Assessing how women access healthcare to inform cervical cancer and HIV screening in rural Uganda
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Objective
This study aims to compare how HIV-positive and HIV-negative women in a remote sub-country in Uganda access health services to inform consideration of potential HIV and HPV-based cervical cancer screening integration at the community level.
Methods
This cross-sectional study recruited women living in the South Busoga District Reserve from January to August 2023. Women were eligible if they were aged 30 to 49 years old, had no history of cervical cancer screening or treatment, had no previous hysterectomy, and could provide informed consent. Participants completed a survey administered by village health teams, which included questions on HIV status, demographics, healthcare access, and services received. The data was analyzed using bivariate descriptive statistics, including chi-square and Fisher’s exact tests.
Results
Among the 1437 participants included in the analysis, 8.8% were HIV-positive. The majority of the respondents were between 30-39 years of age, were married, had received primary education or higher, and were farmers. The majority of women in both groups had accessed outreach visits (HIV-positive = 89.0%, HIV-negative = 85.8%) and health centres (HIV-positive = 96.1%, HIV-negative = 80.2%). The most commonly received services among both groups of women at outreach visits and health centres were immunization and antenatal care, respectively.
Conclusion
Our study demonstrated that there were no significant differences in healthcare access between HIV-positive and HIV-negative women in rural Uganda. Additionally, the high usage of healthcare services by women living with HIV suggests that the integration of cervical cancer and HIV screening may facilitate early detection and prevention of cervical cancer among this population. This can reduce the burden of disease in Uganda and further contribute to the World Health Organization’s initiative to eradicate cervical cancer.
