Determinant of Cervical Cancer Screening Uptake among Women of Reproductive Age Living with HIV in Akamkpa Local Government Area, Cross River State

Abstract

Cervical cancer screening is essential for women living with HIV, yet uptake is shaped by personal resources, health beliefs, and service organisation. This study assessed factors associated with cervical cancer screening uptake among women of reproductive age living with HIV in Akamkpa LGA, Cross River State. A health facility based cross sectional study was conducted among 340 women receiving HIV care in five facilities. Data were collected using a structured interviewer administered questionnaire and a clinical record extraction form. Frequencies and percentages described screening behaviours, while crude odds ratios and 95% confidence intervals were recalculated from verified cross tabulations. Screening uptake was 43.5%. Lack of awareness and financial constraints were the leading reported barriers. Higher screening odds were observed among women aged 25 to 34 years, currently married women, women with secondary or tertiary education, women with higher monthly income, and those diagnosed with HIV for five to ten years. Good knowledge was associated with fourfold higher screening odds (COR = 4.11; 95% CI [2.50, 6.77]), while positive attitude was also significant (COR = 1.94; 95% CI [1.19, 3.18]). Provider referral increased the odds more than threefold, and being directly offered screening during an HIV clinic visit showed the strongest association (COR = 14.58; 95% CI [8.42, 25.25]). The findings indicate that screening depends on both readiness and service opportunity. Routine counselling, provider initiated offers, affordable screening, and integrated HIV and cervical cancer services are required.