Cervical high risk neoplasia is correlated with HPV, specifically oncogenic strains such as 16 and 18.

Women with HIV have higher rates of HPV coinfection and are less likely to clear the HPV. According to the US based HERS cohort, most pap smears in women with HIV are low grade but compared with HIV negative women, there is a rate ratio of 4.5 of developing an abnormal pap smear[vi].