Outcome and barriers to cervical cancer screening amongst human immunodeficiency virus-positive women attending Aminu Kano Teaching Hospital, Kano State, Nigeria

Abstract

Sub-Saharan Africa carries the overwhelming share of the global burden of human immunodeficiency virus (HIV) infection and of HIV-associated cervical cancer. Screening is an effective strategy for the prevention, early diagnosis and prompt management of cervical precancerous lesions among HIV-positive women. This study assessed the outcome and barriers to cervical cancer screening among HIV-positive women attending Aminu Kano Teaching Hospital, Kano. Using a cross sectional study design, a pro forma was used to collect data and screen 740 HIV-positive women. Screening was done using visual inspection with acetic acid and Lugol’s iodine and the data were analysed using SPSS version 24.0. The age of the patients ranged from 25 to 49 years with a mean age of 30.7 ± 2.4 years. Majority (n=698; 94.3%) were  30 years and married (n=592; 80.0%). Almost half (n=362; 48.9%) had secondary level of education and many (n=520; 70.3%) were unemployed. A few (n=42; 5.7%) had positive results on visual inspection with acetic acid and a lesser proportion (n=26; 3.5%) had positive screening results on visual inspection with Lugol’s iodine. Lack of awareness of screening services for cervical cancer was found to be a barrier to cervical cancer screening and treatment among two-thirds (n=565; 76.4%) of the patients while a substantial proportion (n=592; 80.0%) reported that their personal belief which was strengthened by their religion prevented them from accessing cervical cancer screening services. Also, two-thirds (n=493; 66.6%) agreed that their culture which considers cervical screening a taboo was a barrier to screening. There is a need for targeted and enhanced education with counselling to optimize the uptake of screening for cervical cancer among HIV-positive women in HIV treatment centers. The generated data can guide in the provision of evidence-based policy and decision-making.