Liu Y, Prasad-Hayes M, Ganz EM, et al. - Given an increased risk for human papillomavirus (HPV)-associated anal cancer among women living with HIV (WLHIV) and considering the “field effect” of HPV pathogenesis, limitation of anal cancer screening to WLHIV with prior genital disease had been recommended. Researchers here sought to determine the correlation between anal and genital disease in WLHIV in order to better inform anal cancer screening guidelines.  Retrospective study was performed among 153 WLHIV with biopsy-proven anal high-grade squamous intraepithelial lesions (AHSIL) and long-term evaluable cervical/vaginal/vulvar histopathology. They identified association of cervical HPV16/18 infection with multicentric disease. The median genital surveillance period was 8 years (range 1–27). Genital HSIL were observed in 53% of multicentric cases preceding AHSIL with median interval 13 years (range 2–23). Findings suggest frequent development of AHSILs in WLHIV without pre-existing genital disease or after long latency following a genital HSIL diagnosis. Anal cancer screening is thus recommended for WLHIV irrespective of prior genital disease.