Abstract
ABSTRACT Background: Human immunodeficiency virus (HIV)-infected women are at high risk of cervical cancer. Objective: This study assessed uptake and correlates of cervical screening among HIV-infected women in care in Uganda. Methods: A nationally representative cross-sectional survey of HIV-infected women in care was conducted from August to November 2016. Structured interviews were conducted with 5198 women aged 15–49 years, from 245 HIV clinics. Knowledge and uptake of cervical screening and human papillomavirus (HPV) vaccination were determined. Correlates of cervical screening were assessed with modified Poisson regression to obtain prevalence ratios (PRs) using Stata version 12.0. Results: Overall, 94.0% (n = 4858) had ever heard of cervical screening and 66% (n = 3732) knew a screening site. However, 47.4% (n = 2302) did not know the schedule for screening and 50% (n = 2409) did not know the symptoms of cervical cancer. One-third (33.7%; n = 1719) rated their risk of cervical cancer as low. Uptake of screening was 30.3% (n = 1561). Women who had never been screened cited lack of information (29.6%; n = 1059) and no time (25.5%; n = 913) as the main reasons. Increased likelihood of screening was associated with receipt of HIV care at a level II health center [adj. PR 1.89, 95% confidence interval (CI) 1.29–2.76] and private facilities (adj. PR 1.68, 95% CI 1.16–3.21), knowledge of cervical screening (adj. PR 2.19, 95% CI 1.78–2.70), where to go for screening (adj. PR 6.47, 95% CI 3.69–11.36), and low perception of risk (adj. PR 1.52, 95% CI 1.14–2.03). HPV vaccination was 2%. Conclusions: Cervical screening and HPV vaccination uptake were very low among HIV-infected women in care in Uganda. Improved knowledge of cervical screening schedules and sites, and addressing fears and risk perception may increase uptake of cervical screening in this vulnerable population.
Highlights
Human immunodeficiency virus (HIV)-infected women are at high risk of cervical cancer
Cervical cancer is a major cause of death globally and the burden of disease is highest in low-income regions, especially sub-Saharan Africa (SSA) [1]
This study highlights a very low uptake of cervical cancer screening in a very high-risk group, major knowledge gaps and misconceptions, and missed opportunities for cervical screening among women who interface with the health system
Summary
Human immunodeficiency virus (HIV)-infected women are at high risk of cervical cancer. Objective: This study assessed uptake and correlates of cervical screening among HIVinfected women in care in Uganda. Countries in SSA generally have a high prevalence of human papillomavirus (HPV), the virus responsible for most cases of cervical cancer, and other risk factors including high human immunodeficiency virus (HIV) prevalence [2]. HIV-infected women have a higher risk of developing cervical cancer and faster disease progression [3,4]. In a study conducted among 2508 women in Rwanda, HPV prevalence was 34% and was highest among women aged ≤ 19 years. A study that evaluated cervical screening techniques in Uganda found that HIV-infected women had a higher prevalence of cervical intraepithelial neoplasia grade 2+ than uninfected women (12.9% vs 1.7%, respectively) [8]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
