Prevalence and predictors of cervical cancer screening among HIV-positive women in rural western Uganda: insights from the health-belief model

被引:4
作者
Vigneshwaran, Easwaran [1 ]
Goruntla, Narayana [2 ]
Bommireddy, Bhavana Reddy [3 ]
Mantargi, Mohammad Jaffar Sadiq [4 ]
Mopuri, Bhavani [3 ]
Thammisetty, Durga Prasad [5 ]
Veerabhadrappa, Kasturi Vishwanathasetty [6 ]
Bukke, Sarad Pawar Naik [7 ]
机构
[1] King Khalid Univ, Coll Pharm, Dept Clin Pharm, Abha, Saudi Arabia
[2] Kampala Int Univ, Sch Pharm, Dept Clin Pharm & Pharm Practice, Western Campus, Kampala, Uganda
[3] Raghavendra Inst Pharmaceut Educ & Res RIPER Auton, Dept Pharm Practice, Anantapur, Andhra Prades, India
[4] Batterjee Med Coll, Dept Pharmaceut Sci, Pharm Program, Jeddah 21442, Saudi Arabia
[5] Sri Padmavathi Sch Pharm, Dept Pharm Practice, Tirupati 517503, Andhra Prades, India
[6] Kampala Int Univ, Sch Pharm, Dept Pharmacognosy & Pharmaceut Chem, Western Campus, Kampala, Uganda
[7] Kampala Int Univ, Sch Pharm, Dept Pharmaceut & Pharmaceut Technol, Western Campus, Kampala, Uganda
关键词
Cervical cancer; Screening; HIV; Women; Health belief model; Uganda; KNOWLEDGE; SERVICES; BURDEN; RISK;
D O I
10.1186/s12885-023-11683-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundWomen living with HIV are at increased risk of developing cervical cancer (CC). Screening for cancer is an important preventive strategy for the early detection of precancerous lesions and its management. There has been inadequate evidence on cervical cancer screening (CCS) practices among HIV-positive women in rural western Uganda. This study aimed to assess the prevalence and predictors of CCS among HIV-positive women, as well as knowledge and practices regarding cervical cancer screening.MethodsA cross-sectional, analytical study was conducted among HIV-positive women attending HIV care facilities located in rural settings of western Uganda. A validated and interview-based data collection form was used to capture statistics regarding demographics, HIV care, obstetric profile, health belief constructs, and knowledge and history of CCS from the participants. Bivariate and multivariate logistic regression analyses were used to correlate women's characteristics and health beliefs toward CCS practices.ResultsThe prevalence of CCS among HIV-positive women was found to be 39.1% (95%CI: 14.0-71.7). A multivariate logistic regression analysis showed that post-secondary education attainment (AOR = 3.21; 95%CI = 2.12-7.28), four years or more lapsing after being diagnosed as HIV-positive (AOR = 2.87; 95%CI = 1.34-6.13), having more than one child (AOR = 1.87; 95%CI = 1.04-3.35), antenatal care attendance (AOR = 1.74; 95%CI = 1.02-3.43), post-natal care attendance (AOR = 3.75; 95%CI = 1.68-5.89), and having good knowledge regarding CC (AOR = 1.26; 95%CI = 1.98-3.02) were positively associated with adherence to CCS among HIV-positive women in western Uganda. Health Belief Model (HBM) constructs like the perceived risk of developing CC (AOR = 1.82; 95%CI = 1.16-2.01), worries about developing CC (AOR = 5.01; 95%CI = 4.26-8.32), believing that CC leads to death (AOR = 2.56; 95%CI = 1.64-3.56), that screening assists in early identification (AOR = 2.12; 95%CI = 1.84-3.74) and treatment (AOR = 4.63; 95%CI = 2.78-6.43) of precancerous lesions, reducing the risk of mortality (AOR = 1.84; 95%CI = 1.12-2.75), and the reassurance provided by negative test results (AOR = 2.08; 95%CI = 1.33-4.22) were positively associated with adhering to CCS. A female doctor performing the screening (AOR = 2.02; 95%CI = 1.57-3.98) as well as offering a free screening service (AOR = 3.23; 95%CI = 1.99-4.38) were significantly associated with CCS. Meanwhile, screening being painful (AOR = 0.28; 95%CI = 0.12-0.45), expensive (AOR = 0.36; 95%CI = 0.24-0.53), time-consuming (AOR = 0.30; 95%CI = 0.19-0.41), embarrassing (AOR = 0.02; 95%CI = 0.01-0.06), and the fear of positive results (AOR = 0.04; 95%CI = 0.02-0.10) were found to have a significant negative association with adhering to CCS.ConclusionsOnly one-third of HIV-positive women had undergone CCS. Variables including secondary education attainment, four years or more lapsing after being diagnosed as HIV-positive, having more than one child, antenatal care attendance, post-natal care attendance, and knowledge about CC were positively associated with CCS adherence. Educational programs should be geared towards the risk of CC, severity of cases, benefits of screening, and reducing barriers associated with screening, which can significantly improve cervical CCS among HIV-positive women. The study proposes the incorporation of free screening services and the inclusion of trained female staff in CC prevention policies to improve CCS.
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页数:16
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