Prevalence and factors associated with cervical cancer screening uptake among HIV positive women attending the ART clinic at Kawempe national refferal hospital

Abstract

Background: Cervical cancer is a major public health concern globally and in Uganda. The incidence of cervical cancer is at least 4 times higher among HIV-positive women as compared to their HIV-negative counterparts. Cervical cancer screening is a secondary prevention approach in the WHO’s strategy for the elimination of cervical cancer. The target is to have globally, 70% of women screened for cervical cancer by the age of 35 years, and again by 45 years by the year 2030. The major goal of cervical cancer screening is to reduce cervical cancer incidence and mortality through early detection and treatment of women with pre-malignant lesions. Objective: Therefore, the aim of this study was to determine the prevalence and the factors associated with cervical cancer screening uptake among HIV-positive women attending the ART clinic at Kawempe National Referral Hospital Research methods: A cross-sectional study design with quantitative approach was conducted in the ART clinic of Kawempe NRH. 243 WLHIV were subjected to interviewer-administered questionnaires. These were selected by systematic random sampling. Logistic regression analysis was used to determine associated factors to CCS and their prevalence ratios with their confidence intervals were reported. Results: Of the 243 HIV-positive women 86.8% had received cervical cancer screening in this study The mean age of the participants was 34.6%. The factors found to be associated with CCS were; being aged 40 years and beyond [aOR=1.21, 95% CI: 1.11-1.35, P=<0.00001], having a diagnosis of HIV made 10 years and beyond [aOR=0.72, 95% CI: 0.64-0.95, P=0.011], perceived embarrassment of CCS procedures [aOR=0.75, 95% CI: 0.61-0.87, P=0.004]; perceived risk of cervical cancer [aOR=0.82, 95% CI: 0.71-0.93, P=0.006], perceived benefits of CCS [aOR=0.35, 95% CI: 0.08-0.98, P=0.005], awareness of CCS health talks received at ART clinic [aOR=0.52, 95% CI: 00.41-0.74, P= <0.00001] , health worker recommendation on CCS [aOR=0.08, 95% CI: 0.01-0.32, P= <0.00001], awareness of the availability of CCS at the facility [aOR=0.04, 95% CI: 0.004-0.31, P=<0.00001] and the cost of the CCS at the health facility [aOR=0.18, 95% CI: 0.04-0.42, P=0.004]. Conclusion: This study revealed a significantly high uptake of cervical cancer screening among HIV positive women. This highlights the effectiveness of targeted interventions and screening programs in increasing CCS rates among this vulnerable population. The results underscore the importance of continuing to prioritize CCS and prevention in HIV care and treatment programs, particularly in resource-limited settings