Supporting the National Expansion of HPV-based Cervical Cancer Screening in Tanzania Among Women Living With HIV

* Cervical cancer is caused by persistent infections with one of \~13 carcinogenic human papillomavirus (HPV) types and causes substantial morbidity and mortality worldwide. * Highly effective strategies exist, including HPV vaccination and HPV-based screening for early detection and treatment of precancerous lesions. * The investigators are proposing an innovative implementation research program and randomized trial evaluating HPV DNA testing as a primary screening tool for cervical cancer screening in HIV Care and Treatment clinics within Tanzania's National Cervical Cancer Prevention (CECAP) program. * The investigators will combine HPV DNA testing with high quality visual assessment of the cervix for treatment and management of cervical precancerous lesions among HPV+ Women Living with HIV (WLWH). * At 12-month follow up women will be recalled for repeat screening for HPV and visual assessment of the cervix for treatment combined with a second therapeutic dose of HPV vaccine. * The investigators propose to recruit 2000 WLWH from 4 HIV Clinics in Kilimanjaro Region. Two clinics will be randomized to the test, treat and vaccinate strategy and two clinics will be randomized to test, treat and re-screen and then vaccinate strategy. * Currently, there is no Standard of Care (SOC) for vaccination of women who are at risk for HPV in the country. These two arms of the study will allow for treatment and observation to occur that would not be available otherwise.

NCT Number	NCT06402383
Lead Sponsor	Queen's University Collaborators: Merck Canada Inc.
Conditions	Cervical Cancer
Enrollment	2,000 participants
Start Date	2024-05-25
Primary Completion	2027-01 (estimated)
Study Completion	2027-04 (estimated)
Updated on ClinicalTrials.gov	2026-08-12