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Background: Cervical cancer screening program in Uganda is opportunistic and focuses mainly on women aged 25-49 years. Female sex workers (FSWs) are at increased risk of developing invasive cervical cancer. There is limited data regarding the uptake and acceptability of cervical cancer screening among FSWs in Uganda. This study aimed at identifying factors affecting uptake and acceptability of cervical cancer screening among FSWs in Eastern Uganda. Methods: This was a cross-sectional study conducted among 423 FSWs aged 18-49 years attending care at six health facilities serving Key Population in the Teso sub-region. Data was collected using structured investigator administered questionnaire and analyzed using Stata statistical software version 15.0 (Stata Corp, Texas, USA). The primary outcome was uptake of cervical cancer screening measured as the proportion of female sex workers who have ever been screened for cervical cancer. Chi-square test was used to compare the differences in uptake of cervical cancer screening by HIV status. Modified Poisson regression model with a robust variance estimator was used to determine association between the outcome variables and selected independent variables including demographic characteristics. Prevalence ratios (PR) with accompanying 95% confidence intervals have been reported. Statistical significance was considered at two-sided p-values ≤ 0.05. Results: The mean age of the participants was 28.1(±SD=6.6) years. The self-reported HIV prevalence was 21.5% (n=91). There were 138 (32.6%) participants who had ever been screened for cervical cancer (uptake), while 397 (93.9%) were willing to be screened (acceptability). There was a significant difference in cervical cancer screening uptake between women living with HIV and those who were HIV negative, 59.3% vs 26.9% respectively (P<0.001). The significant factors associated with uptake of cervical cancer screening included being HIV positive, adjusted prevalence ratio (aPR) = 1.74; (95% CI: 1.32-2.29), living near a private not for profit (PNFP) facility, aPR = 2.02 (95% CI; 1.38-2.95), availability of screening services at the nearest health facility, aPR=1.66 (95% CI, 1.16-2.37) and being currently on pre-exposure prophylaxis (PrEP), aPR=1.62 (95% CI, 1.12-2.34). Factors significantly associated with acceptability included never screening for cervical cancer, aPR=1.08 (95%CI, 1.01-1.14), and living near a PNFP facility, aPR=1.12 (95% CI, 1.06-1.19). Conclusion: Female sex workers living with HIV are more likely to screen for cervical cancer than the HIV negative clients. Cervical cancer screening uptake is relatively low among the female sex workers. However, majority of the FSWs are willing to be screened for cervical cancer if the services are provided in the nearby healthcare facilities. There is need to make cervical cancer screening services available to all eligible women especially the female sex workers and integrate the services with sexual reproductive health services in general and not just HIV/ART clinics services.
Background: Cervical cancer screening program in Uganda is opportunistic and focuses mainly on women aged 25-49 years. Female sex workers (FSWs) are at increased risk of developing invasive cervical cancer. There is limited data regarding the uptake and acceptability of cervical cancer screening among FSWs in Uganda. This study aimed at identifying factors affecting uptake and acceptability of cervical cancer screening among FSWs in Eastern Uganda. Methods: This was a cross-sectional study conducted among 423 FSWs aged 18-49 years attending care at six health facilities serving Key Population in the Teso sub-region. Data was collected using structured investigator administered questionnaire and analyzed using Stata statistical software version 15.0 (Stata Corp, Texas, USA). The primary outcome was uptake of cervical cancer screening measured as the proportion of female sex workers who have ever been screened for cervical cancer. Chi-square test was used to compare the differences in uptake of cervical cancer screening by HIV status. Modified Poisson regression model with a robust variance estimator was used to determine association between the outcome variables and selected independent variables including demographic characteristics. Prevalence ratios (PR) with accompanying 95% confidence intervals have been reported. Statistical significance was considered at two-sided p-values ≤ 0.05. Results: The mean age of the participants was 28.1(±SD=6.6) years. The self-reported HIV prevalence was 21.5% (n=91). There were 138 (32.6%) participants who had ever been screened for cervical cancer (uptake), while 397 (93.9%) were willing to be screened (acceptability). There was a significant difference in cervical cancer screening uptake between women living with HIV and those who were HIV negative, 59.3% vs 26.9% respectively (P<0.001). The significant factors associated with uptake of cervical cancer screening included being HIV positive, adjusted prevalence ratio (aPR) = 1.74; (95% CI: 1.32-2.29), living near a private not for profit (PNFP) facility, aPR = 2.02 (95% CI; 1.38-2.95), availability of screening services at the nearest health facility, aPR=1.66 (95% CI, 1.16-2.37) and being currently on pre-exposure prophylaxis (PrEP), aPR=1.62 (95% CI, 1.12-2.34). Factors significantly associated with acceptability included never screening for cervical cancer, aPR=1.08 (95%CI, 1.01-1.14), and living near a PNFP facility, aPR=1.12 (95% CI, 1.06-1.19). Conclusion: Female sex workers living with HIV are more likely to screen for cervical cancer than the HIV negative clients. Cervical cancer screening uptake is relatively low among the female sex workers. However, majority of the FSWs are willing to be screened for cervical cancer if the services are provided in the nearby healthcare facilities. There is need to make cervical cancer screening services available to all eligible women especially the female sex workers and integrate the services with sexual reproductive health services in general and not just HIV/ART clinics services.
Background The aim of this study is to examine cervical cancer screening (CCS) uptake among women living with hypertension and HIV in Tanzania. Methods We used the recently released 2022 Tanzania Demographic and Health Survey. The outcome variable assessed in the study was CCS, whereas chronic morbidities constituted the main explanatory variable. Data analysis was based on observations from 6,298 women aged 30–49 years. Multivariable logistic regression models were used to determine the association between hypertension and HIV status, and CCS uptake. The analyses were computed in STATA 18. Results Out of the 6,298 respondents, only 805 (12.8%) had undergone CCS with higher screening uptake among those living with either one of the disease (28.5%) than among those living with neither hypertension or HIV. The highest proportion was found among those who had ever been diagnosed with hypertension (24.1%) and among women with positive HIV test results (36.7%). There was a significantly higher likelihood of undergoing screening for cervical cancer among women living with at least one of the diseases [AOR = 2.4; 95% CI: 1.4–2.8], compared to those without these conditions. Women diagnosed with hypertension showed increased likelihood of undergoing CCS [AOR = 1.4; 95%CI: 1.1–1.7]. Similarly, women with a positive HIV test result demonstrated higher odds of screening uptake [AOR = 5.2; 95%CI: 4.0-6.7]. Conclusion The study found a positive association between comorbidities and CCS uptake in Tanzanian women. Our findings emphasize the critical importance of ensuring accessibility and adherence to essential screenings for individuals with chronic morbid conditions. Future efforts should focus on strengthening existing integrated services and identifying potential barriers to accessing CCS within these healthcare settings to optimize cervical cancer prevention efforts for individuals with chronic morbidities.
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