Higher HIV RNA was associated with increased risk of precancer and cancer in models unadjusted for CD4 count, with associations attenuated after adjustment.<h4>Conclusions</h4>Maintaining high CD4 counts and achieving viral suppression through early ART initiation, along with using CD4 cell count for risk stratification in cervical screening, may help improve cervical cancer prevention among WWH in South Africa. This evidence concerns the gene CD4 and cancer.