Follow-up Cervical Cancer Screening among Women living with HIV in Moshi Municipality, 2019-2024: Adherence and Predictors
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Background
Cervical cancer screening is a critical public health intervention that facilitate the early detection and treatment of precancerous cervical lesions before they progress to invasive cancer. The effectiveness of this intervention largely depends on timely and consistent adherence to recommended follow-up screenings. However, in Tanzania, the adherence to these crucial screenings and its associated predictors remain poorly understood.
Objective
To determine the proportion of WLHIV who adhered to a follow-up screening and its associated predictors among WLHIV who have undertaken their first screening between 2019 and 2022 in Moshi Municipality.
Methodology
This was a retrospective cohort study. Data were analyzed using STATA version 18.0. Descriptive statistics were employed to determine the proportion of adherence to follow-up screening. Multivariable logistic regression analysis was used to estimate adjusted odds ratios and 95% CI for the predictors of adherence.
Results
Among 3,076 WLHIV enrolled into the study, only 33.1% adhered to a follow-up screening. Among these, only 21.4% demonstrated good adherence. Also, adherence was higher in private healthcare facilities [AOR=2.55; 95% CI: 2.02–3.22], lower for WLHIV who had their first screening at an outreach facility [AOR=0.19; 95% CI: 0.12–0.29], higher for those who were diagnosed with abnormal screening outcome in their first screening [AOR=8.19; 95% CI: 4.11–16.34]. It also increases with age, and parity.
Conclusion
Adherence to follow-up screening among WLHIV in Moshi Municipality was low. Strengthening recall systems especially in public and outreach settings, along with targeted interventions for younger, low parity women and those with normal screening outcome in the first screening, is essential to improve adherence to these vital screenings
