Utilization of cervical cancer screening and its associated factors among women living with HIV in East Africa: a systematic review and meta-analysis.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

BMC Women's Health Pub Date : 2025-07-04 DOI:10.1186/s12905-025-03880-3

Gebrie Getu Alemu, Getaneh Awoke Yismaw, Habtamu Abebe Getahun, Habtamu Wagnew Abuhay, Mekuriaw Nibret Aweke, Meron Asmamaw Alemayehu, Nebiyu Mekonnen Derseh, Tigist Kifle Tsegaw, Tilahun Yemanu Birhan, Banchlay Addis, Berhanie Addis Ayele, Emebet Birhanu Lealem, Eyob Akalewold Alemu, Fetlework Gubena Arage

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引用次数: 0

Abstract

Background: Women living with HIV (WLHIV), mostly in East Africa, are six times more likely to develop cervical cancer and are a priority population for secondary prevention. Numerous primary studies report inconsistent, widely varying rates of cervical cancer screening (CCS) among WLHIV in the region. This systematic review and meta-analysis aimed to synthesize data from various primary studies to provide a conclusive estimate of CCS uptake among WLHIV in East Africa and to identify factors associated with screening utilization.

Methods: This review followed PRISMA 2020 guidelines and was registered with PROSPERO. Databases searched included Google Scholar, PubMed, EMBASE, Scopus, Hinari, ScienceDirect, and other manual sources for studies published between January 2015 and April 2025. The Newcastle-Ottawa Scale was used for quality assessment. Data were analyzed using STATA 17, employing a random-effects model due to high heterogeneity. Cochran's Q test (χ²) and Higgins I² statistics were used to identify heterogeneity. Publication bias was assessed by funnel plots and Egger's test. Associations were reported as pooled adjusted odds ratios (aOR), with significance set at p < 0.05.

Results: This meta-analysis pooled effect estimates from 46 studies with a total of 98,028 participants. The pooled CCS uptake among WLHIV in East Africa was 34.48% (95% CI: 30.61, 38.36) with high heterogeneity. Those who had knowledge (aOR = 2.96, 95% CI: 2.60, 3.38) and information (aOR = 3.95, 95% CI: 2.15, 7.28), with a family history of cervical cancer (aOR = 2.18, 95% CI: 1.20, 3.96), high perceived vulnerability (aOR = 2.82, 95% CI: 1.65, 4.84), and low perceived barriers (aOR = 1.96, 95% CI: 1.05, 3.65) were significantly associated with CCS uptake among WLHIV in East Africa.

Conclusion: The percentage of WLHIV in East Africa who obtain CCS is far below the WHO's 70% target. The utilization of CCS was significantly associated with knowledge, information, family history of cervical cancer, perceived vulnerability, and barriers. Increased screening rates can be achieved by interventions that target raising awareness, providing information, reducing barriers, and focusing on women with a family history of cervical cancer.

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东非感染艾滋病毒的妇女宫颈癌筛查及其相关因素的利用：一项系统回顾和荟萃分析

背景：感染艾滋病毒（WLHIV）的妇女，主要在东非，患宫颈癌的可能性是其他地区的6倍，是二级预防的重点人群。许多初步研究报告，在该地区的WLHIV中，宫颈癌筛查（CCS）率不一致，差异很大。本系统综述和荟萃分析旨在综合来自各种主要研究的数据，以提供东非WLHIV中CCS吸收的结结性估计，并确定与筛查利用相关的因素。方法：本综述遵循PRISMA 2020指南，并在PROSPERO注册。检索的数据库包括谷歌Scholar、PubMed、EMBASE、Scopus、Hinari、ScienceDirect和其他手工来源，检索了2015年1月至2025年4月间发表的研究。采用纽卡斯尔-渥太华量表进行质量评估。数据分析使用STATA 17，由于异质性高，采用随机效应模型。采用Cochran’s Q检验（χ²）和Higgins I²统计量来确定异质性。采用漏斗图和Egger检验评估发表偏倚。关联以合并调整优势比（aOR）报告，显著性设置为p。结果：该荟萃分析汇总了46项研究的效应估计，共98,028名参与者。东非WLHIV的总CCS吸收量为34.48% (95% CI: 30.61, 38.36)，异质性高。那些有知识（aOR = 2.96, 95% CI: 2.60, 3.38）和信息（aOR = 3.95, 95% CI: 2.15, 7.28），有宫颈癌家族史（aOR = 2.18, 95% CI: 1.20, 3.96），高易感性（aOR = 2.82, 95% CI: 1.65, 4.84）和低感知障碍（aOR = 1.96, 95% CI: 1.05, 3.65）的人与东非WLHIV的CCS吸收显著相关。结论：东非获得CCS的艾滋病毒感染者比例远低于世卫组织70%的目标。CCS的使用与宫颈癌的知识、信息、家族史、感知易感性和障碍显著相关。提高筛查率可以通过以下干预措施来实现：提高认识、提供信息、减少障碍、关注有宫颈癌家族史的妇女。

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

BMC Women's Health OBSTETRICS & GYNECOLOGY-

CiteScore

3.40

自引率

4.00%

发文量

444

审稿时长

>12 weeks

期刊介绍： BMC Women''s Health is an open access, peer-reviewed journal that considers articles on all aspects of the health and wellbeing of adolescent girls and women, with a particular focus on the physical, mental, and emotional health of women in developed and developing nations. The journal welcomes submissions on women''s public health issues, health behaviours, breast cancer, gynecological diseases, mental health and health promotion.