Cervical cancer is the abnormal growth of cells that starts in the cervix. The cervix is the lower part of the uterus that connects to the vagina. It is one of the most life-threatening diseases that affects Women Living with HIV(WLHIV). According to the fact sheet Malawi 2023 report, the estimates indicated that every year 4145 women are diagnosed with cervical cancer and 2905 die from the disease. Cervical cancer is six to eight times common in WLHIV. Regular cervical cancer screening helps to detect the cancer early for effective treatment.
Main Objective: An observation was made that WLHIV are hesitant to undergo cervical cancer screening in Malawi despite the services being available. Therefore, the study aims to investigate the knowledge and attitudes of HIV positive women towards cervical cancer screening services.
Specific objective: (1) Identifying the proportion of eligible HIV positive women accessing cervical cancer screening services, (2) assessing the willingness of HIV positive women to seek cervical cancer services voluntarily (3) analyzing the perceptions of HIV positive women towards annual cervical cancer screening.
Methodology: In a mixed methods study conducted at Lighthouse, Kamuzu Central Hospital, a sample size of 99 participants was identified using simple random sampling methods. A questionnaire created using kobo-toolbox software was used to collect data and written consent was obtained from all participants involved in the study.
Findings: Results showed that 93% of the respondents had ever accessed cervical screening at Lighthouse (Figure 2), Despite having 93% of WLHIV getting screened, only 52 women out of 99 reported that they have ever gone for screening on their own willingly (Figure 4). 69 respondents (70% of participants) portrayed to have several perceptions towards cervical cancer screening. In Figure 5 the listed perceptions ranked differently according to how the respondents described them. Painful ranked higher with 59% mentions, seconded by embarrassing 34%, scary 31%, degrading 25% and uncomfortable 20%.
Conclusion: In conclusion, there good coverage of cervical cancer screening which is largely associated with successful strategies put in place at the facility to ensure that every eligible woman is screened but the lack of willingness to and negative perceptions towards screening highlighted by WLHIV portrays health promotion gap that needs attention.
Table of Contents
- ACKNOWLEDGEMENTS
- ABSTRACT
- Table of Contents
- List of Figures
- List of Tables
- Abbreviations/ Acronyms
- Chapter 1 Introduction
- 1.1 Chapter Introduction
- 1.2 Background of the Study
- 1.3 Problem Statement
- 1.4 Objectives of the Study
- Main Objective
- Specific Objectives
- 1.5 Research Questions/ Hypotheses
- 1.6 Significance of the Study
- 1.7 Scope of the Study
- 1.8 Limitations of the Study
- 1.9 Chapter Summary
- Chapter 2 Literature Review
- 2.1 Chapter Introduction
- 2.2 Literature Review
- 2.3 Theoretical Framework (Minimum of 1 theory or model)
- 2.4 Conceptual Framework
- 2.5 Chapter Summary
- Chapter 3 Methodology
- 3.1 Chapter Introduction
- 3.2 Research Approach
- 3.3 Research Design
- 3.4 Study Area
- 3.5 Sampling Design
- 3.5.1 Study Population
- 3.5.2 Sampling Technique(s)
- 3.5.3 Sample Size
- 3.6 Data Collection Method/ Instrument
- 3.7 Data Analysis Technique
- 3.8 Validity and Reliability
- 3.9 Ethical Consideration
- 3.10 Chapter Summary
- Chapter 4: Results
- Chapter 5: Discussion
- Chapter 6: Conclusions and Recommendations
- 6.1 Conclusions
- 6.2 Recommendations
- References
Objective & Thematic Focus
This research paper fundamentally aims to investigate the attitudes and knowledge of HIV-positive women towards cervical cancer screening services within the Lighthouse Lilongwe catchment area in Malawi. The primary objective is to understand why women living with HIV may be hesitant to undergo screening despite available services, in order to inform effective health promotion interventions.
- Assessing the current proportion of eligible HIV-positive women who access cervical cancer screening services.
- Evaluating the willingness of HIV-positive women to voluntarily seek cervical cancer screening services.
- Analyzing the perceptions of HIV-positive women regarding annual cervical cancer screening.
- Exploring the role of the Health Belief Model in influencing health-seeking behaviors related to screening.
- Identifying barriers and facilitators that impact the uptake of cervical cancer screening among the target population.
Excerpt from the Book
INVESTIGATING THE ATTITUDES AND KNOWLEDGE OF HIV POSSITIVE WOMEN TOWARDS CERVICAL CANCER SCREENING SERVICES AT LIGHTHOUSE-KAMUZU CENTRAL HOSPITAL, LILONGWE, MALAWI
Cervical cancer is the abnormal growth of cells that starts in the cervix. It is one of the most life-threatening malignant diseases that affects Women Living with HIV(WLHIV). According to the fact sheet Malawi 2023 report, the estimates indicates that every year about 4145 women are diagnosed with cervical cancer and 2905 die from the disease. Cervical cancer is six to eight times common in WLHIV. Regular cervical cancer screening helps to detect the cancer early for effective treatment.
Although cervical cancer is one of the most preventable and treatable malignant diseases, it is the fourth most commonly detected cancer in women worldwide, with more than half a million new cases and 311 365 deaths in 2018 (Stelzle, et al., 2020). On average, one woman dies from cervical cancer every two minutes (UNAIDS, n.d).
According to World Health Organisation, eighty-five percent of women with cervical cancer and HIV live in sub-Saharan Africa, underscoring the major contribution of HIV to the cervical cancer burden in the region (WHO, 2020). This means that the sub-Saharan Africa cervical cancer cases in HIV positive women exceeds the world's average estimation of cervical cancer burden. This high prevalence of cervical cancer can directly be attributed to the high prevalence rate of HIV in adolescent girls and women in the region as per (Kaveri, 2023), in 2022 alone, women and girls accounted for 63% of all new HIV infections in sub-Saharan Africa.
In Malawi 2023, the Fact sheet report on Human Papillomavirus and Related Cancers highlighted that about 6.03million are women of 15years of age and above who are at risk of developing cervical cancer. The estimates indicated that every year 4145 women are diagnosed with cervical cancer and 2905 die from the disease (FactSheet, 2023). It is also indicated that Malawi has the highest rate of cervical cancer globally and cervical cancer is six to eight times more common in women with HIV (Pfaff, et al., 2018)
Integration of HIV services with cervical cancer screening and treatment has been crucial in attempts to reduce deaths caused by the disease in HIV positive women as stipulated by the Sustainable Development Goal 3.4; by 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being (UN, n.d). Gunilla Carlsson, Executive Director, UNAIDS said; "To save a woman's life by providing access to treatment for HIV, yet she dies from cervical cancer because she hasn't had access to cancer screening is unacceptable,” (Carlsson, 2019) This integration of services helps women who regularly attend an HIV clinic more accessible to cervical cancer screening services which is vital for early detection and effective treatment.
Despite integrating cervical cancer screening services into HIV care, still a lot of women show hesitancy to go for cervical cancer screening leading to inconsistent uptake. Therefore, investigating the attitudes and knowledge to establish the causes for their hesitancy is crucial for effective interventions and program sustainability.
Chapter Summaries
Chapter 1 Introduction: This chapter provides an overview of the study's background, problem statement, main and specific objectives, research questions, significance, scope, and limitations, setting the stage for investigating cervical cancer screening among WLHIV.
Chapter 2 Literature Review: This section reviews existing literature on factors influencing HIV-positive women's willingness to seek cervical cancer screening, including education, fear of results, and community awareness, and introduces the Health Belief Model as a theoretical framework.
Chapter 3 Methodology: This chapter details the mixed-methods research approach, descriptive and exploratory study designs, the study area (Lighthouse ART Clinic, Lilongwe), sampling techniques (simple random sampling for 99 participants), data collection methods (questionnaires), and ethical considerations.
Chapter 4 Results: This chapter presents the findings of the study, describing the proportion of eligible WLHIV accessing screening, their willingness to seek services voluntarily, and their perceptions towards annual cervical cancer screening through figures and tables.
Chapter 5 Discussion: This chapter interprets the study's findings in relation to the research objectives, highlighting the high screening coverage achieved through facility strategies but also addressing the significant lack of voluntary willingness and negative perceptions influencing screening uptake among WLHIV.
Chapter 6 Conclusions and Recommendations: This final chapter summarizes the key conclusions, emphasizing the health promotion gap regarding voluntary screening behavior and negative perceptions, and provides recommendations for improving health education and provider communication to enhance screening uptake.
Keywords
HIV-positive women, cervical cancer screening, attitudes, knowledge, Malawi, Lighthouse-Kamuzu Central Hospital, Lilongwe, health promotion, screening uptake, perceptions, Health Belief Model, public health, health equity, program policy, hesitancy.
Frequently Asked Questions
What is this work fundamentally about?
This work fundamentally investigates the attitudes and knowledge of HIV-positive women in Malawi regarding cervical cancer screening services, aiming to understand factors influencing their participation and identify gaps in health promotion.
What are the central thematic areas?
The central thematic areas include the prevalence of cervical cancer among women living with HIV, their attitudes and knowledge towards screening, willingness and perceptions concerning screening services, and the application of health behavior models to understand uptake.
What is the primary objective or research question?
The primary objective is to investigate the attitudes and knowledge of HIV-positive women towards cervical cancer screening services within the Lighthouse Lilongwe catchment area.
Which scientific method is used?
The study employs a mixed-methods approach, combining both qualitative and quantitative research. It utilizes descriptive and exploratory study designs, with data collected via questionnaires and analyzed using descriptive statistics and thematic analysis.
What is covered in the main part?
The main part of the work covers the introduction and background of the study, a literature review, the methodology employed, the presentation of results, a discussion of these findings, and finally, conclusions and recommendations based on the research.
Which keywords characterize the work?
Key terms characterizing this work include HIV-positive women, cervical cancer screening, attitudes, knowledge, Malawi, health promotion, perceptions, and the Health Belief Model.
What is the role of the Health Belief Model in this study?
The Health Belief Model (HBM) serves as the theoretical framework for this study, aiming to explain and predict health-related behaviors. It helps to understand how women living with HIV's beliefs about perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy influence their decision to seek cervical cancer screening.
What are the main findings regarding WLHIV's willingness to seek screening?
Despite a high proportion (93%) of eligible WLHIV having accessed screening, largely due to facility-driven referral strategies, only 52% reported doing so voluntarily. A significant number expressed hesitancy and reasons for not seeking screening on their own, such as lack of knowledge about screening intervals or forgetting appointments.
What are some negative perceptions highlighted by the study?
Negative perceptions towards cervical cancer screening highlighted by the study include the process being perceived as painful (59%), embarrassing (34%), scary (31%), degrading (25%), and uncomfortable (20%). These perceptions significantly influence women's willingness to participate.
Where was the study conducted and who were the participants?
The study was conducted at Lighthouse ART Clinic within the Lilongwe KCH Lighthouse Trust catchment area. The participants were HIV-positive women and girls in the reproductive age range of 15-55 years receiving care at this clinic.
- Arbeit zitieren
- Collins Mtumodzi (Autor:in), 2026, Investigating the Attitudes and Knowledge of HIV-Positive Women Towards Cervical Cancer Screening Services in Malawi, München, GRIN Verlag, https://www.grin.com/document/1696304
