Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Cancer. 2019 Oct 23;19(1):989. doi: 10.1186/s12885-019-6171-6.
Cervical cancer is a global public health problem and the second most common cancer causing morbidity and mortality in Ethiopia. Few available evidences revealed that despite distribution and severity of cervical cancer among HIV-positive women and the ease with which it can be prevented, cervical cancer screening practice in Ethiopia among them is considerably low. Thus, this study aims to assess predictors of cervical cancer screening practice among HIV-positive women by applying health belief model concepts.
Facility based cross-sectional study was conducted in Bishoftu. Data was collected from 475 women who visit the health facilities for anti-retroviral services using interviewer-administered questionnaires. Champion's revised Health Belief Model sub-scales were used as data collection tools containing sources of information, knowledge, perception on cervical cancer screening and cervical cancer screening practice as variables. Frequencies, percentage, mean and standard deviation were used to describe findings. Multi-variable logistic regression and 95% confidence intervals were considered to identify predictors of cervical cancer screening practice by controlling possible confounders.
Cervical cancer screening practice among HIV-positive women in this study was 25%. Health proffesionals were the main sources of information about cervical cancer and its screening. There was a difference between the 'ever' and 'never' screened groups in mean scores of their perceived severity, perceived benefit, perceived barrier, perceived self-efficacy, perceived threat and net-benefit towards screening (P < 0.05). Perceived self-efficacy (AOR 1.24, 95%CI 1.13-1.37), perceived threat (AOR 1.08, 95%CI 1.05-1.12) and perceived net-benefit (AOR 1.18, 95% CI 1.12, 1.24) were the predictors of cervical cancer screening practice.
Cervical cancer screening practice in this study was lower than that of the recommended coverage of the target group by the national guideline (80%). This finding has an important implication for public health intervention aimed at cervical cancer prevention. Morever, womens' perceptions on cervical cancer screening had a significant influence on the utilization of cervical cancer screening service. Therefore, educational programmes geared towards severity of the case, availability of screeningand helpfulness of being screened can significantly improve the uptake of cervical cancer screening.
宫颈癌是一个全球性的公共卫生问题，也是导致埃塞俄比亚发病率和死亡率的第二大常见癌症。尽管有一些可用的证据表明，艾滋病毒阳性妇女中宫颈癌的分布和严重程度以及宫颈癌筛查的容易程度，但在埃塞俄比亚，她们进行宫颈癌筛查的情况相当低。因此，本研究旨在应用健康信念模型的概念，评估艾滋病毒阳性妇女进行宫颈癌筛查的预测因素。
在比绍夫图进行了一项基于机构的横断面研究。研究人员使用访谈者管理的问卷，从 475 名前往卫生机构接受抗逆转录病毒治疗的妇女中收集了数据。冠军修订的健康信念模型子量表被用作数据收集工具，其中包含信息来源、知识、对宫颈癌筛查的认知和宫颈癌筛查实践等变量。使用频率、百分比、平均值和标准差来描述研究结果。多变量逻辑回归和 95%置信区间用于确定通过控制可能的混杂因素对宫颈癌筛查实践的预测因素。
本研究中，艾滋病毒阳性妇女的宫颈癌筛查实践率为 25%。专业医疗人员是了解宫颈癌及其筛查的主要信息来源。在“曾”和“未”筛查组之间，其感知严重程度、感知益处、感知障碍、感知自我效能、感知威胁和筛查的净收益的平均得分存在差异（P<0.05）。感知自我效能（AOR 1.24，95%CI 1.13-1.37）、感知威胁（AOR 1.08，95%CI 1.05-1.12）和感知净收益（AOR 1.18，95%CI 1.12,1.24）是宫颈癌筛查实践的预测因素。
本研究中的宫颈癌筛查实践低于国家指南建议的目标人群的覆盖率（80%）。这一发现对旨在预防宫颈癌的公共卫生干预具有重要意义。此外，妇女对宫颈癌筛查的认知对宫颈癌筛查服务的利用有显著影响。因此，针对病例的严重程度、筛查的可及性和筛查的有益性开展教育计划，可以显著提高宫颈癌筛查的普及率。
