Abstract:

Introduction: Cervical cancer and HIV infection are highly burdening diseases in developing countries. It is approximated that 85% of cervical cancer cases and deaths occur in developing countries; where 95% of women are not screened for premalignant cervical lesions. Ushetu district has HIV prevalence of 6.3% and premalignant cervical lesions screening was not done due to the lack of technical knowhow and unavailability of screening tools. Therefore, this study aimed at establishing information on prevalence of premalignant cervical lesions and associated factors among HIV positive women in this district.

Methodology: A cross sectional health facilities based study was conducted at Ushetu district health facilities from July to September 2016. 505 HIV positive women ho where attending care and treatment clinics (CTC) were enrolled into the study. Pretested structured questionnaire, CTC cards/database and cervical cancer screening register were used to obtain demographic information, clinical information, level of knowledge on premalignant cervical lesions and screening results. Screening of premalignant cervical lesions was done using visual inspection with acetic acid (VIA) method. Data were analyzed using STATA software version 11.0 according to the objectives of the study.

Results: Majority of the participants were from catchment of Chambo dispensary, 132 (26.1%) and Ukune health centre, 132 (26.1%). The median age (IQR) of the study participants was 39 (32- 46). Their baseline and current median CD4 counts (IQR) were 291 (150-444) and 459 (345-650) respectively. Majority of participants were less knowledgeable on premalignant cervical lesions 375 (74.3%) and the prevalence of premalignant cervical lesions was 11.3% (57/505). Presence of premalignant cervical lesions was significantly associated with lower median age (p-value=0.012), shorter duration on ART (p-value=0.002) and less knowledge (p-value=0.027).

Conclusion and Recommendation: Premalignant cervical lesions are prevalence among HIV positive women; therefore screening is recommended and should be integrated in HIV care and treatment clinics in Ushetu District.