The CHESS Protocol: A Mixed-Methods Evaluation of an HPV Screening Intervention for Women Living With HIV in Nigeria

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Objectives: In this protocol, we describe a planned intervention to adapt the Mother Mentor (MoMent) peer support program for women living with HIV (WLWH). WLWH face a six-fold higher risk of cervical cancer, yet screening and treatment rates remain low in Nigeria. Methods: Using an implementation science approach, we will engage key stakeholders-including ministries of health, NACA, professional bodies, WLWH, Mentor Mothers, healthcare providers, and development partners (e.g., WHO, US CDC, USAID)-through deliberative democracy to adapt and expand MoMent for home-based HPV screening and follow-up treatment. We will pilot the adapted MoMent HIV+HCC program with 1,500 women in 15 health facilities across Nigeria's five geopolitical zones. The RE-AIM framework will guide evaluation of reach, adoption, fidelity, effectiveness, and sustainability. Results: This study is designed to contribute to WHO's global strategy to eliminate cervical cancer by improving access to home-based screening and care in low-resource settings. Conclusion: Findings will inform national HPV prevention efforts and may drive broader integration into Nigeria's cervical cancer program. Clinical Trial Registration: Clinicaltrials.gov, identifier NCT06751030.

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