Factors associated with underutilization of cervical cancer screening services among HIV positive women in Serenje District, Central Province
Résumé
Abstract Cervical cancer is the most common cancer among women living with Human Immunodeficiency Virus (UNAIDS 201959). An estimated 604,000 new cases were diagnosed globally and an estimate of 342,000 deaths recorded in 2020 (Sung et al., 2021). According to WHO (202056) about 6.5% of all female cancers are cervical cancer related and 5% of cases are attributable to HIV. Zambia is ranked second on incidences of Cervical Cancer and mortality is estimated at 1,839 (WHO, 202030). Current utilization of cervical cancer screening services (CCSS) in Zambia among HIV positive women at 27%, implies underutilization (UNAIDS 201959). HIV Positive women in Serenje District have not been utilizing the services, as the percentage (25.8) of women accessing the service is low. This study determined factors associated with underutilization of Cervical Cancer Screening Services (CCSS) among HIV + women in Serenje district. Methods; Descriptive cross-sectional study was conducted involving 303 HIV positive women in Serenje District of central province, Zambia. Systematic random sampling was used to recruit respondents from selected facilities and a structured questionnaire used for data collection. Statistical Software (STATA V 15), Univariate/bivariate and multivariable logistic regressions were performed to determine associations between variables. Results; Utilisation of CCSS in Serenje District was low. Only 42.24% of respondents reported utilizing the service. Being far from a healthcare facility [AOR: 0.49 (P < 0.036, 95% CI 0.25–0.96)], having low/inadequate knowledge [AOR: 0.26 (P < 0.001, 95% CI 0.13–0.54)], Low income [AOR: 0.16 (P < 0.001, 95% CI 0.06–0.37)] and attitude of women on CCSS [AOR: 0.26 (P < 0.001, 95% CI 0.12–0.53)] contributed to reduced utilisation. Conclusion; low knowledge, poor attitude and far distances to facilities as well as poor socio economic status were found to be the contributing factors to underutilization of the CCSS. In order to take the CCSS as closer to the communities as possible, it is recommended that the District designs and implements awareness campaigns on cervical cancer screening service; engages in outreach awareness campaigns; and conducts screening camps.
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