article · BMC Public Health
Cervical cancer is the primary gynaecological malignancy in Uganda, causing over four thousand deaths each year. Women living with HIV face a six-fold higher risk of developing the disease, yet screening coverage remains low. An investigation into screening uptake among 381 women of reproductive age living with HIV in Alebtong district revealed that 49.6 percent had undergone screening. Although higher than previously documented national averages for this group, this level falls well below the 70 percent global target required for cervical cancer elimination. Screening uptake was significantly associated with social and structural factors, including encouragement from family and friends, support from spouses, good knowledge regarding screening, literacy, living within five kilometres of a health facility, and a stated preference for male healthcare providers. Addressing these social and geographic barriers is vital for expanding preventive services in rural communities.
Women living with HIV are six times more likely to develop cervical cancer than HIV-negative women, yet many present with advanced disease due to poor screening rates. Understanding local barriers and facilitators in rural settings helps health systems design targeted interventions. Involving spouses, boosting literacy, and reducing travel distances can directly improve uptake, helping lower mortality and achieve cervical cancer elimination goals.
The abstract does not evaluate a commercial product or technology, but its findings can inform public health programme designers and healthcare delivery organisations. Interventions could include tailored community health outreach tools, educational campaigns, or service-integration programmes within antiretroviral clinics. As an observational study, the work is at an early research stage, offering evidence to guide operational strategies rather than representing a near-market commercial product.
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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.
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DOI: 10.1186/s12889-026-29073-7
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