Prevalence and associated factors of pre-cancerous cervical lesions among HIV-positive women on ART in Northwest Ethiopia: a retrospective cross-sectional study

Abstract Cervical cancer is a major public health concern in Ethiopia with high mortality rates, especially in women living with HIV/AIDS. While its screening service has been available in Ethiopia since 2009, the updated prevalence of precancerous cervical lesions among HIV-positive women is not well understood. Therefore, this study aimed to determine the prevalence of precancerous cervical lesions and its associated factors among women living with HIV receiving ART in the Northwest Ethiopia. An institution-based retrospective cross-sectional study was conducted from February 28 to April 1, 2024 at the University of Gondar Comprehensive Specialized Hospital. A total of 419 eligible participants were selected by using simple random sampling technique. The data were collected through patient chart review using a pre-tested and structured checklist. The data were entered into Epi-info version 7, cleaned, and analyzed using SPSS version 20. Binary logistic regression model was used to identify factors associated with the outcome variable, and odds ratios with 95% confidence intervals and its corresponding p-values were computed to identify significant variables in the multivariable analysis. In this study, the prevalence of precancerous cervical lesions was found to be 11.5% (95% CI: 8.2–14.7). History of STI (AOR = 3.7, 95% CI: 1.79–7.62), age at first marriage less than 15 years (AOR = 3.02, 95% CI: (1.00-9.24), monthly income below 3000 Ethiopian Birr (AOR = 6.3, 95% CI: 1.20-32.82), and being widowed (AOR = 0.36, 95% CI: 0.13–0.95) were factors significantly associated with the occurrence of precancerous cervical lesions. The present study revealed 11.5% of precancerous cervical lesions among women living with HIV. History of sexually transmitted infections (STIs), early marriage, low income level, and being widowed were significantly associated with the outcome variable. Therefore, targeted interventions such as delaying early marriage and strengthening strategies that promote protection against sexually transmitted infections and poverty are recommended to reduce the burden of the disease in this highly vulnerable population.