Infection with certain types of a common virus called human papillomavirus, or HPV, can cause cell changes in the cervix that can lead to cervical cancer. People with HIV who have a cervix (women and transmen who have a cervix) should have a cervical screening test soon after they are diagnosed with HIV. You should then have a repeat test once a year. (This is more often than for HIV-negative people, who are generally advised to have screening every three to five years. However, the age range for cervical screening for HIV-positive people is the same as that for people without HIV – 25 to 65 years of age.)

Some types of HPV can also cause cell changes in the anus. The value of regular anal screening is much less certain, and currently it is not recommended that it be included in routine monitoring, although some clinics may offer it. High-risk types of HPV can also cause vulval, vaginal, penile and some mouth and throat cancers.

Other monitoring tests for these cancers and cell changes include a colposcopy and an anoscopy. A colposcopy examines the cervix with a microscope under a very bright light, while an anoscopy does the same for the examination of the anus. Any abnormal cells can usually be treated under a local anaesthetic, using heat, cold or laser beams to burn away the cells, or electric current to remove them. Most commonly, abnormal cells in the cervix are removed using an electric current or through minor surgery, known as a cone biopsy, which can both diagnose and treat the abnormal cells. The latter might mean you will need a general anaesthetic and possibly an overnight stay in hospital.