Improved awareness of Pap test by Nigerian women may not necessarily increase its use. This hypothesis was tested using female medical practitioners in Enugu state, Nigeria. They were expected to be advocates of disease screening and therefore should lead by example. All respondents were aware of the Pap smear but only 18% had used it. The mean frequency of Pap smear was 1.8+/-1.2 (range 1-5). Repeat Pap tests were observed only among respondents that had screened as routine. The majority (32%) of those who never screened for cervical cancer had no reason. There may be more to the use of Pap smear among women in Nigeria than its awareness.

This study was carried out in two medical facilities in Enugu, Nigeria, from September to November 2007. An interviewer-administered questionnaire was used to collect data from HIV-positive pregnant women accessing PMTCT (prevention of maternal-to-child transmission) services at the two centres. Ninety-two women were interviewed: 89 (96.7%) had disclosed their status, while 3 (3.3%) had not. Of the 89 women who had disclosed, 84 (94.4%) had disclosed to partners, 82 (92.1%) to husbands, 2 (2.2%) to fiancés, 18 (20.2%) to sisters, 13 (14.6%) to mothers, 10 (11.2%) to brothers, 10 (11.2%) to fathers and 10 (11.2%) to priests. Fifty-two (58.4%) gave emotional support as the reason for disclosure and 46 (51.7%) gave economic and financial support as reasons. Fifty-six (62.9%) reported understanding from partner as a positive outcome and 44 (49.4%) reported financial support. Forty-six (51.7%) reported no negative outcome. Serostatus disclosure rate in this study was high with most women disclosing to their partners.

Although cervical cancer is the commonest cause of cancer death in Nigeria, the use of cervical cancer screening is poor. This study aimed at determining the awareness and use of the available cervical cancer screening method (Pap smear) by women attending the outpatient clinics of a tertiary institution in Enugu, South-eastern Nigeria. Questionnaires were administered to 912 women from November 2005 to May 2006. A total of 550 (60.3%) respondents knew about cervical cancer but only 41.2% of them were aware of the Pap smear. Only 89 (9.0%) respondents had used the Pap smear. The majority (61.9%) of those who had not been screened despite knowledge of the Pap smear had no reason, while the remaining 112 (38.1%) felt they were not susceptible to cervical cancer. The use of the Pap smear among women attending the outpatient clinics in Enugu, Nigeria is very low. Routine cervical cancer counselling and screening with opt-out option should be offered to every eligible woman attending the outpatient clinics.

The objective of this study was to assess the attitude of men in Nigeria towards vasectomy as a method of family planning. This was a cross-sectional study, using self-administered pre-tested questionnaires containing mainly close-ended questions. The questionnaires were given to 146 randomly selected men. The responses were analyzed with descriptive statistics. Ten (6.8%) may accept vasectomy with the knowledge they have while 130 (89.0%) will not. Eighty-eight (67.7%) believe sterilization procedures should be left for women only. Vasectomy was viewed as castration by 55 (40.7%). Forty-three (31.2%) may consider vasectomy if they understand that it is not associated with problems, 82 (59.4%) refused while 13 (9.4%) did not know if they would ever accept the procedure. There was a lack of knowledge of vasectomy and attitudes towards it were based on myths and misconceptions regarding the procedure; some may accept it if they understand the safety of it. Interestingly, level of education does not improve vasectomy uptake. A concerted effort to involve men in reproductive health is needed. Interpersonal communication and counseling will greatly improve vasectomy uptake in developing countries.

HIV infection is a risk factor for cervical cancer and both diseases are prevalent in Nigeria. The study determined the prevalence of cervical squamous intraepithelial lesion (SIL) among HIV-positive women in Enugu state, which has the highest HIV burden in South-eastern Nigeria. Pap smear was carried out on 150 HIV-positive (HIV+ve) women and 150 HIV-negative (HIV?ve) controls at the University of Nigeria Teaching Hospital, Enugu, Nigeria from December 2007 to March 2008. The prevalence of SIL for the HIV+ve group and the control group were 12.6% and 4.6%, respectively (p = 0.014). Also, the prevalence of each category of SIL identified in the study, was higher among the HIV+ve group. There is an association between HIV infection and SIL in Enugu, South-eastern Nigeria. Cervical cancer screening should be incorporated into the antiretroviral (ARV) clinics, so as to prevent the impending surge in the burden of cervical cancer in Nigeria.