Utilization of Cervical Cancer Screening Services Among Women Living with HIV/AIDS in Machakos County, Kenya
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Date
2024-11
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Kenyatta University
Abstract
Cervical cancer (CC) represents a significant health challenge globally, particularly in low- and middle-income countries (LMIC), where it ranks third in incidence and mortality. In Kenya, CC constitutes 20% of female cancer cases and accounts for 15% of cancer-related deaths annually. Women living with HIV/AIDS (WLWHIV) face a higher risk of developing cervical cancer, which adversely impacts their quality of life. Consequently, early screening for cervical cancer among WLWHIV is crucial for timely diagnosis and treatment. This study aimed to evaluate the utilization of cervical cancer screening services among WLWHIV in Machakos County, Kenya. It focused on several specific objectives: identifying socio-demographic factors, assessing knowledge and attitudes toward screening, and analyzing health system factors that influence screening utilization. The study involved 422 HIV-positive women aged 18 to 49 years attending the Comprehensive Care Clinic (CCC) at Machakos County hospitals. Researchers employed a systematic random sampling method, and data were analyzed using the R statistical program, particularly logistic regression to explore variable relationships. Out of 422 participants, 410 women (97%) completed the questionnaire, with an average age of 31.7 years. Screening uptake was notable, with 249 women (61%) having been screened for cervical cancer according to Ministry of Health (MOH) guidelines, while 161 women (39%) had not. Bivariate analysis revealed that age (OR=2.758, P=<0.001) and religion (OR=5.953, P=0.050) were socio-demographic factors linked to screening utilization. Additionally, knowledge and attitudes played a crucial role; women with adequate knowledge of cervical cancer screening had a significantly higher odds ratio (OR=10.210, P=<0.001), as did those who believed in the importance of early screening, even in the absence of symptoms (OR=19.317, P=<0.001). Health system factors also emerged as significant. For instance, WLWHIV motivated by health workers showed a higher likelihood of utilizing screening services (OR=19.317, P=<0.01), as did those who received health education about cervical cancer screening (OR=1.636, P=<0.039). In multivariable analysis, two factors retained a significant association with screening: having adequate knowledge about cervical cancer and its risks, along with the availability of screening services (AOR=3.67, P=<0.001), and the belief in the necessity of screening regardless of symptom presence (AOR=5.460, P=<0.001).In conclusion, the findings highlight that a notable 39% of WLWHIV in Machakos County are not compliant with MOH guidelines for cervical cancer screening. Key factors influencing screening utilization include adequate knowledge of the disease, perceived risks, and belief in the need for screening. To enhance screening rates among WLWHIV, it is essential for the Ministry of Health in Machakos County to implement targeted strategies that promote awareness and education about cervical cancer. Strengthening public health programs focused on WLWHIV can significantly improve knowledge and encourage adherence to recommended screening practices, thereby enhancing early detection and treatment outcomes.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Public Health (Reproductive Health) in the School of Health Sciences of Kenyatta University, November 2024.
Supervisors:
1. Redempta Mutisya
2. Rosebella Kipkalom