for females ages 25-65 (full criteria)
at La Jolla, California and other locations
study started
completion around
Principal Investigator
by Gregory Aarons, PhD
Headshot of Gregory Aarons
Gregory Aarons



While there has been a significant increase in the uptake of antiretroviral therapy among women living with HIV (WLHIV) in many low- and-middle income countries (LMICs), the coverage of cervical cancer screening and treatment (CCST) among WLHIV remains low. This study aims to leverage the available infrastructure for HIV care and treatment programs in Nigeria to integrate cervical cancer screening and treatment and conduct a cluster randomized, hybrid type III trial design to assess the comparative effectiveness of a Core set of implementation strategies versus a Core+ (enhanced) set of implementation strategies to implement cervical cancer screening, onsite treatment, referral and referral completion, treatment, and retention in care among WLHIV. The overarching goal is to improve the health and life expectancy of WLHIV with co-occurring cervical cancer.


Nigeria has one of the largest HIV epidemics in the world with 1.8 million people living with HIV infection. With an estimated female population of 102 million and HIV prevalence of 1.6% among adult females, Nigeria has the largest population of women and the 4th largest number of women living with HIV (WLHIV) in Africa. Although access to antiretroviral therapy (ART) among WLHIV in Nigeria has increased over the years, with over 98% of the 960,000 WLHIV on ART, AIDS-related mortality remains high. In 2020, 16,000 WLHIV died from AIDS- related illnesses including cervical cancer. A pilot implementation program in Nigeria demonstrated that leveraging the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) supported HIV programs for the provision of evidence-based cervical cancer screen-and-treat interventions in WLHIV is feasible. The pilot program demonstrated, however, that tailored implementation strategies will be needed to address specific multilevel barriers along the cancer control continuum in order to address adoption, reach, and sustainability that are necessary for successful scale-up. However, in many African countries with a high burden of both HIV and cervical cancer, there is a paucity of evidence-based implementation strategies to inform effective integration of HIV and cervical cancer services delivery. Objectives of this proposal are to: 1) Refine strategies to integrate cervical cancer screening, treatment and management within existing comprehensive HIV treatment programs and determine implementation readiness; 2) Determine the comparative effectiveness of a Core set of implementation strategies versus Core+ enhanced implementation strategies; and 3) assess sustainment of the integration of cervical cancer screening, treatment, and management intervention into HIV programs. The investigators have assembled a strong team from University of California San Diego, the University of Nigeria, Nsukka, and Northeastern University with expertise in implementation science, HIV care and research, and cancer care and research. Our proposal is responsive to the NCI request for applications (RFA) and consistent with the World Health Organization global plan of elimination of cervical cancer by 2030. If effective, the proposed project will result in a set of feasible, culturally adaptable, and sustainable implementation strategies to integrate evidence-based cervical cancer screening and treatment into HIV programs in order to improve the health and life expectancy of WLHIV.


HIV, Cervical Cancer, Implementation Science, Cluster randomized trial, Capacity building, Low and middle income countries, Research infrastructure, Exploration Preparation Implementation Sustainment (EPIS), EPIS Framework, Uterine Cervical Neoplasms, Core Implementation strategies, Core+ Enhanced Implementation Strategies


You can join if…

Open to females ages 25-65

- Women living with HIV

You CAN'T join if...


  • UC San Diego accepting new patients
    La Jolla California 92093 United States
  • University of Nigeria, Nsukka accepting new patients
    Enugu Nigeria

Lead Scientist at UCSD

  • Gregory Aarons, PhD
    Dr. Aarons is clinical and organizational psychologist, is a Professor in the Department of Psychiatry at the University of California, San Diego (UCSD), a faculty member in the UCSD/SDSU Joint Doctoral Program in Clinical Psychology, Director of the Child and Adolescent Services Research Center (CASRC) and Co-Director of the Center for Organizational Research on Implementatio…


accepting new patients
Start Date
Completion Date
University of California, San Diego
Study Type
Expecting 2436 study participants
Last Updated