Correlates of cervical cancer screening among women living with HIV in Kenya: A cross-sectional study.

ABSTRACT

OBJECTIVE: Cervical cancer is the leading cause of cancer-related death among Kenyan women. It is important to identify how demographics and knowledge of cervical cancer are associated with screening to determine best practices for targeted screening efforts. METHODS: We conducted a sub-analysis of women who were asked about cervical cancer from a cross-sectional study of women attending large HIV care and treatment programs across Kenya between June and September 2016. RESULTS: 1671 of 3007 (56%) women reported ever being screened, 804 (48%) of whom were screened within the last 12 months. Prevalence of screening was highest among women who were older (adjusted prevalence ratio [APR] age 35-49 vs. 18-24 2.26, 95% CI 1.68-3.05, P < 0.001), employed (APR 1.55, 95% CI 1.24-1.93, P < 0.001), married (APR 1.27, 95% CI 1.01-1.59, P = 0.047), had at least secondary education (APR 1.45, 95% CI 1.19-1.77, P < 0.001), with longer time since HIV diagnosis (APR 1.09/year average increase, 95% CI 1.04-1.13, P < 0.001). 36% knew cervical cancer is treatable. CONCLUSION: Characteristics linked to social or economic capital are correlated with cervical cancer screening. Integrating cervical cancer screening into HIV care and educating patients on the need for annual screening and potential treatment are important strategies for increasing screening uptake.