CD4 and vulva cancer: In our study, the mean CD4 count among women with VSCC was above the AIDS diagnosis threshold: 200 cells/μL.37 In contrast, in a 2014 study in Botswana, 35% of women living with HIV with vulvar cancer had CD4 counts below 200 cells/μL (range: 68–854).22 In another study in Ethiopia in 2018, the range of CD4 counts was above the AIDS diagnosis threshold (230 cells/μL – 600 cells/μL).27 Our study was unique in that it showed that there was no association between CD4 count and the diagnosis of VSCC.