By Pelumi Adewale

An expert in public health and pharmaceutical sciences has raised serious concern about the alarming intersection between HIV and cervical cancer in Nigeria, describing it as a “silent public health crisis” that demands urgent national attention.

In a paper obtained by vanguard Newspaper, Mercy Oluwaseun Itopa, a seasoned pharmacist and global health professional, observed that cervical cancer, though highly preventable, remains one of the deadliest cancers affecting women globally, particularly among those living with HIV.

“Women living with HIV are up to six times more likely to develop cervical cancer due to their compromised immune systems,” Itopa said, drawing from her years of frontline health advocacy in Nigeria. “We cannot ignore the data. HIV-positive women face a significantly higher risk of persistent HPV infection, which is the primary cause of cervical cancer. Screening them regularly is not a luxury, it is a life-saving intervention.”

Itopa, who holds a key role with APIN Public Health Initiatives, a leading implementing partner of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), with funding from the U.S. Centers for Disease Control and Prevention (CDC), has led expansive campaigns to improve cervical cancer screening among HIV-positive women. Under her leadership, outreach programs reached more than 60,000 women across Nigeria, focusing on awareness, early detection, and access to care.

“When we educate women and give them access, the uptake improves remarkably,” she said. “But when we stay silent, the cost is their lives.”

According to the World Health Organization (WHO), women living with HIV should begin cervical cancer screening immediately after HIV diagnosis and continue at regular intervals. However, in Nigeria, widespread gaps in healthcare access, persistent stigma, and a lack of political commitment have hindered the implementation of this guideline.

Itopa recounted how, during clinical support visits to antiretroviral therapy (ART) clinics across Southwestern Nigeria between 2017 till date, she encountered multiple cases of late-stage cervical cancer in HIV-positive women, many of whom had never been screened. “The resources were simply not available. And where they were, the patients didn’t know,” she said. “We need to normalize these conversations in every HIV care setting.”

She emphasized the need for integrated care models where cervical cancer screening is embedded within routine HIV services. “It’s not enough to provide ARVs. Holistic HIV care must include cancer prevention strategies like Pap smears and VIA [visual inspection with acetic acid]. These are not prohibitively expensive. What’s lacking is the political will and sustained funding,” she said.

A passionate advocate for health equity, Itopa insisted that geography or income should not determine a woman’s right to preventive care. “Whether a woman lives in urban Abuja or rural Ondo, she should have access to screening. It is a basic right,” she stated.

With academic credentials spanning pharmacy, public health, and global supply chain management, Itopa brings a rare combination of scientific depth and hands-on experience to her work. She continues to bridge the gap between policy and practice.

One of the barriers, she explained, is cultural. “Many women still associate gynecological exams with shame or infidelity,” she said. “Community education must address this head-on. Faith-based and traditional leaders need to be part of this conversation.”

To that end, Itopa recommends intensive training for frontline healthcare workers to offer culturally sensitive, respectful, and stigma-free counseling and screening services. “When women feel safe and respected, they are more likely to access care. Trust is everything,” she said.

She also appealed to development partners and donor agencies to channel resources directly into cervical cancer screening for HIV-positive women. “Donors have made commendable investments in HIV treatment. But cervical cancer screening has been left behind. It must become a funding priority,” she urged.

From a policy standpoint, Itopa advocated for a national directive mandating cervical cancer screening as part of HIV treatment protocols. “This should not be optional. If we can mandate viral load testing, we can do the same for cervical cancer screening,” she argued.

Reflecting on the impact of her advocacy, she said, “Lives were saved because someone got tested early. That’s the power of preventive care.”

As Nigeria continues to tackle a double burden of infectious diseases and rising cases of non-communicable conditions, Itopa’s call to prioritize cervical cancer screening, particularly for HIV-positive women, is both timely and urgent.

“No woman should die from a preventable disease,” she concluded. “Breaking the silence around cervical cancer is the first step.”