Georgia Consortium to Eliminate Cervical Cancer in Women Living with HIV (GaCECC-WLWH)

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, wellfunded 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.