 There have been only a few studies looking at anal cytology in HIV-infected women. The largest study n235, by Holly and Palefsky 4, found that HIV positive women had a 26 prevalence of anal cytologic abnormalities mostly atypical squamous cells of undetermined significance ASCUS and low grade squamous intraepithelial lesions LSIL. Forty-six of these women with abnormal cytology 60 underwent high resolution anoscopy HRA and 14 were found to have biopsy proven HSIL. 