INTENTION AND PREDICTORS TOWARD CERVICAL CANCER SCREENING AMONG WOMEN ATTENDING ANTIRETROVIRAL THERAPY SERVICES IN SIDAMA REGION, ETHIOPIA 2023.

Abstract

Background: Cervical cancer continues to be a serious public health problem in developing countries. In Ethiopia, the proportion of women with human immunodeficiency virus (HIV) who receive cervical cancer screening services remains low. To promote screening behavior, it is important to understand the predictors of women’s intention to receive cervical cancer screening. Objective: To assess intention and predictors toward cervical cancer screening among women attending antiretroviral therapy services in the Sidama region, Ethiopia, 2023. Methods: An institutional-based mixed-method study was conducted from June 6 to July 4, 2023. Using systematic random sampling, a total of 422 women on antiretroviral therapy services were involved in the study, whereas a purposively selected 10 women were included in an in-depth interview. Data collection tools adapted from Theory of planned behavior for both qualitative and quantitative measure. Quantitative data was collected by Kobo Collector and analyzed using SPSS version 25. Linear regression analyses were done to identify statistically significant independent variables with the intention of cervical cancer screening. The qualitative data were analyzed using ATLAS.ti7 through thematic analysis. The study obtained ethical approval from Hawassa University of college of medicine and health science. Result: A total of 415 patients participated in this study with making a response rate of 98%. The mean age of respondents was 35.96±8.79 years. Theory of planned behaviors variables explained 72.2% of the variance in intention to receive cervical cancer screening among women on antiretroviral therapy. The mean score of intention was 3.92±0.92. About three-fourths 314 (72.5%) of the participants who scored above the mean were intended to be screened for cervical cancer in the next three months. Attitude towards cervical cancer screening (β=0.456, p<0.05), social influence (β=0.207, p<0.05), perceived easiness and difficulty towards intention to screen cervical cancer (β=0.156, p<0.05), past screening experience (β=0.110, p<0.05), and comorbidities (β=0.065, p<0.05) were significant predictors of intention to receive screening for cervical cancer. Qualitative findings revealed that a negative attitude towards screening, community disapproval, and cervical cancer treatment costs were barriers to cervical cancer screening intention. Conclusion: Nearly three-fourth of women was found to have the intention to receive cervical cancer screening. Attitude towards screening, social influence, perceived easiness and difficulty of the intention to screen, past screening experience, and comorbidities were factors affecting women’s intention to screen cervical cancer. So, we recommend interventions aimed at enhancing HIV-positive women’s cervical cancer screening behavior by targeting attitudinal change and creating positive social pressure toward screening. Further research is recommended using a prospective cohort study design to see how much intention is transformed into behavior.