Prevalance and factors associated with cervical cancer screening uptake among HIV positive women in the rural communities of Alebtong district in Uganda

Cervical cancer (CC) is the leading gynaecologic malignancy in Uganda and affects about 6959 women and 4607 die annually. Despite the launch of the global call to elimination of CC in 2020, only 10% of women in Uganda are screened and studies in Uganda among women of reproductive age group(WRAG) living with Human Immune virus (HIV) [(WRAG-LHIV)] have reported rates of 30.3% to 39.4%. Subsequently 85% patients with CC present with advanced disease leading to poor outcomes. Furthermore, women living with (HIV) have a six-fold higher risk of developing CC compared to their HIV negative counterparts. Alebtong district in Northern Uganda is reported to have a higher HIV prevalence than the national average and CCS uptake among women of reproductive age group living with HIV (WRAG-LHIV) is unknown. Therefore this study aimed to determine the prevalence of CCS uptake and its determinants among WRAG-LHIV in Alebtong district. A cross-sectional study was conducted at 7 purposively selected high volume antiretroviral therapy (ART) offering health facilities and their attached 34 community drug distribution points (CDDPs). 381 WRAG-LHIV were recruited by systematic sampling. Researcher administered pretested closed-ended questionnaires were used to collect quantitative data. The data was entered into Microsoft Excel and subsequently imported into Stata version 14 for statistical analysis. Statistical significance was set at a p -value < 0.05. A total of 381 women with a mean age of 32.9 years (SD ± 7) participated in the study. The majority, 80.8% (308/381) had had at most primary education, 81.4% were either married/cohabiting and 53.3% (203/381) resided within 5 km of a health facility. Importantly, 53.5%( 204/381) had had early sexual debut and 81.6%( 311/381) were multiparous. The prevalence of cervical cancer screening (CCS) uptake was 49.6% (189/381). The statistically significant factors associated with CCS uptake were encouragement by friends and family members, spouse support, good knowledge about cervical cancer screening, and preference of male healthcare providers, literacy and distance of ≤ 5km. CCS uptake among WRAG-LHIV was suboptimal and below the 70% target set for CC elimination. There is need for more emphasis on male involvement in terms of spouses and clinical team, peer advocacy integration of CCS into chronic care clinics and adopting modalities that would encourage community participation and males in CCS activities.