Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria
Abstract Background High HIV prevalence, and lack of organized screening for the indigent population receiving care and treatment within HIV clinics in low-resource settings increases cervical cancer incidence. We sought to determine predictors of cervical precancer in women living with HIV and rece...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-024-17739-z |
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| author | F. A. Magaji M. I. Mashor S. A. Anzaku A. R. Hinjari N. T. Cosmas B. V. Kwaghe J. M. Ali Elizabeth N. Christian A. S. Sagay Ariel Chandler Imran Khan Robert L. Murphy Lifang Hou J. Musa |
| author_facet | F. A. Magaji M. I. Mashor S. A. Anzaku A. R. Hinjari N. T. Cosmas B. V. Kwaghe J. M. Ali Elizabeth N. Christian A. S. Sagay Ariel Chandler Imran Khan Robert L. Murphy Lifang Hou J. Musa |
| author_sort | F. A. Magaji |
| collection | DOAJ |
| description | Abstract Background High HIV prevalence, and lack of organized screening for the indigent population receiving care and treatment within HIV clinics in low-resource settings increases cervical cancer incidence. We sought to determine predictors of cervical precancer in women living with HIV and receiving cervical cancer screening in Jos, Nigeria. Methods A cross-sectional study of women living with HIV and receiving care and treatment in adult HIV/AIDS clinics in Jos-Metropolis, Nigeria between June 2020 and April 2023. Ethical approvals were obtained from the ethics committee in Jos, Nigeria and Northwestern University IRB, USA. Informed consent was obtained from eligible participants, and data on socio-demographics, cancer risk factors, and cytology reports were collected. The outcome variables were cervical precancer lesions. The independent variables were prior Pap smear status, socio-demographics, income, educational, and other reproductive health factors. Descriptive statistics was done to obtain means ± sd, frequencies, and percentages for the variables. Univariate and bivariate analyses were done to determine predictors of cervical dysplasia. Analyses were performed using R software. Results Of 957 women screened, 570 were living with HIV and 566 women had cytology report and were included in the final analysis. The mean age was 45.08 ± 8.89 years and 81.6% had no prior evidence of Pap test (under-screened). Prevalence of cervical dysplasia was 24% (mild and severe dysplasia were 12.9% and 11.1%, respectively). Age above 45 years (aOR = 3.48, p = 0.009), postmenopausal status (aOR = 7.69, p = 0.000), and women with no history of prior IUCD use (aOR = 5.94, p = 0.0001), were predictors for severe dysplasia. Women who had history of STI (aOR = 0.17, p = 0.000), prior use of IUCD (aOR = 0.32, p = 0.004), prior use of condom (aOR = 2.50, p = 0.003) and had co-morbidities (aOR = 0.46, p = 0.009) were more likely to have had a Pap test in the past. Conclusions The majority of indigent women receiving care at HIV clinics had their first Pap test screening, and lack of organized screening among older and post-menopausal women with HIV, puts women at a higher risk of developing severe cervical precancer lesions. |
| first_indexed | 2024-03-08T12:33:51Z |
| format | Article |
| id | doaj.art-d9ff2954d3484e3fb584006722f75130 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T12:33:51Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-d9ff2954d3484e3fb584006722f751302024-01-21T12:38:25ZengBMCBMC Public Health1471-24582024-01-0124111510.1186/s12889-024-17739-zCommunity cervical cancer screening and precancer risk in women living with HIV in Jos NigeriaF. A. Magaji0M. I. Mashor1S. A. Anzaku2A. R. Hinjari3N. T. Cosmas4B. V. Kwaghe5J. M. Ali6Elizabeth N. Christian7A. S. Sagay8Ariel Chandler9Imran Khan10Robert L. Murphy11Lifang Hou12J. Musa13Gynecologic-Oncology Division, Department of Obstetrics and Gynecology, University of JosDepartment of HistopathologyBingham University Teaching HospitalGynecologic-Oncology Division, Department of Obstetrics and Gynecology, University of JosGynecologic-Oncology Division, Department of Obstetrics and Gynecology, University of JosDepartment of Anatomic Pathology and Forensic Medicine, Jos University Teaching HospitalGynecologic-Oncology Division, Department of Obstetrics and Gynecology, University of JosRobert J. Havey, MD Institute for Global HealthGynecologic-Oncology Division, Department of Obstetrics and Gynecology, University of JosProgram Department Health Analytics, School of Professional Studies, Northwestern UniversityProgram Department Health Analytics, School of Professional Studies, Northwestern UniversityNorthwestern University Feinberg School of MedicineNorthwestern University Feinberg School of MedicineGynecologic-Oncology Division, Department of Obstetrics and Gynecology, University of JosAbstract Background High HIV prevalence, and lack of organized screening for the indigent population receiving care and treatment within HIV clinics in low-resource settings increases cervical cancer incidence. We sought to determine predictors of cervical precancer in women living with HIV and receiving cervical cancer screening in Jos, Nigeria. Methods A cross-sectional study of women living with HIV and receiving care and treatment in adult HIV/AIDS clinics in Jos-Metropolis, Nigeria between June 2020 and April 2023. Ethical approvals were obtained from the ethics committee in Jos, Nigeria and Northwestern University IRB, USA. Informed consent was obtained from eligible participants, and data on socio-demographics, cancer risk factors, and cytology reports were collected. The outcome variables were cervical precancer lesions. The independent variables were prior Pap smear status, socio-demographics, income, educational, and other reproductive health factors. Descriptive statistics was done to obtain means ± sd, frequencies, and percentages for the variables. Univariate and bivariate analyses were done to determine predictors of cervical dysplasia. Analyses were performed using R software. Results Of 957 women screened, 570 were living with HIV and 566 women had cytology report and were included in the final analysis. The mean age was 45.08 ± 8.89 years and 81.6% had no prior evidence of Pap test (under-screened). Prevalence of cervical dysplasia was 24% (mild and severe dysplasia were 12.9% and 11.1%, respectively). Age above 45 years (aOR = 3.48, p = 0.009), postmenopausal status (aOR = 7.69, p = 0.000), and women with no history of prior IUCD use (aOR = 5.94, p = 0.0001), were predictors for severe dysplasia. Women who had history of STI (aOR = 0.17, p = 0.000), prior use of IUCD (aOR = 0.32, p = 0.004), prior use of condom (aOR = 2.50, p = 0.003) and had co-morbidities (aOR = 0.46, p = 0.009) were more likely to have had a Pap test in the past. Conclusions The majority of indigent women receiving care at HIV clinics had their first Pap test screening, and lack of organized screening among older and post-menopausal women with HIV, puts women at a higher risk of developing severe cervical precancer lesions.https://doi.org/10.1186/s12889-024-17739-zAdult HIV-clinicIndigent womenPap testCervical precancer and cancerJos-Nigeria |
| spellingShingle | F. A. Magaji M. I. Mashor S. A. Anzaku A. R. Hinjari N. T. Cosmas B. V. Kwaghe J. M. Ali Elizabeth N. Christian A. S. Sagay Ariel Chandler Imran Khan Robert L. Murphy Lifang Hou J. Musa Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria BMC Public Health Adult HIV-clinic Indigent women Pap test Cervical precancer and cancer Jos-Nigeria |
| title | Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria |
| title_full | Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria |
| title_fullStr | Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria |
| title_full_unstemmed | Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria |
| title_short | Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria |
| title_sort | community cervical cancer screening and precancer risk in women living with hiv in jos nigeria |
| topic | Adult HIV-clinic Indigent women Pap test Cervical precancer and cancer Jos-Nigeria |
| url | https://doi.org/10.1186/s12889-024-17739-z |
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