Abstract
BackgroundDespite the fact that HIV-positive women carry an increased risk of developing cervical cancer (CC) in comparison with HIV-negative women, HIV and CC screening programs in many developing countries have remained unintegrated. The objective of this study is to explore perceptions and preferences of community members in Uganda, including women, men, and village health teams, regarding the integration of HIV and CC screening services in a single-visit approach.MethodsThis qualitative study was conducted in three districts in Uganda. Data were collected through focus group discussions with women and village health teams, and individual interviews with men. Respondents were purposely selected from among those linked to three CC clinics in the three districts. The content analysis method was used to analyze the data.ResultsThree themes emerged from the data, namely appreciating the benefits of integration, worrying about the challenges of integration, and preferences for integration. The women endorsed the benefits. However, there were worries that integration would prolong the waiting time at the health facility and induce tiredness in both the healthcare providers and the women. There were also fears of being found positive for both HIV and CC and the consequences such as stress, self-isolation, and social conflicts. Participants, particularly the women, considered the challenges of screening integration to be manageable by, for example, taking a day off work to visit the hospital, delegating house chores to other family members, or taking a packed lunch on visiting the hospital.ConclusionsThe community members in Uganda perceive the benefits of HIV and CC screening integration to outweigh the challenges, and expect that the challenges can be minimized or managed by the women. Therefore, when considering HIV and CC screening integration, it is important to not only recognize the benefits but also take into consideration the perceived challenges and preferences of community members.
Highlights
Despite the fact that Human immunodeficiency virus (HIV)-positive women carry an increased risk of developing cervical cancer (CC) in comparison with HIV-negative women, HIV and CC screening programs in many developing countries have remained unintegrated
The study sites provided perspectives from different levels of healthcare in Uganda, namely, the national referral hospital situated in the capital city of Kampala, the regional referral hospital situated in a semi-urban setting, and the district general hospital situated in a rural setting
The community members’ perceptions of integration of HIV and CC screening fall under three themes, namely perceived benefits, challenges, and preferences
Summary
Despite the fact that HIV-positive women carry an increased risk of developing cervical cancer (CC) in comparison with HIV-negative women, HIV and CC screening programs in many developing countries have remained unintegrated. Cervical cancer (CC) is the third commonest cancer among women globally in terms of 5-year prevalence, with an estimated 527,624 new cases and 265,672 deaths in 2012 [1]. In East Africa, CC is the most prevalent cancer and the leading cause of HIV/AIDS is a major cause of morbidity among adults globally, and more so in developing countries. The prevalence of HIV among women aged 15–49 years in Uganda increased from 7.5% in 2005 to 8.3% in 2011 [2]. Between 2007 and 2013 the estimated number of people living with HIV in Uganda increased from 1.2 million to 1.5 million, and 56% of these AIDS sufferers are women aged 15 years and older [2].
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