Hu Jiawei, Duan Rufei, Zhang Hongyun, Zhao Xuelian, Wu Aihui, Li Le, Zhao Fanghui, Zhang Yong
Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, China.
The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital/Yunnan Cancer Center, 519 Kunzhou Road, Kunming, Yunnan, China.
BMC Womens Health. 2024 Dec 4;24(1):636. doi: 10.1186/s12905-024-03478-1.
Cervical cancer is a major health threat in the female population. Human immunodeficiency virus (HIV)-positive women encounter a higher risk of cervical cancer. It is significant to promote cervical cancer screening attendance among HIV-positive women. Little is known about the awareness, attendance, and attitudes toward cervical cancer screening, as well as the associated factors, among Chinese HIV-positive women.
A cross-sectional study was conducted among 411 HIV-positive women attending a large ART clinic in Yunnan, an HIV-endemic province in China. Participants were recruited using the convenient sampling method from January 2019 to August 2020. An interviewer-administered semi-structured questionnaire was utilized to collect information on socio-demographic and behavioral characteristics, clinical characteristics related to HIV infection, awareness, attendance, and attitudes toward cervical cancer screening. Binary logistic regression analyses were used to determine factors associated with awareness, attendance, and attitude toward cervical cancer screening.
Some 69.8% (287) of the participants were aware of cervical cancer screening, but only 27.7% (114) had attended screening within 3 years. After receiving a brief health education, 72.3% (297) of the participants exhibited a positive attitude toward cervical cancer screening. Participants with a higher education background and longer duration of antiretroviral therapy were more likely to be aware of cervical cancer screening and have up-to-date screening. The up-to-date screening attendance was also influenced by age, smoking status, and health insurance. Single participants were less likely to show a positive attitude toward cervical cancer screening compared married or cohabiting counterparts. The main facilitators to attending cervical cancer screening were health promotion activity and well-organized programs, while the main barriers were high costs of the service and inadequate awareness.
Although most HIV-positive women attending a large ART clinic in Yunnan were aware of cervical cancer screening, the up-to-date attendance was low. It is crucial to conduct health education and promotion through efficient channels to improve awareness and attendance. The discrepancy between awareness and attendance also emphasized the importance of adopting appropriate screening strategies and powerful health policies that can foster the attendance of cervical cancer screening among HIV-positive women. Efforts should be devoted to constructing a comprehensive healthcare system with high accessibility in China for cervical cancer prevention and management for HIV-positive women.
宫颈癌是女性群体面临的重大健康威胁。感染人类免疫缺陷病毒（HIV）的女性患宫颈癌的风险更高。提高HIV阳性女性的宫颈癌筛查参与率具有重要意义。对于中国HIV阳性女性对宫颈癌筛查的认知、参与情况和态度以及相关因素，我们了解甚少。
在中国HIV高发省份云南的一家大型抗逆转录病毒治疗（ART）诊所，对411名HIV阳性女性进行了一项横断面研究。2019年1月至2020年8月期间，采用方便抽样法招募参与者。通过由访谈员实施的半结构化问卷，收集有关社会人口学和行为特征、与HIV感染相关的临床特征、对宫颈癌筛查的认知、参与情况和态度等信息。采用二元逻辑回归分析来确定与宫颈癌筛查认知、参与情况和态度相关的因素。
约69.8%（287名）参与者知晓宫颈癌筛查，但仅27.7%（114名）在3年内进行过筛查。在接受简短的健康教育后，72.3%（297名）参与者对宫颈癌筛查表现出积极态度。具有较高教育背景和较长抗逆转录病毒治疗时间的参与者更有可能知晓宫颈癌筛查并进行最新的筛查。最新的筛查参与情况还受到年龄、吸烟状况和医疗保险的影响。与已婚或同居者相比，单身参与者对宫颈癌筛查表现出积极态度的可能性较小。参与宫颈癌筛查的主要促进因素是健康促进活动和组织良好的项目，而主要障碍是服务成本高和认知不足。
尽管在云南一家大型ART诊所就诊的大多数HIV阳性女性知晓宫颈癌筛查，但最新参与率较低。通过有效渠道开展健康教育和促进活动以提高认知度和参与率至关重要。认知与参与之间的差异也凸显了采用适当的筛查策略和有力的卫生政策的重要性，这些策略和政策可促进HIV阳性女性参与宫颈癌筛查。应致力于在中国构建一个具有高可及性的综合医疗保健系统，以预防和管理HIV阳性女性的宫颈癌。
