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Methods We modeled our infrastructure after a successful PEPFARfunded HIV care and treatment program and selected HIVinfected women as our initial target population. Zambian nurses underwent classroom and clinically-mentored training to become primary service providers for screening women for cervical lesions using visual inspection with acetic acid (VIA) and treatment with cryotherapy, when indicated. Women with cryotherapy-ineligible lesions were referred to the university hospital where physicians were trained to perform punch biopsy and loop electrosurgical excision procedure (LEEP) for histologic evaluation. We utilized telecervicography for distance consultation as well as reviewing digital images weekly for quality assurance and continuing education. Patients with invasive cancer were referred for hysterectomy, radiation or palliation, depending on the stage of their disease

Implementation of a "see and treat" cervical cancer prevention program linked to HIV care in Zambia