Cervical Cancer Screening Uptake and Associated Factors among HIV-Positive Women in Ethiopia: A Systematic Review and Meta-Analysis

Background. Women living with human immunodeficiency virus (HIV) are more likely to develop an increased risk of invasive cervical cancer. Morbidity and mortality due to cervical cancer could be reduced with early detection through cervical screening. Though uptake of cervical screening was investigated in Ethiopia, inconsistent findings were reported. Therefore, this systematic review and meta-analysis was designed to estimate the pooled prevalence of cervical cancer screening uptake among HIV-positive women and its associated factors in Ethiopia. Methods. A comprehensive search of PubMed/MEDLINE, Scopus, EMBASE, CINAHL, Google Scholar, Science Direct, and Cochrane Library was conducted. The data were extracted using a standardized data extraction format. Statistical analysis was done using the STATA, version 14, software. The heterogeneity of the studies was assessed using the I2 test. Funnel plots and Egger’s test were used to check publication bias. A random effects model was computed to estimate the pooled prevalence of cervical cancer screening uptake. Moreover, pooled odds ratios with 95% confidence intervals were used to determine the association of identified determinant factors with cervical cancer screening uptake. Results. A total of 10358 studies were retrieved, and 7 studies were included in the meta-analysis. The pooled prevalence of cervical cancer screening uptake among HIV-positive women in Ethiopia was 18.17% (95% CI : 11.23, 25.10) with exhibited heterogeneity (I2 = 96.6%; p<0.001). Educational status of women (AOR = 3.50; 95% CI : 1.85, 6.07), knowledge of women on cervical cancer (AOR = 3.26; 95% CI : 2.50, 4.43), and perceived susceptibility (AOR = 3.26; 95% CI : 2.26, 4.26) were significantly associated with cervical cancer screening uptake among HIV-positive women. Conclusion. The uptake of cervical cancer screening among HIV-positive women in Ethiopia was low. The findings of this study suggest the need to improve the existing national strategies of cervical cancer screening so as to strengthen reproductive health education and promotion, in addition to providing screening services. Furthermore, cervical screening service should be integrated to the routine care and treatment, so that HIV-positive women can get counseling services in every clinical contact.

Download Full-text

Cervical cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis

10.1101/2020.12.26.20248864 ◽

2021 ◽

Author(s):

Nigus Bililign Yimer ◽

Mohammed Akibu Mohammed ◽

Kalkidan Solomon ◽

Mesfin Tadese ◽

Stephanie Grutzmacher ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Meta Analysis ◽

Cervical Screening ◽

Sub Saharan Africa ◽

African Countries ◽

Screening Uptake ◽

Analytic Review ◽

Sub Saharan

AbstractBackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375

Download Full-text

Cervical cancer screening uptake among HIV-positive women in Ontario, Canada: A population-based retrospective cohort study

Preventive Medicine ◽

10.1016/j.ypmed.2017.11.023 ◽

2018 ◽

Vol 107 ◽

pp. 14-20 ◽

Cited By ~ 1

Author(s):

Ann N. Burchell ◽

Claire E. Kendall ◽

Stephanie Y. Cheng ◽

Aisha Lofters ◽

Michelle Cotterchio ◽

...

Keyword(s):

Cervical Cancer ◽

Cohort Study ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Population Based ◽

Hiv Positive ◽

Screening Uptake ◽

Hiv Positive Women

Download Full-text

Patients’ self-reported factors influencing cervical cancer screening uptake among HIV-positive women in low- and middle-income countries: An integrative review

Gynecologic Oncology Reports ◽

10.1016/j.gore.2020.100596 ◽

2020 ◽

Vol 33 ◽

pp. 100596

Author(s):

Maryam Kasraeian ◽

Kamran Hessami ◽

Homeira Vafaei ◽

Nasrin Asadi ◽

Leila Foroughinia ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Integrative Review ◽

Hiv Positive ◽

Middle Income ◽

Screening Uptake ◽

Middle Income Countries ◽

Factors Influencing ◽

Hiv Positive Women

Download Full-text

Role of awareness on cervical cancer screening uptake among HIV positive women in Addis Ababa, Ethiopia: A cross-sectional study

Women s Health ◽

10.1177/17455065211017041 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110170

Author(s):

Kassahun Emru ◽

Tsega-Ab Abebaw ◽

Admas Abera

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Addis Ababa ◽

Cross Sectional Study ◽

Reproductive Age ◽

Hiv Positive ◽

Cross Sectional ◽

Screening Uptake ◽

Hiv Positive Women

Background: Cervical cancer is the second commonest cancer among women living in less developed countries. Although cervical cancer screening for HIV-infected women has been started in different centers in Addis Ababa, there is a paucity of data on the uptake of this service, particularly among HIV-infected women. Objective: This study is aimed to assess the level and determinants of cervical cancer screening uptake among HIV-positive reproductive-age women in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted using a structured questionnaire on 411 HIV-infected women aged 15–49 years in St. Paul’s and Zewditu Hospitals. Data were collected using a pre-tested structured questionnaire on randomly selected study participants’ proportional allocation in the two hospitals. Logistic regression analyses were used to assess predictors of cervical cancer screening uptake. Results: Only 25.5% of HIV-positive reproductive-age women have been screened for cervical cancer. Respondents who have not heard about cervical cancer and the screening were 75% and 78% less likely to be screened compared to their counterparts, respectively. Conclusion: The uptake of cervical cancer screening was low in the study area. Awareness about cervical cancer screening was positively associated with cervical cancer screening uptake. Specific awareness programs focusing HIV positive women need to be implemented.

Download Full-text

Role of awareness on cervical cancer screening uptake among HIV positive women in Addis Ababa, Ethiopia. A cross-sectional study

10.21203/rs.2.19261/v1 ◽

2019 ◽

Author(s):

Kassahun Emru ◽

Tsega-Ab Abebaw ◽

Admas Abera Abaerei

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Addis Ababa ◽

Cross Sectional Study ◽

Hiv Positive ◽

Sectional Study ◽

Cross Sectional ◽

Screening Uptake ◽

Hiv Positive Women

Abstract Background: Cervical cancer is the second commonest cancer among women living in less developed countries. Women infected with the Human Immunodeficiency Virus (HIV) are at increased risk. However cervical cancer screening for HIV infected women has been started in limited centers in Addis Ababa, data on the uptake of this service are lacking. Therefore, this study aimed to assess the level and predictors of cervical cancer screening uptake among HIV positive women in Addis Ababa, Ethiopia.Methods: A cross-sectional study was conducted using a structured questionnaire on 411 HIV infected women in St. Paul's and Zewditu Hospitals, from April 20, 2015-May 10, 2015. Both bivariate and multivariable logistic regression analyses were performed to assess predictors of cervical cancer screening uptake. Results: Only 25.5% of the respondents had undergone cervical screening. Respondents who hadn't heard about cervical cancer and the screening were 75% and 78% less likely to be screened than those who had heard about it respectively. Conclusion: The uptake of cervical cancer screening was very low. Awareness about cervical cancer and screening were predictive factors. To increase the level of screening, specific awareness programs should be implemented by relevant authorities. Keywords: Cervical cancer, HIV, Screening, Women, Awareness

Download Full-text

Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-019-4718-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Abiyu Ayalew Assefa ◽

Feleke Hailemichael Astawesegn ◽

Bethlehem Eshetu

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cross Sectional Study ◽

Partner Support ◽

Hiv Positive ◽

Screening Service ◽

Hiv Diagnosis ◽

Cross Sectional ◽

Hiv Positive Women

Abstract Background In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Methods An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. Results Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. Conclusions The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.

Download Full-text