Abstract:

Background: Cervical cancer is one of the most common neoplastic diseases affecting women, with a combined worldwide incidence of almost half a million new cases annually, second only to breast cancer. Cervical cancer remains the most common cancer among women in Eastern and central Africa, and the disease is strongly associated with high risk serotypes of human papilloma virus (HPV), which are mostly transmitted through sexual intercourse among other ways. The situation is complicated by the high prevalence of HIV which is estimated to be 8% in general population, the proportion of women at risk is expected to be high as HIV infection is associated with a rapid progression of invasive cervical cancer. This study aimed at assessing the awareness, knowledge and readiness for cervical cancer screening among HIV positive women attending health services in Mwanza city.

Methodology: A cross sectional hospital based study was conducted in Mwanza city, involving 156 HIV positive women aging 18 years and above. The Swahili version questionnaire was used to interview the respondents. The information collected included demographical characteristics of respondents, awareness and basic knowledge on cervical cancer including the cause, risk factors, common ways of HPV transmission, common symptoms, modalities of treatment, prevention and suggestions from respondents on various ways to be used for community education about the disease. Also information about screening practices and readiness for screening were collected. Information collected was analysed and processed using statistical package of social sciences version 17.0.


Results: Most of the participants (84.0%) admitted to have heard about cervical cancer, where by mass media was 41.2% was the most common way of getting information. Of all participants, only 37.7% had ever screened for cervical cancer at least once, and among these, 25.5% had screened two or more times. Among those who had never screened, 96.2% of them said to be ready for screening upon being given necessary information and education on cervical cancer. The commonest reasons for not screening were; 27.6% not aware of the screening services, 12.2% didn’t see the symptoms, 10.3% see no need for screening, 8.3% didn’t get time for screening because of were so busy. 26.3% correctly identified HPV as the cause for cervical cancer, 32.1% correctly identified coitus as the common way for HPV transmission. Also, 76.9% didn’t know HIV to be the risk factor for developing cervical cancer. Only 14.7% correctly identified both multiple sexual partners and early sexual debut as risks associated with increased likelihood for HPV infection. Average of 59.08% correctly identified all six mentioned symptoms of cervical cancer. Also, 10.7% were able to identify all three mentioned treatment modalities for cervical cancer. 23.7% were aware of presence of vaccine against some HPV types but only 4.5% of these participants knew the recommended time for vaccine administration. 12.8% knew the recommended time to start cervical cancer screening and 49.4% knew the recommended time interval between screening episodes. The overall knowledge level on cervical cancer was 27.2%. Moreover, 58.3% suggested all the places/ways mentioned in the study to be used for provision of education and information on cervical cancer.

Conclusion: In spite of the efforts by the government, and other stakeholder in combating cervical cancer, there is still a significant lack of education and other important information about cervical cancer among these women, despite high awareness, and this has contributed much in decreasing their tendency towards screening. So, provision of education and other important information about cervical cancer will reduce HPV transmission rates, improve the screening rate hence decrease late diagnosis and intervention and hence decrease cervical cancer deaths among women, especially those living with HIV.