Predictors of Cervical Cancer Screening Practice Among HIV Positive Women Attending Adult Anti-retroviral Treatment Clinics in Bishoftu Town, Ethiopia: the Application of a Health Belief Model

Background: Cervical cancer is a global public health problem and the second most common cancer causing morbidity and mortality in Ethiopia. Few available evidences revealed that despite distribution and severity of cervical cancer among HIV-positive women and the ease with which it can be prevented, cervical cancer screening practice in Ethiopia among them is considerably low. Thus, this study aims to assess predictors of cervical cancer screening practice among HIV-positive women by applying health belief model concepts.

Methods: Facility based cross-sectional study was conducted in Bishoftu. Data was collected from 475 women who visit the health facilities for anti-retroviral services using interviewer-administered questionnaires. Champion's revised Health Belief Model sub-scales were used as data collection tools containing sources of information, knowledge, perception on cervical cancer screening and cervical cancer screening practice as variables. Frequencies, percentage, mean and standard deviation were used to describe findings. Multi-variable logistic regression and 95% confidence intervals were considered to identify predictors of cervical cancer screening practice by controlling possible confounders.

Results: Cervical cancer screening practice among HIV-positive women in this study was 25%. Health proffesionals were the main sources of information about cervical cancer and its screening. There was a difference between the 'ever' and 'never' screened groups in mean scores of their perceived severity, perceived benefit, perceived barrier, perceived self-efficacy, perceived threat and net-benefit towards screening (P < 0.05). Perceived self-efficacy (AOR 1.24, 95%CI 1.13-1.37), perceived threat (AOR 1.08, 95%CI 1.05-1.12) and perceived net-benefit (AOR 1.18, 95% CI 1.12, 1.24) were the predictors of cervical cancer screening practice.

Conclusions: Cervical cancer screening practice in this study was lower than that of the recommended coverage of the target group by the national guideline (80%). This finding has an important implication for public health intervention aimed at cervical cancer prevention. Morever, womens' perceptions on cervical cancer screening had a significant influence on the utilization of cervical cancer screening service. Therefore, educational programmes geared towards severity of the case, availability of screeningand helpfulness of being screened can significantly improve the uptake of cervical cancer screening.