Uptake of Cervical Cancer Screening and the Associated Factors Among Women Living With HIV in Northern Tanzania

Abstract Background: HIV infection is a common risk for developing cervical cancer (CC). Routine screening for CC among women living with Human Immune Deficiency Virus (WLHIV) is recommended for early detection and control of pre-malignancies. Evidence on CC uptake and its associated factors is scanty among WLHIV in Tanzania similar to other sub-Saharan Africa (SSA) countries. This study therefore aimed to assess the uptake of CC screening and its associated factors among WLHIV in Tanzania. Methods: This cross-sectional study was conducted between June and September 2020 among WLHIV attending Care and Treatment Center (CTC) at the Kilimanjaro Christian Medical Center (KCMC). Data was collected through face to face interview using a pre-tested standardized questionnaire interviewed in Swahili. Analyses were conducted using descriptive statistics to establish the CC uptake and using regression analyses to characterize the CC screening uptake and factors associated with the CC uptake through SPSS version 23 software. Associations with P<0.05 were considered statistically significant. Results: A total of 341 WLHIV with mean age 45.6 years (SD 10.8) were recruited for interview. Of them, 184 (54%) WLHIV reported ever being screened for cervical cancer. After adjusting for confounders, knowledge of the screening methods was one of the factors associated with uptake of CC screening [AOR=15.61, (95% CI: 7.93-30.72), p<0.0001]. Other factors included living with HIV for at least 10 years since diagnosis [AOR=2.83; (95% CI: 1.11-7.26), P=0.030]; having knowledge of CC [AOR= 1.75, (95% CI: 1.02-3.01), p=0.041]; and having knowledge of the signs or symptoms of CC [AOR=1.95, (95% CI: 1.17-3.27), p=0.011]. Conclusion: More than four in ten WLHIV attending CTC at KCMC have never been screened for cervical cancer. Knowledge of the available screening methods, the disease condition, and duration since fist HIV diagnosis were associated with CC uptake of the screening. Addressing low CC screening uptake in Tanzania call strengthening WLHIV’s knowledge on cervical cancer screening methods, its signs, symptoms and their risk profiles. Moreover, strengthening CC screening capacity through integrated care and strengthening health providers’ capacity for counseling and screening will lead into a sustainable and effective care.