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NewsAntiretroviral therapy (ART) for HIV doesn't appear to reduce the risk of anogenital cancers — and longer treatment duration may actually be linked to higher risk. A Botswana study found that people living with HIV on ART for 10+ years had significantly elevated cancer risks compared to HIV-negative individuals. Researchers say expanded HPV vaccination and cancer screening for people with HIV are urgently needed.
A new study out of Botswana is challenging the assumption that antiretroviral therapy (ART) protects people living with HIV (PLWH) from anogenital cancers. Researchers found that longer ART duration does not reduce cancer risk — and those on treatment for 10 or more years actually faced the highest cancer risk compared to all other groups studied.
The case-cohort study analyzed over 1,000 anogenital cancer cases (cervical, vulvar, anal, and penile) diagnosed between 2013 and 2018, comparing them to more than 13,000 community residents. A striking 79% of cancer patients had HIV, and 86% of those were already on ART — suggesting treatment alone isn't enough to neutralize the risk. Researchers believe the elevated risk may stem from earlier periods of immune suppression and cumulative HIV-related immune dysfunction, even after treatment begins.
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Why it matters: These findings highlight a critical gap in HIV care — long-term survivors remain at elevated cancer risk despite treatment. Clinicians are urged to prioritize HPV vaccination and expand anogenital dysplasia screening and treatment for people living with HIV.
