Factors associated with uptake of cervical cancer screening among women living with HIV (25-60 years) at TASO Tororo ART Clinic

Abstract

Introduction Cervical cancer is a significant public health challenge globally, particularly in low-and middle income countries (LMICs) like Uganda, where women, especially those living with HIV, face a disproportionate burden of incidence and mortality. Despite Uganda's adoption of WHO guidelines for cervical cancer screening (CCS) since 2007, uptake remains low, particularly in rural areas. Therefore, this study aimed to determine the factors associated with uptake of CCS among Women Living with HIV (WLHIV) aged 25-60 years at TASO-Tororo ART clinic. Methodology It was a cross sectional study that employed mixed research methods. Quantitative data was collected using a pre-tested electronic researcher administered questionnaire to 383 WLHIV, while qualitative data were obtained using Key Informant Interviews and In Depth Interviews. Data was collected from June to July 2024. Quantitative analysis was done using STATA version 15.0, 2017 for descriptive statistics and modified Poisson regression to determine factors associated. Qualitative data was analysed thematically using Atlas ti.6. Results The uptake level of CCS was 76%. Women aged ≥50 years; Muslim women, those with social support, good knowledge of cervical cancer, positive attitude and those who received health worker recommendations had higher prevalence of CCS uptake. Health worker recommendation significantly influenced uptake of screening (Adjusted Prevalence Ratio APR: 2.14, 95% CI: 1.49-3.07). Qualitative findings revealed that health worker recommendations were a key facilitator for CCS while fear of procedure, lack of awareness, lack of reminders and high transportation costs were major barriers to CCS. Conclusion This study highlighted a moderately high uptake level of CCS among WLHIV, with health worker recommendations, good knowledge of CCS, and positive attitudes as key facilitators. However, barriers such as poor knowledge, fear of the procedure, lack of reminders, and transportation costs reveal areas of improvement.