Knowledge, attitudes, and practices of cervical cancer preventive services among mothers living with HIV in Lagos, Nigeria: a cross-sectional study

Abstract

BACKGROUND: Women living with HIV are at higher risk of cervical cancer, and their cervical cancer preventive behaviors may influence those of their daughters. Women’s preventive behaviors may cluster within families. This study was conducted to assess the knowledge, attitudes, and practices of cervical cancer prevention services among mothers living with HIV (MLWH) in Lagos, Nigeria. METHODS: In this cross-sectional descriptive study conducted between June 8 and July 14, 2023, mothers aged 25–65 years who had at least one daughter younger than 26 years and were attending the Nigerian Institute of Medical Research-AIDS Prevention Initiative Nigeria (NIMR-APIN) clinic for HIV services were included by convenience sampling method. Data were collected through interviews conducted by trained research assistants. Participants were categorized into no, poor, fair, and good knowledge level groups. RESULTS: Of the 507 participants surveyed, 133/507 (26.2%) reported an average monthly income lower than 18,000 Naira (23.7 USD). A total of 133/507 (26.2%) MLWH had ever undergone cervical cancer screening, including three who had also received HPV vaccination. Three mothers had their daughters vaccinated. 350 (69.0%) of MLWH were aware of cervical cancer, 290 participants (57.2%) had knowledge of cervical cancer screening, and only 29/507 (5.7%) participants were informed about the HPV vaccine. Mothers who were reluctant (adjusted OR = 0.17, 95% CI: 0.06–0.55) or hesitant (adjusted OR = 0.06, 95% CI: 0.01–0.28) to undergo screening themselves showed significantly lower odds of expressing willingness to vaccinate their daughters. CONCLUSIONS: This study revealed that only one-quarter of MLWH had ever been screened, underscoring the urgent need for enhanced cervical cancer screening in this group. Given the observed association between mothers’ screening willingness and their intent to vaccinate their daughters, targeted dyadic interventions that combine education, counseling, and facilitated access to screening and vaccination services may help enhance both maternal screening uptake and HPV vaccination coverage among their daughters.