INVESTIGATING THE IMPACT OF KNOWLEDGE, ATTITUDES, AND BELIEFS, AMONG WOMEN LIVING WITH HIV ON CERVICAL CANCER SCREENING AND TREATMENT: AT ITOJO GENERAL HOSPITAL.

Abstract

Cervical cancer is a type of uncontrollable cell growth that occurs in the cells of the cervix. The cervix is the lower part of the uterus that connects to the vagina. Cervical cancer is primarily caused by the human papillomavirus (HPV) and typically presents with symptoms such as vaginal bleeding (after sexual intercourse, between periods, or after menopause), watery or bloody vaginal discharge with a foul odor, and pelvic pain or pain during sexual intercourse (CDC, 2021). Cervical cancer is preventable and can be cured if detected early; however, it remains one of the most common types of cancer and one of the leading causes of cancer-related deaths among women worldwide (WHO, 2020). Globally, it is estimated that in 2020, over 604,000 women were diagnosed with cervical cancer, of whom 342,000 died from the disease, with a mortality rate of more than 50% (WHO, 2021). However, cervical cancer disproportionately affects women living with the human immunodeficiency virus . It is estimated that 5% to 40% of cervical cancer cases can be attributed to HIV, with noticeable regional variations (Stelzle et al., 2021). HIV contributes significantly to the observed disparity in cervical cancer burden across regions with high and low HIV prevalence (WHO, 2021). Africa, which bears the brunt of the HIV epidemic (Goliber, 2002), also faces a significant burden from cervical cancer (Stelzle et al., 2021). In southern Africa, up to 68% of cervical cancer cases occur among Women Living with HIV, while in eastern Africa, up to 30% of cervical cancer cases are among Women Lliving with HIV, resulting in an HIV-attributable cervical cancer rate of more than 20 per 100,000 cases (Stelzle et al., 2021). However, this finding must be contextualized, as only about 44% of women in African countries have ever been screened for cervical cancer, compared to over 60% in developed countries (Lemp et al., 2020). Consequently, the actual proportion of cervical cancer cases in developing countries is likely higher than reported. In Uganda, the most recent estimate indicates that approximately 7,000 women are diagnosed with cervical cancer annually, with more than half (approximately 4,607) dying from the disease (ICO/IARC, 2021). Cervical cancer is the most frequent cancer among women in Uganda, particularly among those of reproductive age, of whom 3.6% are estimated to harbor HPV, one of the causes of cervical cancer (ICO/IARC, 2021). This situation is compounded by Uganda’s high HIV prevalence, which, as noted earlier, increases the risk of cervical cancer (Stelzle et al., 2021), causing at least 7% of cervical cancer cases in the country (ICO/IARC, 2021). While district-specific cervical cancer prevalence rates are not properly documented, about 6.4% of women in ntugamo, where Itojo General Hospital is located, are living with HIV (MoH, 2019). It serves a significant number of people living with HIV (PLHIV), offering care and treatment services, the majority of whom are women (DHIS2, 2020). These women are at an elevated risk of acquiring and dying from cervical cancer (Stelzle et al., 2021). This study will explore the knowledge, attitudes, and beliefs of these women regarding cervical cancer screening and treatment at Itojo Hospital.