Impact of healthcare access and HIV testing on utilisation of cervical cancer screening among US women at high risk of HIV infection: cross-sectional analysis of 2016 BRFSS data

Abstract

ObjectivePrevious studies identified several factors associated with cervical cancer screening. However, many of them used samples from the general population and limited studies focused on women with high-risk health behaviours. We aimed to disentangle the association of cervical cancer screening with healthcare access and HIV testing among women at a high risk of HIV infection.DesignNationwide cross-sectional survey in the USA.Setting2016 Behavioral Risk Factor Surveillance System.Participants3448 women with a history of high-risk behaviours associated with HIV infectionExposure and outcomeClinical check-up, having personal healthcare provider, health coverage and HIV testing history were treated as exposures. Appropriate cervical cancer screening, which was defined according to 2016 US Preventive Services Task Force guideline, was treated as the outcome of interest.Data analysisMultivariable logistic regression model was performed to evaluate associations of healthcare access and HIV testing with the uptake of cervical cancer screening; adjusted odds ratio (aOR) and 95% CI were reported. We further investigated if educational attainment modified associations identified in the primary multivariable model.ResultsA total of 2911 (84.4%) high-risk women in our sample underwent cervical cancer screening. In the multivariable model, delayed clinical check-up (≥5 years ago vs within the past year: aOR: 0.19, 95% CI: 0.14 to 0.26), having no health insurance (aOR: 0.60, 95% CI: 0.46 to 0.79) and no history of HIV testing (no testing vs testing within the past year: aOR: 0.46, 95% CI: 0.35 to 0.61) were inversely associated with cervical cancer screening utilisation.ConclusionFactors reflecting healthcare access, specifically clinical check-up and health coverage, as well as history of HIV testing were associated with cervical cancer screening in this population-based study of high-risk women. Targeted interventions are warranted to further increase cervical cancer screening among women at high risk of HIV infection.

Awareness of cervical cancer screening services and uptake of free liquid-based cytology test among brothel-based female sex workers in Sokoto State, Nigeria

“…The highest proportion (72.1%) of the respondents utilised the free LBC test offered in this study, which is impressive and comparable to studies done in the USA (84.4%) and India (98.6%) (Joshi et al, 2015;Zhang et al, 2020), The later studies reported higher figures probably because USA has an organized Ca Cervix screening programme while the study in India offered the services free to the FSWs. The commonest barrier to reported past uptake of Ca Cervix screening services was lack of awareness, followed by lack of request by the doctor, which further buttresses the importance of Source: Author awareness in the utilisation of such services.…”

Is education or income associated with insufficient fruit and vegetable intake among cancer survivors? A cross-sectional analysis of 2017 BRFSS data

“…Participants’ self-reported histories of routine clinical check-ups and healthcare coverage that included health insurance, prepaid plans (eg, Health Maintenance Organization), government plans (eg, Medicare) and Indian Health Service. 23 Cancer-related indicators included time elapsed since cancer diagnosis, number of cancers diagnosed and cancer type.…”