Background: Women in sub-Saharan Africa bear a disproportionate burden of HIV and HPV infections. HPV is the pre-eminent etiologic agent of cervical cancer and its precursor lesions while HIV is a risk factor. The interactions between HPV and HIV infections pose a great challenge to public health especially where HIV prevalence is high and HPV vaccine coverage is low. This is the case in Uyo, Akwa Ibom State. Objective: This case-control, cross-sectional study was carried out to determine the prevalence of cervical epithelial abnormalities in HIV-seropositive women in Uyo and correlating it with their CD4 count and HIV viral load. Methodology: Four hundred and sixty six consenting females comprising 231 HIV positive women as cases and 235 HIV negative women as controls were recruited and screened for cervical cancer and its precursor lesions using conventional Pap smear between February 2013 and April 2014. The cases were those attending the HIV clinic in UUTH while the controls were women attending the Gynaecology, Family planning, and General Out-Patient clinics who tested negative for HIV on VCT. Pap smears were collected and fixed in 95% Isopropyl alcohol and then stained in the histopathology laboratory using standard Papanicolaou staining protocols. I reviewed the slides with my supervising consultants. The slides were classified according to the 2001 Bethesda classification. HIV testing was done by two rapid tests (Determine and Unigold), CD4 count was 2 measured by flow cytometry, while the HIV viral load was determined by semi-automated conventional PCR within two weeks of Pap smear screening