Low uptake of cervical cancer screening among HIV positive women in Gondar University referral hospital, Northwest Ethiopia: cross-sectional study design

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.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0579-z) contains supplementary material, which is available to authorized users.

Role of awareness on cervical cancer screening uptake among HIV positive women in Addis Ababa, Ethiopia. A cross-sectional study

“…According to this study, majority of the respondents (81.8%) had heard about cervical cancer which is comparable with a similar study conducted in Gondar 87.7% (16) and significantly higher than another study conducted in Gondar (49.6%) (17) and 56.2% in Nigeria (20). Those who had heard about cervical cancer screening in this study were 76.1%, which is higher than 37.8% from a study in Gondar (17), 42.7% in Addis Ababa (25) and 34.5% in Nigeria (20). The source of information in the majority of the cases was health personnel which was similar to other study conducted in Addis Ababa (18).…”

Human papilloma virus-related premalignant and malignant lesions of the cervix and anogenital tract in immunocompromised women

“…Studies have also been conducted to assess the therapeutic effectiveness of HPV vaccinations in the population of immunosuppressed patients [28].…”

“…The uptake of cervical screening in underprivileged countries is clearly even lower. Nega et al [28] reported a 10% lifetime uptake of cervical screening in Ethiopia among HIV positive females, and 93.4% of those were only screened after the diagnosis of HIV.…”

The prevalence and factors associated with cervical cancer screening among women in the general population: Evidence from National Health Survey

“…Cervical cancer is one of the most common causes of cancer death in women worldwide [1,2]. Incidence and mortality rates have decreased in high-resource countries.…”