Cervical Cancer Screening of Commercial Sex Workers in NW and SW Regions of Cameroon

Abstract

Background: In 2008, the Cameroon Baptist Convention Health Services (CBCHS) organized New Life Clubs (NLC) for commercial sex workers to provide: 1) medical information and free HIV testing and male and female condoms to reduce transmission of HIV and other reproductive tract infections (RTIs); 2) psychosocial and spiritual support, and; 3) training on safer sex and more sustainable income-generating opportunities. Since about one third of the 600 NLC members are HIV-positive, they are high risk for cervical cancer. Methods: In 2017 CBCHS educated NLC members in Mutengene, Bamenda and Banso about cervical cancer, obtained informed consent to screen them visually after application of acetic acid and Lugol's iodine enhanced by digital cervicography, examined those who consented for free, treated women with precancers, provided condoms at no cost to reduce transmission of HIV and prevent unintended pregnancies, and evaluated the program impact. Results: Of the 103 NLC members screened, 101 records were analyzed; 40 were HIV-positive (39.6%) and 33 of those (82.5%) were on treatment. Six were diagnosed with cervical precancer (5.9%). Three were treated (50%); two with thermal coagulation and one with LEEP. Three were treated for RTIs and two for genital warts. Conclusion: Cervical cancer screening and treatment of precancers of commercial sex workers is feasible, if the costs are subsidized. The WHP will expand screening and train NLC coordinators to be cervical cancer educators and to assess unmet family planning needs. Treatment of HIV-positive sex workers is a priority because treatment is prevention.