Knowledge and Perceptions Towards Cervical Cancer and Screening among HIV-infected Women Attending Public Health Facilities in Kisii County, Kenya

Abstract

Context: Knowledge of cancer of the cervix and perceptions of the disease and screening are key determinants for the utilization of screening services among HIV-infected women. HIV infection predisposes women to an increased risk of having cancer of the cervix. Utilization of cervical cancer screening services among women is important as it leads to early diagnosis of pre-cancerous lesions and their prompt treatment. Kenya is among those countries in Africa reporting low screening rates for cancer of the cervix among HIV-infected women.

Aim: This study sought to investigate the knowledge and perceptions towards cervical cancer and screening and their association with the uptake of screening services among HIV-infected women in Kisii County, Kenya.

Methods: A cross-sectional survey involving 612 HIV-infected women aged between 15-49 years who were attending HIV care clinics in two sub-county hospitals in Kisii County. The enrolled respondents were recruited through a systematic random sampling method. Data were collected through a structured questionnaire focusing on socio-demographic parameters, knowledge of the disease and screening, perceptions of the disease, and screening practices.

Results: The median age of the respondents was 42 years. Those with a primary level of education were 52.9% (n=324). The respondents who were married were 53.7% (n=329). A large proportion of the respondents were aware of and had heard about the disease and screening, at 86.6% (n=530) and 75.5% (n=462), respectively. Only 10.6% (n=65) of them knew that human papillomavirus caused cancer of the cervix, and 31.5% (n=193) of them knew that HIV was a risk factor for cancer of the cervix. A large proportion of the respondents, 53.1% (n=325), had low levels of total knowledge of cervical cancer and screening scores. A statistically significant association (p ≤ 0.05) was observed between the uptake of screening and knowledge of cervical cancer screening, as well as perceived benefits and barriers to screening.

Conclusion: The respondents in this study demonstrated low levels of knowledge about cervical cancer and cervical cancer screening. There was a direct relationship between knowledge of cervical cancer and screening, perceived benefits, perceived barriers of screening for cancer of the cervix, and uptake of screening. There is a need to enhance cervical cancer health education in HIV care clinics to improve knowledge and shift perceptions toward cancer of the cervix and screening among HIV-infected women.