Participation and acceptance of cervical cancer screening among HIV-infected women visiting antiviral outpatient clinics in Yunnan province: a hospital-based survey

Abstract

ObjectiveTo analyze past participation in cervical cancer screening and its influencing factors among human immunodeficiency virus type 1 (HIV-1) positive women attending the antiviral clinics in Kunming city of Yunnan province, and to examine the acceptance and procedure preference of cervical cancer screening among the population. MethodsUsing continuous sampling, we recruited 419 HIV-1-positive women receiving antiretroviral therapy (ART) at the Antiviral Clinic of the Third People’s Hospital of Kunming city, Yunnan province from January 2019 to August 2020. Relevant information was collected from medical records or by on-site survey using a self-developed semi-structured questionnaire. Health education on cervical cancer and cervical screening were conducted concurrently with the survey. Multivariate logistic regression analysis was used to analyze factors influencing past participation in cervical cancer screening. ResultsOf the 411 participants with valid responses, 69.83% reported the awareness of cervical cancer screening and 39.66% had participated in screening. Multivariate analysis showed that participants with the following characteristics were more likely to have participated in cervical cancer screening: age 41 – 50 years (odds ratio [OR] = 2.768, 95% confidence interval [CI]: 1.278 – 5.996), having completed secondary education (OR = 2.111, 95%CI: 1.199 – 3.719) or higher education (OR = 3.056, 95%CI: 1.315 – 7.105), being a non-smoker (OR = 4.281, 95%CI: 1.773 – 10.338), having experienced post-sexual bleeding (OR = 2. 463, 95%CI: 1.249 – 4.859), receiving ART for 2 years or more (OR = 2.733, 95%CI: 1.321 – 5.654), and being aware of cervical cancer screening (OR = 13.574, 95%CI: 6.114 – 30.136); however, those with a most recent CD4 count ≤ 500 cells/μL (OR = 0.463, 95%CI: 0.267 – 0.804) were less likely to have participated in the screening. After receiving on-site health education, 96.59% of participants reported willingness to participate in cervical cancer screening, 93.20% reported willingness to accept further examination upon recall, and 77.58% agreed to undergo treatment if necessary. ConclusionAwareness and uptake of cervical cancer screening were low among HIV-infected women attending an antiviral clinic in Kunming city. Factors influencing the participation of HIV-infected women in screening should be fully considered when implementing cervical cancer screening programs, as well as the propensity of this high-risk group to seek related health care services.

Keywords

• hiv-infected women
• cervical cancer
• screening
• participation
• acceptance