Abstract
BackgroundCervical cancer is one of the leading causes of death in women worldwide. Majority of the cases are found in developing countries. The increasing risk of cervical cancer death and the high prevalence of human papilloma virus (HPV) infection in Human immuno-deficiency virus(HIV) positive women calls for determining the level of premalignant cervical cancer (Ca) screening uptake. So, this study aimed to assess the uptake of cervical cancer screening and its associated factors.MethodsAn institution based cross sectional study was conducted from April to May, 2016, among adult HIV positive women attending care and treatment at Gondar University Referral Hospital. The data were collected using an interviewer administered questionnaire.Bivariate and multivariable logistic regression analyses were used to determine the presence and the degree of association between dependent and independent variables. In the multivariable logistic analysis, a P-value of < 0.05 and odds ratio with a 95% confidence interval were considered to determine independent predictors for the uptake of cervical cancer(Ca) screening.ResultsThe life-time uptake of cervical cancer screening among HIV positive women was 10% (95% Confidence Interval(CI): 7.3–12.8). In multivariable the analysis, women with primary education (Adjusted Odds Ratio(AOR) = 3.92, 95%CI:1.70–8.99), secondary education (AOR = 3.84, 95%CI: 1.50–9.83), and tertiary level education (AOR = 4.16, 95%CI: 1.24–13.98), having a child (AOR = 3.02, 95%CI: 1.23–7.46), diagnosed as HIV positive ten years back or more (AOR = 2.71, 95% CI: 1.06–6.97), and Cell Differentiation 4(CD4) count of less than or equal to 200cell/mm3 (AOR = 5.29, 95% CI: 2.58–10.83) were significantly associated with the uptake of cervical cancer screening.ConclusionIn this study, the uptake of cervical cancer screening was very low. Educational status, parity, length of time after diagnosis as HIV positive, and CD4 count are important predictors of cervical cancer screening. Health care workers and cervical cancer prevention and control program coordinators and implementers need to provide counseling services for all Anti-retroviral Therapy(ART) care attendants. So as to explore the root causes for the low utilization of precancerous stage of cervical Ca screening service, conducting a study on the supply side with a qualitative component is mandatory.
Highlights
Cervical cancer is one of the leading causes of death in women worldwide
Study design and period An institution- based cross sectional study was conducted among Human Immunodeficiency Virus (HIV) positive women attending adult ART (Anti-Retroviral Therapy) Clinic at Gondar University Referral Hospital, northwest Ethiopia, from April 16 to May 15, 2016
The HIV care service of the hospital was established in 2003 Gregorian calendar (GC) and has three clinics: Adult ART, pediatric ART, and Volunteer Counseling and Testing (VCT)
Summary
Cervical cancer is one of the leading causes of death in women worldwide. Majority of the cases are found in developing countries. The burden of the disease and death from cervical cancer is very high in developing countries [2]. Cervical cancer is the second most common cancer in women living in less developed regions, with an estimated 445, 000 new cases in 2012 [3]. More than 2.7million women are at risk of cervical cancer, out of which about 80% were found in less developed regions [4]. The 2012 estimate showed that the age-standardized incidence rates of cervical cancer of Ethiopia = 26.4/100,000 women. The same estimate noted that about 4732 cervical cancer deaths occurred annually and age-standardized mortality rate of the problem was 18.4/100,000 in the country [5]
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