Exploring barriers to cervical cancer screening among women living with HIV (WLHIV) attending an ART clinic at Nkhoma Hospital, Malawi
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Date
2020-11-01
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Kamuzu University of Health Sciences
Abstract
Women living with HIV (WLHIV) are at higher risk of developing cervical cancer than those who are HIV negative. In order to increase access to services, international policy recommendations include the integration of cervical cancer screening into HIV care: a pilot study carried out in Malawi reported high uptake of cervical cancer screening after integration with HIV care in Malawi. However, evidence has shown that despite attempts at integration, there is still underutilization of cervical cancer screening services among WLHIV in clinics across Malawi. Hence this study that aimed to explore the barriers to cervical cancer screening among WLHIV attending the Anti-Retroviral Treatment (ART) clinic at Nkhoma Hospital, Malawi. A qualitative study design , was carried out at Nkhoma Hospital ART clinic. Seventeen in-depth interviews were conducted among WLHIV who had never accessed cervical cancer screening services. Data was analyzed using thematic analysis method. Eight (8) themes emerged from the study. These include: (i) poor communication approaches, (ii) lack of knowledge of where to access screening services, (iii) fear emanating from negative experiences shared by peers, and fear of a cancer diagnosis itself), (iv) feeling of embarrassment over exposure of private body parts, (v) myths and misconceptions (vi), low perceived vulnerability, (vii) long travelling distances and (viii) long waiting times. These findings confirm the need to improve delivery of cervical cancer screening for WLHIV at Nkhoma Hospital. They highlight the need for client-centered counseling and support to overcome fears and misconceptions, and designing health promotion messages that may directly address the concerns of WLHIV.