Abstract
BackgroundIn Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low.MethodsAn institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05.ResultsOf the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization.ConclusionsThe study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.
Highlights
In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIVpositive women
A comparative study conducted to assess cervical cytology among human immunodeficiency virus (HIV) positive and HIV negative women in a tertiary hospital in north-central Nigeria shows that abnormal Papanicolou Smear results were higher in HIV positive women which is 76 (56.3%) compared with HIV negative women of 17 (12.6%) [5]
In our study, we have found that 40.1% of HIV positive women utilize cancer screening (CCS), which is significantly higher compared with the study done in Morocco (9%) [22], Gondar (10%) [18] and Addis Ababa (11.5%) [19]
Summary
In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIVpositive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Seventy percent of all CC cases throughout the world are caused by only two types of human papillomavirus (HPV); HPV-16 and HPV-18 [2]. Many studies revealed that women living with human immunodeficiency virus (HIV) have a higher prevalence of HPV along with infection with multiple high-risk HPV types [3, 4]. According to the World Health Organization (WHO), in areas where HIV is endemic, cervical cancer screening (CCS) results may be positive for precancerous lesions in15–20% of the target population [1]. A study conducted in south Ethiopia, 22% of women infected with HIV were positive for precancerous lesions [6]. About 85% of new cases and 87% of all deaths of CC occur in the less developed regions [8]
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