Uptake of Cervical Cancer Screening Services among HIV Positive Women in Dagoretti, Nairobi City County, Kenya
Nasambu, Lukorito Judith
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Although cervical cancer is said to be the leading cause of cancer deaths among women in low resource settings, screening services in health facilities remains very low. The risk of death from this disease is higher among HIV positive women as a result of persistent Human Papilloma Virus (HPV) infection with quicker progression to cancer. As a result, screening services have been in cooperated in routine care of all HIV positive women, but uptake remains very low. This could be due to low levels of awareness on the importance of screening within our facilities. In addition, there could be other unaddressed barriers to utilization of these services. This study sought to determine whether the level of awareness, socio-demographic and economic factors and health facility factors affect uptake of cervical cancer screening services among HIV positive women in Dagoretti, Nairobi County. A descriptive cross sectional facility based survey using proportionate random sampling involving HIV positive women receiving care within HIV clinics was conducted. Data was collected using interviewer administered questionnaire and an observation checklist. Data analysis was performed using SPSS version 20 (IBM, USA).Chi-square test was used to establish comparisons between categorical variables. Associations between socio demographic and economic factors, level of awareness and health facility factors with uptake of cervical cancer screening services were analyzed using correlation, binary logistic regression was conducted. Out of the interviewed respondents, 19% had screened for disease yet only 56% of those who had screened were as a result of a doctor’s recommendation. Most of those who had never screened (44%) feared to undress before a health care provider. A greater proportion (72%) had good knowledge levels on cervical cancer screening. Out of the six facilities, only 2 were well equipped for screening. Women with higher level of education (p=0.023), those aged above 45 years (p=0.003), those with current circumcised partner (p<0.0001) and those currently employed (p=0.0008) had good knowledge on screening services. Women aged 45 years and above were 2 times more likely to have been screened (OR 2.071; 1.115-3.847; P=0.021). Women with good knowledge are 2 times more likely to screen (OR2.2981, 1.062-4.973; P=0.035). Respondents with current circumcised partners are 3 times more knowledgeable (OR 2.935, 1.363-6.320; P=0.006) while those in formal education are 2.5 times more likely to have good knowledge (OR 2.537, 1.110-5.797; P=0.027). Findings of this study demonstrated that some socio demographic and economic factors affect uptake of cervical cancer screening services even with good knowledge levels. The information generated in this study might be valuable in informing cervical cancer managers and policy makers on policy review concerning cervical cancer screening and treatment in Dagoretti, Nairobi County and therefore consolidate the gains made in the control of this killer disease among HIV women.