BackgroundCervical cancer is the most common malignancy affecting South African women aged 15–44 years, with a higher prevalence among women living with HIV (WLWH). Despite recommendations for a screening target of 70%, the reported rate of cervical cancer screening in South Africa is 19.3%.ObjectivesTo investigate the adherence of healthcare workers to cervical cancer screening guidelines in a tertiary-level HIV clinic.MethodA retrospective cross-sectional record audit of women attending the Charlotte Maxeke Johannesburg Academic Hospital HIV Clinic over a 1-month period.ResultsOut of 403 WLWH who attended the clinic, 180 (44.7%) were screened for cervical cancer in the 3 years prior to the index consultation. Only 115 (51.6%) of those women with no record of prior screening were subsequently referred for screening. Women who had undergone screening in the previous 3 years were significantly older (47 years vs 44 years,P= 0.046) and had a longer time since diagnosis of their HIV (12 years vs 10 years,P= 0.001) compared to women who had not undergone screening. There was no significant difference in CD4 count or viral suppression between women who had and had not undergone screening.ConclusionThe rate of cervical cancer screening in our institution is below that recommended by the World Health Organization and the South African National Department of Health.