Factors Affecting Cervical Cancer Screening Among Women Living with HIV in Ndola District

Abstract

The cervix is the lower, narrow part of the uterus in the female reproductive system and connects the uterus to the vagina, forming part of the birth canal. In 2018, Zambia had the third highest incidence of cervical cancer in the world with 66.4 new cases per 100,000 women despite the establishment of the Cervical Cancer Prevention Program in Zambia (CCPPZ) in 2006. The high incidence of cervical cancer is linked to the heavy burden of HIV and AIDS. Globally, approximately 311,000 women died from cervical cancer in 2018, with over 570,000 living with the disease. Although there is substantial literature on factors affecting cervical cancer (CACX) screening among women living with HIV worldwide, there is inadequate knowledge on this topic in Ndola District of the Copperbelt Province. This descriptive cross-sectional study was conducted in Ndola District using a quantitative data collection method through a semi-structured questionnaire administered to women living with HIV aged above 15 years. Participants were selected using simple random sampling and were clients on ART for at least 12 months at their respective facilities. Data were entered in Excel and imported into STATA version 14.0 statistical software, where descriptive, chi-square, and logistic regression analyses were performed using a 95% confidence level. Out of the 400 participants, 67% had not been screened for CACX in the past 12 months while only 33% had been screened, indicating that screening coverage remains below the 75% target. The main reasons cited for not accessing screening were fear of pain during the procedure (43%), being shy (30.75%), lack of awareness of the service (13%), long distance to the facility (11.25%), and lack of qualified staff (2%). The study revealed low uptake of CACX screening services among women living with HIV, mainly associated with fear of pain and shyness.