Background:
Studies show that Pap smears (Paps) are not consistently offered in Sexually Transmitted Disease (STD) clinics because of follow-up problems by patients and possibility that infections make Paps' unsatisfactory for interpretations. However, studies show that STD patients have higher risks for abnormal Paps and cervical cancers. Therefore, integrating Paps in STD clinics provides services to a high-risk group and serves to correct patients' misconceptions that Paps are generally included in all pelvic exams.

Objective:
To evaluate the prevalence, incidence of STD co-morbidities, and follow-up of abnormal Paps.

Method:
A review of computerized data of patients' charts and Pap results (Paps) between January 1, 2002 and December 31, 2004.

Result:
2,230 Paps were performed between 2002 and 2004. Abnormal Paps (ASCUS, AGUS, LGSIL and HGSIL) occurred in 186 (8.34 %); ASCUS in 114 (61%); LGSIL in 55 (30%); HGSIL in 9 (4.8%); AGUS in 8 (4.3%).
Bacteria Vaginosis (BV) co-morbidity occurred in 62/114 (54%) ASCUS; 27/55 (49%) LGSIL; 6/8 (75%) AGUS; 5/9 (55%) HGSIL.
Trichomonas co-morbidity occurred in 14/114 (12%) ASCUS; 0/55 LGSIL; 0/9 HGSI; 0/8 AGUS.
Yeast co-morbidity occurred in 16/114 (14%) ASCUS; 9/55 (16.4%) LGSIL; 2/9 (22%) HGSIL; 0/8 AGUS.
Chlamydia occurred in 16/114 (14%) ASCUS; 8/55 (14.5%) LGSIL; 0/9 HGSIL; 0/8 AGUS.
Gonorrhea occurred in 5/114 (4.3%) ASGUS, 1/55 (1.8%) LGSIL; 0/9 HGSIL; 1/8 (12.5%) AGUS.
Herpes occurred in 1/55 (2%) LGSIL.
Cytology detected 49 and 54% of clinical BV in ASCUS and LGSIL only.
Finally, 61 (2.8%) of Paps were declared unsatisfactory while 38 (20%) of patients with abnormal Paps did receive follow-up.


Conclusion:
Rate of abnormal Paps in STD Clinic is low (<10%) just as the rate of unsatisfactory Paps (2.8%). Most common STD associated with abnormal Paps is BV with follow-up noncompliance of 20%.

Implications:
Performing Paps in STD Clinic is prudent policy that should be continued.