Socio-demographic characteristics influencing cervical cancer screening intention of HIV-positive women in the central region of Ghana

Abstract

BackgroundThe burden of HIV and cervical cancer is concentrated in sub-Saharan Africa. Women with HIV are more likely to have persistent HPV infection leading to cervical abnormalities and cancer. Cervical cancer screening seems to be the single most critical intervention in any efforts to prevent cervical cancer. The purpose of this study was to determine the socio-demographic factors influencing intention to seek cervical cancer screening by HIV-positive women in the Central Region of Ghana.MethodsA descriptive cross-sectional study involving a convenience sample of 660 HIV-positive women aged 20 to 65 years receiving antiretroviral therapy in HIV care centres in the Central Region of Ghana was conducted using an interviewer-administered questionnaire. The data were summarised and analysed using frequencies, percentages and binary logistic regression.ResultsThe study revealed that 82.0% of HIV-positive women intended to obtain cervical cancer screening. Level of education was a determinant of cervical cancer screening intention. HIV-positive women with low levels of education were 2.67 times (95% CI, 1.61–4.42) more likely to have intention to screen than those with no formal education. Those with high levels of education were 3.16 times (95% CI, 1.42–7.02) more likely to have intention to screen than those with no formal education. However, age, religion, marital status, employment status, and ability to afford the cost of cervical cancer screening were not determinants of intention to screen.ConclusionsEducation of women of all ages needs to be a priority, as it could enable them to adopt appropriate health behaviours and engage in cervical cancer screening. Additionally, interventions to improve understanding of cervical cancer screening among HIV-positive women are highly recommended. These include health education about the disease and availability of screening options in HIV/AIDS care centres.

Cervical Cancer Screening Uptake and Associated Factors among HIV-Positive Women in Ethiopia: A Systematic Review and Meta-Analysis

“…This systematic review and meta-analysis revealed that HIV-positive women having formal education were 3.50 times more likely to be screened for cervical cancer as compared with HIV-positive women who have no formal education. This finding was supported by previous studies [ 44 , 53 , 54 ]. The reason could be the fact that women who are educated have better understanding of the cause, risk factors, prevention mechanism, and treatment of the disease given from healthcare workers, mass media, and different stakeholder.…”

Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study

“…That is, women who had post-primary level of education are more likely to use CCS services than those with no formal education levels. The same finding was observed in studies done in, India [29], Nigeria [30], Ghana [31], Gondar [18] and Addis Ababa [19], in which level of education can predict CCS. Similarly, a study conducted in Italy [32] reported lack of Pap-smear in the last year was significantly associated with lower educational level.…”

A cross-sectional study of barriers to cervical cancer screening uptake in Ghana: An application of the health belief model

“…An outcome which was not consistent with the current study. However, a study conducted in Ghana showed that marital status is not a statistically significant determinant of women' intention to have CC screening [48]. Thus the influence of marital status on CC screening appears to be inconsistent across studies.…”

“…Similarly, a study in Ethiopia said that women who were employed were four times more likely to utilize CC screening services [47]. However, amongst HIV patients, a study conducted in Ghana indicated that employment was not expected to affect the intention to have CC screening [48]. A possible explanation to this finding could be attributed to the fact that women who are employed have the financial ability to afford the cost of screening or perhaps they are keen on their health to be able to continue their work.…”

“…Thus, education could play a significant role in enhancing participation of CC screening activities. According to Ebu [48], educated women are placed in a position to understand health risk and so are more likely to engage in screening test. Education tends to change beliefs and unfavourable behaviours towards interventions put in place to enhance knowledge of health and illness [49].…”