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To the Editor: The new Bethesda Consensus Guidelines for the Management of Women With Cervical Cytological Abnormalities, which were described by Dr Wright and Colleagues,¹ strongly endorse human papillomavirus (HPV) testing for women with atypical squamous cells of uncertain significance (ASC-US). This protocol may lead to a heightened public awareness that cytological abnormalities are caused by a sexually transmitted infection. While HPV testing is partly justified by a desire to reduce the discomfort and anxiety associated with colposcopy, testing may lead to stigma and shame and considerably increase the psychological burden of cervical screening on women, which could ultimately reduce the advances made in cervical cancer prevention.

Sexually transmitted infections are widely stigmatized.² Although research is currently limited, there is evidence that many women have little knowledge or understanding of HPV, its relationship to cervical cancer, or its sexually transmitted nature.^3-4 We found (unpublished data) that women were shocked and . . . [Full Text of this Article]

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