Knowledge, awareness and attitudes about cervical cancer among women attending or not an HIV treatment center in Lao PDR

Abstract

BackgroundCervical cancer is the first female cancer in Lao PDR, a low-income country with no national screening and prevention programs for this human papillomavirus (HPV) associated pathology. HIV-infected women have a higher risk of persistent oncogenic HPV infection.The purpose of this study was to determine the knowledge, awareness and attitudes about cervical cancer among Lao women attending or not an HIV treatment center, in order to understand if this attendance had offered an opportunity for information and prevention.MethodsA cross-sectional case–control survey was conducted in three provinces of Lao PDR, Vientiane, Luang Prabang and Savannakhet. Cases were 320 women aged 25 to 65, living with HIV and followed in an HIV treatment center. Controls were 320 women matched for age and place of residence, not attending an HIV treatment center.ResultsCases had a greater number of sexual partners and used condoms more often than controls. Only 36.6% of women had consulted a gynecologist (47.5% among cases and 25.6% among controls, p < 0.001) and 3.9% had benefited from at least one Pap smear screening (5.6% cases and 2.2% controls, p = 0.02). The average knowledge score was 3.5 on a 0 to 13 scale, significantly higher in cases than in controls (p < 0.0001). Despite having a lower education level and economic status, the women living with HIV had a better knowledge about cervical cancer and were more aware than the controls of the risk of developing such a cancer (35.9% vs. 8.4%, p = 0.0001). The main source of information was healthcare professionals. The main reasons for not undergoing Pap smear were the absence of symptoms and the default of medical injunction for cases, the lack of information and ignorance of screening usefulness for controls.ConclusionIn Lao PDR, routine consultation in HIV treatment centers is not enough harnessed to inform women of their high risk of developing cervical cancer, and to perform screening testing and treatment of precancerous lesions. Implementing this cost-effective strategy could be the first step toward a national prevention program for cervical cancer.

Knowledge about cervical cancer and barriers toward cervical cancer screening among HIV‐positive women attending public health centers in Addis Ababa city, Ethiopia

“…Some respondents also mentioned fear of the test results. A study conducted in LAO PDR had similar findings, in that the majority of the respondents reasoned no symptoms, followed by having never heard of screening [27]. HIV-positive South African and Nigerian women reported fear of procedure and anticipated cost of the test, respectively, as the main barrier [13,22].…”

“…Half of 294 (50.6%) of the study participants said cervical cancer is preventable, which is substantially higher compared to findings in other settings. Much lower proportion was reported in Johannesburg, Burkina Faso, and LAO PDR [27][28][29]. These variations may in part reflect differences in awareness creation strategies, including the extent of media coverage, and as well as cultural differences.…”

Awareness of cervical cancer risk factors and symptoms: cross‐sectional community survey in post‐conflict northern Uganda

“…Perhaps women interact more with health‐care professionals during child and maternal health visits which men in East Africa rarely attend . In the DRC, the commonest source of information was health‐care professionals . These sources of information may all be used to increase awareness about HPV and Pap smears.…”

“…[62][63][64] In the DRC, the commonest source of information was health-care professionals. 65 These sources of information may all be used to increase awareness about HPV and Pap smears.…”

Cervical cancer screening practices, knowledge of screening and risk, and highly active antiretroviral therapy adherence among women living with human immunodeficiency virus in Lima, Peru

“…This recommendation is also observed by the Centers for Disease Control and Prevention (CDC) 7 who add that annual testing should follow 2 Paps within 1 year of HIV diagnosis. Potential predictors of CC screening practices include knowledge of risk 8, 9 and adherence to other health programs (i.e. highly active antiretroviral therapy “HAART” enrollment).…”