CERVICAL CANCER SCREENING AMONG WOMEN LIVING WITH HIV IN ZAMFARA STATE: KNOWLEDGE, ATTITUDES, AND ASSOCIATED FACTORS

Abstract

Background: Cervical cancer is a leading cause of morbidity and mortality among women in sub-Saharan Africa, with women living with HIV (WLHIV) at higher risk due to immunosuppression. This study assessed knowledge, attitudes, and factors influencing cervical cancer screening uptake among WLHIV in Zamfara State, Nigeria. A cross-sectional survey was conducted between June 2024 and January 2025 among 216 WLHIV aged 25–49 years enrolled in ACE3-supported HIV facilities across three Local Government Areas. Participants were randomly selected, and data were collected through structured questionnaires. Descriptive statistics, chi-square tests, and bivariate analyses were performed. Of 216 respondents, 55% had awareness of cervical cancer screening, yet only 41% had ever been screened. Despite this, all participants (100%) expressed willingness to undergo screening if available. Nearly all (99%) acknowledged that early screening and treatment of precancerous lesions could prevent cervical cancer. Reported barriers included lack of awareness (45%), painfulness (31%), stigma (3%), and shyness (5%). Knowledge and positive attitudes were significantly associated with uptake (p < 0.05). Screening uptake among WLHIV in Zamfara State is low despite high willingness. Integrating cervical cancer screening into HIV care, raising awareness, and addressing stigma are essential strategies to improve uptake. Strengthening screening within HIV platforms can reduce the burden of cervical cancer in high-risk populations.