute of General Medical Sciences (NIGMS, award #1P20GM1483240-01), the Puerto Rico Central Cancer Registry (grant NU58DP007164), and the PR HIV AIDS Surveillance System (grant# PS18-180). IRB: Study approved by the IRB of the Comprehensive Cancer Centre of the University of Puerto Rico (#2411004755). Citation Format: Marievelisse Soto-Salgado, Verónica García-Ramírez, Lorena González-Sepúlveda, Sharee Umpierre, Carlos R. Torres-Cintrón, Axel Gierbolini, Melisa Ramos-Sepúlveda, Vivian Colón-López, Maritza Cruz, Edna Marrero, Ana P. Ortiz. Experienced delays in cervical cancer care among women living with HIV in Puerto Rico abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C069.