Cancer Screening Practices Among Women Living with HIV in Istanbul, Turkey: A Qualitative Study

Women living with HIV (WLWH) are at a higher risk of developing cancers. Despite the presence of national cancer screening programs in Turkey, the participation and awareness of WLWH regarding these programs remain unclear. This study aims to explore the knowledge, beliefs, and behaviors of WLWH in Turkey regarding cancer screenings.

This is a qualitative study. In-depth interviews were conducted with women aged 20 and older who were being followed up at the HIV outpatient clinics of a training and research hospital in Istanbul, Turkey. Data was collected through phone interviews to ensure confidentiality and continued until data saturation was achieved. The collected data were analyzed using thematic content analysis with the help of Atlas.ti software.

A total of 14 WLWH participated in the study, with a median age of 46.5 years (IQR:21 years). Three themes emerged: Cancer Awareness, Behaviors Towards Cancer Screening, and Barriers and Motivators in Cancer Screening Participation. Participants' knowledge about cancer and screening programs varied widely, with particularly low awareness of colorectal and breast cancer screenings. While some women practiced breast self-examination, regular participation in national screening programs was found to be low. The main barriers included lack of information, HIV-related stigma, and systemic challenges in accessing healthcare services. Many participants reported negative reactions from healthcare professionals upon disclosing their HIV status, leading to avoidance of screening services. Despite these challenges, the importance of early diagnosis was widely acknowledged, and participants said they would be more likely to participate in screenings if provided with proper information and support.

Low levels of cancer screening participation were observed among women living with HIV. To improve engagement in screening, these women need greater support, access to accurate information, and respectful care. Integrating screening into routine HIV services, providing training for health professionals, and reducing stigma are essential strategies to enhance participation and promote early detection in this vulnerable population.