Barriers Associated with Adherence to Cervical Cancer Screening Among Women Living with HIV in Nkhatabay District, Malawi: A Mixed-Methods Study.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
ACS Applied Bio Materials Pub Date : 2024-03-20 eCollection Date: 2024-01-01 DOI:10.2147/IJWH.S442522
Phyllis Chinsamba Baluwa, Reuben Christopher Moyo, Masumbuko Albert Baluwa, Lot Nyirenda
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引用次数: 0

Abstract

Background: Cervical cancer (CC) incidence among Women Living with HIV (WLHIV) is high compared to the general population of women. As such, the Malawi National CC guideline recommends yearly screening among WLHIV. However, only 15.9% of WLHIV were screened nationally using Visual Inspection with Acetic Acid (VIA) by 2015 and there is no data regarding adherence and barriers to yearly screening. This study assessed adherence levels and associated barriers to yearly Cervical Cancer screening (CCS) among WLHIV.

Methods: A cross-sectional concurrent mixed-method study was conducted at Nkhatabay District Hospital (NBDH) and Chintheche Rural Hospital (CRH) in Malawi. A sample of 205 WLHIV participated in quantitative strand and in-depth interviews were conducted with 10 health care workers and 10 WLHIV. Quantitative data were analysed using STATA version 16. Pearson's chi-square test and Multivariate logistic regression analysis were performed. P value was set at 0.05. Qualitative data were analysed deductively following six steps of thematic analysis.

Results: Only 5.4% (n=11) of the participants had been screened as required. Women aged ≥45 had 4 times the odds of being screened for CC compared to ≤30 (OR 4.18, 95% CI 0.65-26.8). WLHIV on ART > 10 years had more than 5 times the odds of being screened (OR 5.9, 95% CI 1.08-33.19) compared with those on ART <3 years. Use of male service providers (p =< 0.001), fear of the VIA procedure (p = <0.001) and lack of interest (p = <0.015) were significant barriers to adherence. Qualitative findings revealed a lack of knowledge regarding CCS protocol and the use of male providers.

Conclusion: WLHIV face many challenges in accessing CCS and adherence to yearly CCS is very low. There is urgent need for targeted community awareness, scaling up of HPV tests and incorporation of CCS into routine integrated outreach services.

马拉维 Nkhatabay 地区感染艾滋病毒妇女坚持宫颈癌筛查的相关障碍:混合方法研究。
背景:与普通妇女相比,感染艾滋病毒的妇女(WLHIV)的宫颈癌(CC)发病率很高。因此,马拉维国家宫颈癌指南建议每年对 WLHIV 进行筛查。然而,截至2015年,全国仅有15.9%的女性艾滋病病毒感染者接受了醋酸白带肉眼检查(VIA),而且没有关于每年筛查的依从性和障碍的数据。本研究评估了 WLHIV 每年进行宫颈癌筛查(CCS)的依从性水平和相关障碍:在马拉维的 Nkhatabay 地区医院(NBDH)和 Chintheche 乡村医院(CRH)开展了一项横断面同期混合方法研究。205名WLHIV样本参与了定量研究,并对10名医护人员和10名WLHIV进行了深入访谈。定量数据使用 STATA 16 版本进行分析。进行了皮尔逊卡方检验和多元逻辑回归分析。P 值设定为 0.05。定性数据按照专题分析的六个步骤进行演绎分析:只有 5.4%(n=11)的参与者按照要求进行了筛查。年龄≥45岁的女性接受CC筛查的几率是年龄≤30岁的女性的4倍(OR 4.18,95% CI 0.65-26.8)。接受抗逆转录病毒疗法 > 10 年的 WLHIV 接受筛查的几率是接受抗逆转录病毒疗法结论者的 5 倍多(OR 5.9,95% CI 1.08-33.19):女性艾滋病毒感染者在接受社区保健服务方面面临许多挑战,而且每年接受社区保健服务的依从性非常低。迫切需要开展有针对性的社区宣传,扩大 HPV 检测的规模,并将 CCS 纳入常规综合外展服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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