Cervical Cancer Threat Weighs Heaviest on Women With HIV in Africa

For millions of women across East and Southern Africa, a routine diagnosis carries a weight that women elsewhere rarely face. The subregion carries the heaviest combined burden of HIV and cervical cancer anywhere on the planet. The consequences are measured in lives lost at rates far beyond what should be expected. Cervical cancer is the fourth most common cancer among women worldwide, yet mortality rates in Africa are nearly three times the global average. In countries such as Eswatini, Malawi and Zimbabwe, which report some of the highest cervical cancer incidence rates in the world, the threat to women’s health and survival is especially acute.

The scale of the crisis is inseparable from the region’s HIV burden. An estimated 5% of all cervical cancer cases globally are attributable to HIV, but the overlap is far more pronounced in Southern Africa. In nine countries there, Botswana, Eswatini, Lesotho, Malawi, Mozambique, Namibia, South Africa, Zambia and Zimbabwe, more than 40% of women diagnosed with cervical cancer are women living with HIV. That figure underscores a stark reality: the people most exposed to one of the region’s deadliest cancers are also among those least equipped to fight it.

The medical reasons for this vulnerability are well established. HIV infection increases a person’s susceptibility to human papillomavirus (HPV), the virus that causes cervical cancer. It also reduces the body’s ability to clear the virus once acquired, and it accelerates the progression from HPV infection to cancer. People living with HIV therefore face a distinct and heightened risk, one that standard protection measures were not designed to address on their own.

In recognition of this elevated danger, WHO has recommended a multi-dose HPV vaccination schedule for all immunocompromised individuals, a measure intended to afford them durable protection. The rationale behind that recommendation has made it urgently imperative, health authorities argue, to devise targeted and integrated action to protect one of the most vulnerable populations in the subregion.

That imperative brought governments, global health agencies and advocates together in Cape Town, South Africa, from 17 to 19 November 2025 for a subregional workshop on HPV vaccination for people living with HIV. The timing was deliberate. The gathering coincided with the first official World Cervical Cancer Elimination Day, a coincidence intended to amplify the call to action for elimination efforts worldwide.

Those at the table reflected the breadth of the response required. Immunization and HIV programme leads from five key countries, Eswatini, Malawi, the United Republic of Tanzania, Zimbabwe and South Africa, took part, joined by major global partners including WHO, Gavi, the Vaccine Alliance, the United Nations Children’s Fund (UNICEF), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Gates Foundation. Leading researchers and civil society representatives rounded out the group, ensuring that scientific expertise and community perspectives were both present in the discussions.

Among the most affecting moments of the proceedings was a testimony from a youth advocate living with HIV, which grounded the technical conversations in lived experience. For the programme leads and partners in the room, the message was a reminder that behind every statistic on incidence and mortality stands a person navigating the compounded risks of two intertwined health threats.

For the public across East and Southern Africa, the stakes of such efforts are concrete. Women living with HIV, who make up a large share of cervical cancer diagnoses in nine Southern African countries, stand to gain the most from vaccination strategies tailored to their needs. The workshop’s convergence of national immunization programmes, HIV services and international partners signals an attempt to close the gap between what WHO recommends and what people at highest risk actually receive.

Whether the momentum from Cape Town translates into durable protection for the subregion’s most vulnerable women will depend on the follow-through of the governments and partners who gathered there. What is clear is that the burden they are confronting is not distributed evenly around the world, and that the populations bearing the heaviest weight are now, at least on paper, the focus of a coordinated response.