CD4 and cervical squamous intraepithelial neoplasia: Even in the absence of HIV infection, Silva et al., in Pernambuco, also described earlier age of first sexual intercourse, HPV type and smoking as risk factors for CIN.4 Parham et al. found that among HIV-infected women, age, CD4+ cell count, and presence of any high-risk HPV type were significantly associated with abnormal cytological smears.