Readiness and affordability of utilizing human papillomavirus testing for cervical cancer screening among sexually active women in Gombe, Nigeria

BACKGROUND: Cervical cancer remains a major cause of morbidity and mortality in Nigeria despite being preventable through timely screening and vaccination. While awareness of cervical cancer is increasing, uptake of human papillomavirus (HPV) testing remains low due to structural and socioeconomic barriers. OBJECTIVES: This study assessed the readiness and affordability of HPV-based cervical cancer screening among sexually active women in Gombe State, Nigeria. METHODS: A cross-sectional study was conducted among 640 women attending gynecology and sexual health clinics across three levels of healthcare facilities. Data were collected from consenting participants, using a structured interviewer-administered questionnaire assessing socio-demographics, knowledge, attitudes, risk exposures, and willingness to pay for HPV testing. Descriptive statistics, Chi-square tests, and multivariable logistic regression were used for analysis. RESULTS: Overall, 91.6% of respondents expressed willingness to undergo HPV screening, yet actual uptake and HPV vaccination were extremely low (8.7% and 8.9%, respectively). While 82.6% identified HPV as a cause of cervical cancer, only 22.6% knew the eligible vaccination age. Self-sampling was preferred by 83.3% of respondents, and nearly all preferred female providers. None of the socio-demographic or risk factors significantly predicted willingness to screen (P > 0.05). Knowledge gaps, service unavailability, and affordability were major constraints. CONCLUSION: Despite high willingness, structural barriers and inadequate detailed knowledge hinder cervical cancer prevention in Gombe. Strengthening service availability, expanding self-sampling options, subsidizing HPV testing, and intensifying community education are essential to translate readiness into action and accelerate progress toward Health Organization cervical cancer elimination targets.