Abstract:

Women living with Human Immunodeficiency Virus (WLHIV) have a higher risk of developing cervical cancer due to their immune-compromised state. Cervical cancer screening leads to early detection and treatment. The aim of the study was to determine the knowledge, attitude, and practices of cervical cancer screening among women infected with HIV in Kasenengwa District, Eastern Province, Zambia. A descriptive cross-sectional study design using a semi-structured questionnaire was used to collect data from 266 WLHIV. Basic descriptive statistics were done using SPSS version 23.0. Almost two-thirds (62.7%) of the 266 WLHIV in the study had adequate knowledge about cervical cancer screening. Almost three-fifths of the respondents (57.1%) had a negative attitude toward cervical cancer screening. The majority (78.2%) had been counselled by healthcare workers on cervical cancer screening with good emotional support from family members (72.9%). About two-thirds (68.4%) of the respondents had been screened for cervical cancer. Most women indicated that they didn’t have access to cervical cancer screening services because they did not know where to go (61.5%) and distant screening sites (56.3%) WLHIV in the study had adequate knowledge, but unfavorable attitude towards cervical cancer screening, while two-thirds had been screened for cervical cancer. Accessibility to screening sites was poor. More education and sensitization are needed in the district to eliminate misconceptions about cervical cancer screening, which may influence uptake.

References:

[1] Moshi, F. V., Vandervort, E. B., & Kibusi, S. M. (2018). Cervical Cancer Awareness among Women in Tanzania: An Analysis of Data from the 2011-12 Tanzania HIV and Malaria Indicators Survey. International journal of chronic diseases, 2018, 2458232. https://doi.org/10.1155/2018/2458232.

[2] Mungo, C., Cohen, C. R., Maloba, M., Bukusi, E. A., & Huchko, M. J. (2013). Prevalence, characteristics, and outcomes of HIV-positive women diagnosed with invasive cancer of the cervix in Kenya. International journal of gynecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 123(3), 231–235. https://doi.org/10.1016/j.ijgo.2013.07.010.

[3] Chambuso, R. S., Shadrack, S., Lidenge, S. J., Mwakibete, N., & Medeiros, R. M. (2016). Influence of HIV/AIDS on Cervical Cancer: A Retrospective Study from Tanzania. Journal of global oncology, 3(1), 72–78. https://doi.org/10.1200/JGO.2015.002964.

[4] Costing the national strategic plan on prevention and control of cervical cancer: Zambia, 2019–2023. World Health Organization, Geneva 2020 https://cdn.who.int/media/docs/default-source/cervical-cancer/zambia-cxca-costing-report 20201112.pdf?sfvrsn=a433474c_4&download=true Date accessed: July 21, 2021.

[5] Kimondo, F. C., Kajoka, H. D., Mwantake, M. R., Amour, C., & Mboya, I. B. (2021). Knowledge, attitude, and practice of cervical cancer screening among women living with HIV in the Kilimanjaro region, northern Tanzania. Cancer Reports. https://doi:10.1002/cnr2.1374.

[6] WHO. Comprehensive Cervical Cancer Control: A Guide to Essential Practice. 2nd ed. Geneva: WHO; 2014:408.

[7] Liu, G., Sharma, M., Tan, N., & Barnabas, R. V. (2018). HIV-positive women have a higher risk of human papilloma virus infection, precancerous lesions, and cervical cancer. AIDS (London, England), 32(6), 795–808. https://doi.org/10.1097/QAD.0000000000001765.

[8] Wanyenze, R. K., Bwanika, J. B., Beyeza-Kashesya, J., Mugerwa, S., Arinaitwe, J., Matovu, J., Gwokyalya, V., Kasozi, D., Bukenya, J., & Makumbi, F. (2017). Uptake and correlates of cervical cancer screening among HIV-infected women attending HIV care in Uganda. Global health action, 10(1), 1380361. https://doi.org/10.1080/16549716.2017.1380361.

[9] Centre for Infectious Disease Research in Zambia. Women’s Health: Cervical Cancer. 2021. http://www.cidrz.org/cervical-cancer/. Accessed 22 July 2021.

[10] Nyambe, A., Kampen, J. K., Baboo, S. K., & Van Hal, G. (2019). Knowledge, attitudes, and practices of cervical cancer prevention among Zambian women and men. BMC public health, 19(1), 508. https://doi.org/10.1186/s12889-019-6874-2.

[11] American Cancer Society. Cancer Statistics Center. http://cancerstatisticscenter.cancer.org Accessed March 14, 2022.

[12] Fitzpatrick, M., Pathipati, M. P., McCarty, K., Rosenthal, A., Katzenstein, D., Chirenje, Z. M., & Pinsky, B. (2020). Knowledge, attitudes, and practices of cervical cancer screening among HIV-positive and HIV-negative women participating in human papillomavirus screening in rural Zimbabwe. BMC women’s health, 20(1), 153. https://doi.org/10.1186/s12905-020-01017-2.

[13] Tchounga, B., Boni, S. P., Koffi, J. J., Horo, A. G., Tanon, A., Messou, E., Koulé, S. O., Adoubi, I., Ekouevi, D. K., & Jaquet, A. (2019). Cervical cancer screening uptake and correlates among HIV-infected women: a cross-sectional survey in Côte d’Ivoire, West Africa. BMJ Open, 9(8), e029882. https://doi.org/10.1136/bmjopen-2019-029882.

[14] Kabalika, C., Mulenga, D., Mazaba, M. L., & Siziya, S. (2018). Acceptance of Cervical Cancer Screening and its Correlates Among Women of a Peri-Urban High-Density Residential Area in Ndola, Zambia. International Journal of MCH and AIDS, 7(1), 17–27. https://doi.org/10.21106/ijma.223.

[15] Shiferaw, N., Brooks, M. I., Salvador-Davila, G., Lonsako, S., Kassahun, K., Ansel, J., Osakwe, C., Weldegebreal, T., Ahmed, I., Asnake, M., & Blumenthal, P. D. (2016). Knowledge and Awareness of Cervical Cancer among HIV-Infected Women in Ethiopia. Obstetrics and gynecology international, 2016, 1274734. https://doi.org/10.1155/2016/1274734.

[16] Obalase S., Akindutire O., Adelusi O., Adegboro S., (2017) Knowledge and Awareness of Cervical Cancer Screening Among Women of Reproductive Age in Ikere Ekiti Local Government Area, Ekiti State, Nigeria. International Journal of caring sciences May– August 2017 Volume 10 | Issue 2| Page 755.

[17] Bogale, A. L., Teklehaymanot, T., Haidar Ali, J., & Kassie, G. M. (2021). Knowledge, attitude and practice of cervical cancer screening among women infected with HIV in Africa: Systematic review and meta-analysis. PloS one, 16(4), e0249960. https://doi.org/10.1371/journal.pone.0249960.

[18] Mtengezo, J. (2019). Knowledge and Attitudes Regarding Cervical Cancer Screening Among Women Living with HIV/AIDs in Malawi: A Cross-sectional Study Graduate Doctoral Dissertations. 458. https://scholarworks.umb.edu/doctoral_dissertations/458.

[19] Mutambara, Julia & Mutandwa, Phillip & Mahapa, Mildred & Chirasha, Vonai & Nkiwane, Sibusiso & Shangahaidonhi, Traquilister. (2017). Knowledge, attitudes, and practices of cervical cancer screening among women who attend traditional churches in Zimbabwe. Journal of Cancer Research and Practice. 4. 10.1016/j.jcrpr.2017.02.001.

[20] Ahmed, S. A., Sabitu, K., Idris, S. H., & Ahmed, R. (2013). Knowledge, attitude, and practice of cervical cancer screening among market women in Zaria, Nigeria. Nigerian medical journal: journal of the Nigeria Medical Association, 54(5), 316–319. https://doi.org/10.4103/0300-1652.122337.

[21] Ngwenya, D., & Huang, S. L. (2018). Knowledge, attitude, and practice on cervical cancer and screening: a survey of men and women in Swaziland. Journal of public health (Oxford, England), 40(3), e343–e350. https://doi.org/10.1093/pubmed/fdx174.

[22] Tsegay, A., Araya, T., Amare, K., & G/Tsadik, F. (2021). Knowledge, Attitude, and Practice on Cervical Cancer Screening and Associated Factors Among Women Aged 15-49 Years in Adigrat Town, Northern Ethiopia, 2019: A Community-Based Cross-Sectional Study. International journal of women’s health, 12, 1283–1298. https://doi.org/10.2147/IJWH.S261204.

[23] Nyambe, N., Hoover, S., Pinder, L. F., Chibwesha, C. J., Kapambwe, S., Parham, G., & Subramanian, S. (2018). Differences in Cervical Cancer Screening Knowledge and Practices by HIV Status and Geographic Location: Implication for Program Implementation in Zambia. African journal of reproductive health, 22(4), 92–101. https://doi.org/10.29063/ajrh2018/v22i4.10.