Influence of Cues on Cervical Cancer Screening Intention of Women Living With HIV in Ghana

Abstract

Cervical cancer is a malignant disease that affects women. Women with Human Immunodeficiency Virus (HIV) are more vulnerable to the disease, as there is a strong evidence that cervical abnormalities in women living with HIV progress faster to cancer due to their immune-compromised state (Vermund & Kelley, 2018). Early detection is critical for follow up care and treatment of pre-cancer lesions (Madeddu et al., 2014). Previous studies have reported that screening recommendations from medical doctors, knowing where to obtain the test and knowing someone who had the test strongly predicted cervical cancer screening (Okunowo et al., 2018; Bringedal, Fretheim, Nilsen, & Rø, 2019). Maree and Moitse (2014) affirmed that HIV-positive women who participated in cervical cancer screening in South Africa had information from doctors and nurses. The purpose of this study was to determine the specific cues that predict intention of women living with HIV to obtain cervical cancer screening in the Central Region of Ghana. Methods: A hospital-based study was conducted using descriptive cross-sectional survey design. Six hundred and sixty women living with HIV and receiving antiretroviral therapy (ART) in the Central Region of Ghana were conveniently sampled for the study. Data were collected with the aid of a validated interview schedule and analysed with the Statistical Package for Social Sciences version 21.0. Descriptive and inferential statistics were used including frequencies, percentages and the binary logistic regression analysis. Results: The results showed that over 80.0% of the women living with HIV intended to seek cervical cancer screening. The main cues that significantly influenced cervical cancer screening intention were education on the need for cervical cancer screening at the hospital (95% Cl, 1.65-3.22) and referral by medical doctor (95% Cl, 2.19-5. 91). Women who received education at the hospital were two times more likely to have intention to screen whiles those referred by medical doctor were three times more likely to have intention to screen. Furthermore, 17.7% of participants were not likely to screen despite information from mass media. Conclusion: A high proportion of women living with HIV had the intention of seeking cervical cancer screening. Consequently, there is the need for stakeholders in HIV care to intensify health education on cervical cancer and screening in health facilities, and also refer women living with HIV for cervical cancer screening.