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An intervention to increase cervical cancer screening among women living with HIV: A mixed methods study
Matthew Asare1, Dorcas Obiri-Yeboah2, Nancy Innocentia Ebu Enyan3
1Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, PO Box 1 Bear Place, Waco, TX, USA.
Objective:
We examined the effectiveness of a behavioral intervention in promoting cervical cancer screening among women living with HIV (WLWH) in Ghana.
Methods:
A Mixed-methods study was conducted involving 83 WLWH, who were randomly assigned to an intervention group (n = 42) to receive voice-recorded messages based on the 3 R model (Reframing, Reprioritizing, and Reforming) or a control group (n = 41) to receive standard care. The primary outcomes were screening uptake and HPV prevalence. Other outcomes were the acceptability, appropriateness, and feasibility of the intervention.
Results:
The intervention group had a 100% screening rate, and the control group had a 14.63% screening rate. The prevalent rate of high-risk (hr)-HPV genotypes among the women was 67.5% (95%C.I: 0.56-0.77). Over 48% of the participants had multiple hr-HPV genotypes, 64.29% had HPV16/18/45%, and 73.21% had HPV 31/33/45/52/58. Of the women (89.30%) who screened positive, 60% of them were diagnosed and treated for pre-cancer lesions. The intervention messages were acceptable (encourage proactive behavior), feasible (simple, easy to understand), and appropriate (helpful, informative). Facilitators and barriers to self-sampling were identified.
Conclusion:
Combining the 3 R model with self-sampling increases cervical cancer screening among WLWH.
Practice Implication:
Healthcare professionals and policymakers can use this model to increase cervical cancer screening.
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