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Enyan NIE, Ken-Amoah S, Tuoyire DA, Akakpo KP, Agyare E, Obiri-Yeboah D. HIV status and knowledge of cervical cancer among women in Ghana. BMC Womens Health 2024; 24:112. [PMID: 38347531 PMCID: PMC10863268 DOI: 10.1186/s12905-024-02953-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Cervical cancer remains a disease of significant concern to women's health. The aim of this study was to identify predictors of knowledge of cervical cancer among women living with HIV and those with negative or unknown HIV status at the Cape Coast Teaching Hospital (CCTH). METHODS This study was based on a larger hospital-based analytical cross-sectional study conducted at the antiretroviral therapy (ART) and gynaecology clinics of the Cape Coast Teaching Hospital in Ghana. Participants were women living with HIV (WLHIV) and women without HIV or whose status was unknown, aged 25 to 65 years, seeking healthcare. Data were collected with a questionnaire and analysed using frequencies, percentages, Chi-square test, binary logistic regression and multivariate analysis. RESULTS The mean age was 39.5 years (± 9.8) and 47.2 years (± 10.7) for women without or unknown HIV and WLHIV, respectively. HIV-negative/unknown women were mostly nulligravida (76%) and nullipara (69%), while WLHIV mostly had pregnancies (76%) and children (84%) in excess of seven. Knowledge of cervical cancer was statistically significantly associated with HIV status (X2 = 75.65; P-value = 0.001). The odds of having knowledge of cervical cancer for women considered to be negative/unknown for HIV were about three times (AOR = 3.07; 95% CI = 1.47, 6.41) higher than their compatriots with HIV. Women with post-secondary/tertiary (AOR = 4.45; 95% CI = 2.11, 9.35) education had significantly higher odds of having knowledge of cervical cancer than those with no education or those with just primary education. CONCLUSIONS To improve knowledge of cervical cancer among women, an intentionally structured health education programme is needed, particularly for WLHIV, those with lower levels of education and the unemployed.
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Affiliation(s)
- Nancy Innocentia Ebu Enyan
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana.
| | - Sebastian Ken-Amoah
- Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Derek Anamaale Tuoyire
- Department of Community Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Kafui Patrick Akakpo
- Department of Pathology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Dorcas Obiri-Yeboah
- Department of Microbiology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
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McIntyre AC, Cody SL, Ezemenaka CJ, Johnson K, Mugoya G, Foster P. HIV Knowledge, Risk Factors, and Utilization of Services in the US Rural Deep South. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01868-z. [PMID: 37985647 DOI: 10.1007/s40615-023-01868-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND HIV prevalence in the rural South remains high among Black Americans due to limited access to prevention and treatment services and poverty. HIV care inequities for Black Americans living in the rural South are further intensified by high mortality rates, low HIV health literacy, stigma, and discrimination. Few studies have focused on HIV knowledge and risk factors within Black Americans in the rural South. METHODS This cross-sectional study examined the association between HIV risk factors, HIV knowledge, and utilization of HIV and/or sexually transmitted infection (STI) testing services among Black Americans (N = 200) living in the rural South. HIV knowledge, risk factors, and utilization of testing services were assessed via The HIV Knowledge Questionnaire, The HIV Risk Factor Questionnaire, and three investigator-generated questions, respectively. Linear regression was used to examine the relationship between demographic characteristics, HIV knowledge, utilization of testing services, and HIV risk factors. RESULTS Among 200 participants, a smaller percentage (37.7%, n = 75) reported using HIV/STI testing services compared to non-users. Controlling for demographic covariates in the model, HIV knowledge (p < .0001) and marital status (p = .010) were significantly associated with HIV risk factors. HIV risk factors decreased as HIV knowledge increased. Individuals who reported being single also reported having fewer risk factors. CONCLUSION Future research should examine the impact of HIV education tailored for individuals with greater HIV risk factors within rural Black Americans. Studies exploring barriers to the utilization of HIV/STI testing services within Black American rural communities are warranted.
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Affiliation(s)
- Alissa C McIntyre
- Department of Psychology, The University of Alabama, 348 Gordon Palmer Hall, Tuscaloosa, AL, 35487-0348, USA.
| | - Shameka L Cody
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL, USA
| | | | - Karen Johnson
- Department of Social Work, The University of Alabama, Tuscaloosa, AL, USA
| | - George Mugoya
- Department of Educational Studies, The University of Alabama, Tuscaloosa, AL, USA
| | - Pamela Foster
- Department of Community Medicine/Population Health, School of Medicine, The University of Alabama, Tuscaloosa Regional Campus, Tuscaloosa, AL, USA
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Mboya E, Mizinduko M, Balandya B, Mushi J, Sabasaba A, Amani DE, Kamori D, Ruhago G, Faustine P, Maokola W, Sambu V, Nyamuhagata M, Jullu BS, Juya A, Rugemalila J, Mgomella G, Asiimwe S, Pembe AB, Sunguya B. HIV burden and the global fast-track targets progress among pregnant women in Tanzania calls for intensified case finding: Analysis of 2020 antenatal clinics HIV sentinel site surveillance. PLoS One 2023; 18:e0285962. [PMID: 37824470 PMCID: PMC10569580 DOI: 10.1371/journal.pone.0285962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND For successful HIV response, updated information on the burden and progress toward HIV elimination targets are required to guide programmatic interventions. We used data from the 2020 HIV sentinel surveillance to update on the burden and factors associated with HIV infection, HIV status awareness, and ART coverage among pregnant women in Tanzania mainland. METHODOLOGY We conducted the surveillance in 159 antenatal clinics (ANC) from all 26 regions of Tanzania's mainland from September to December 2020. This cross-sectional study included all pregnant women (≥15 years) on their first ANC visit in the current pregnancy during the survey period. Routine HIV counselling and testing were done at the facility. A multivariable logistic regression model accounting for the survey design was used to examine factors associated with HIV infections. RESULTS 38,783 pregnant women were enrolled (median age (IQR) = 25 (21-30) years). HIV prevalence was 5.9% (95%CI: 5.3% - 6.6%), ranging from 1.9% in the Manyara region to 16.4% in the Njombe region. Older age, lower and no education, not being in a marital union, and living in urban or semi-urban areas were associated with higher odds of HIV infection. HIV status awareness among women who tested positive was 70.9% (95% CI: 67.5%- 74.0%). ART coverage among those aware of their status was 91.6% (86.5%- 94.9%). Overall, 66.6% (95% CI: 62.4%- 70.6%) of all pregnant women who tested positive for HIV knew their HIV status and were on ART. CONCLUSION HIV is increasingly prevalent among pregnant women in Tanzania mainland especially among older, those with lower or no formal education, those outside marital union, and pregnant women living in urban and semi-urban areas. Behind the global fast-target to end HIV/ AIDS, about a third of pregnant women living with HIV initiating ANC were not on ART. Interventions to increase HIV testing and linkage to care among women of reproductive age should be intensified.
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Affiliation(s)
- Erick Mboya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mucho Mizinduko
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Belinda Balandya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Amon Sabasaba
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Davis Elias Amani
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Doreen Kamori
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - George Ruhago
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | | | | | | | - Boniphace S. Jullu
- St. Francis University College of Health and Allied Sciences, Morogoro, Tanzania
| | - Amir Juya
- Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, Tanzania
| | | | - George Mgomella
- Centre for Diseases Control, Country Office, Dar es Salaam, Tanzania
| | | | - Andrea B. Pembe
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno Sunguya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Pachuau LN, Tannous C, Chawngthu RL, Agho KE. HIV and its associated factors among people who inject drugs in Mizoram, Northeast India. PLoS One 2023; 18:e0286009. [PMID: 37216389 DOI: 10.1371/journal.pone.0286009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
AIM To estimate the prevalence and associated factors with the human immune-deficiency virus (HIV) among people who inject drugs (PWID) in Mizoram, Northeast India. METHODS The data source for the analysis was the 2019-2020 Mizoram State AIDS Control Society (MSACS) survey from 2695 PWID registered for the Targeted Intervention (TI) services. Logistic regression analysis was conducted to examine the factors associated with HIV among PWID after adjusting for sociodemographic characteristics, injection, and sexual behaviours. RESULTS 21.19% of the participants tested positive for HIV and the prevalence of HIV among male and female participants were 19.5% and 38.6%, respectively. Multiple logistic regression analysis revealed that female (AOR 1.74; 95% CI 1.26-2.41), 35 years or older (AOR 1.45; 95% CI 1.06-1.99), married (AOR 1.41; 95% CI1.08-1.83), divorced/separated/widowed (AOR 2.12; 95% CI 1.59-2.82) and sharing of needle/syringe (AOR 1.62; 95% CI 1.30-2.00) were all positively associated with HIV infection. We also found that concomitant alcohol use was reduced by 35% (AOR 0.65; 95% CI 0.51-0.82) among HIV positive PWID, and HIV infection was also reduced by 46% (AOR 0.54; 95% CI 0.44-0.67) among those PWID who use a condom with a regular partner. CONCLUSION The findings of this study suggested that there is a high prevalence of HIV among PWID with 1 in 5 PWID reported to have HIV. HIV among PWID was significantly higher among those over 35 years of age, females and divorced/separated/widowed participants. Needle/syringe sharing behaviour is an important determinant of HIV infection. The high prevalence of HIV among PWID population is multifactorial. To reduce HIV among PWID in Mizoram, interventions should target those sharing needles/syringes, females, especially those over 35 years of age and unmarried participants.
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Affiliation(s)
| | - Caterina Tannous
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | | | - Kingsley Emwinyore Agho
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Campbelltown, Australia
- African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, South Africa
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Pachuau LN, Tannous C, Chawngthu RL, Agho KE. Changes in and Predictors of HIV among People Who Inject Drugs in Mizoram, Northeast India, from 2007 to 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105871. [PMID: 37239596 DOI: 10.3390/ijerph20105871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
This study aimed to examine the changes in and predictors of the human immunodeficiency virus (HIV) among people who inject drugs (PWID) in Mizoram, Northeast India, over a period of 15 years (2007-2021). A sample of 14783 PWID was extracted from the Targeted Intervention (TI) services under the Mizoram State AIDS Control Society (MSACS). A chi-square test was used to compare the differences in HIV prevalence across the three 5-year periods, and a multiple logistic regression analysis was used to determine predictors after adjusting for sociodemographic, injecting and sexual behaviours. The results showed that compared to 2007-2011, HIV prevalence was almost three times higher in 2012-2016 (AOR 2.35; 95% CI 2.07-2.66) and almost two times higher in 2017-2021 (AOR 1.41; 95% CI 1.24-1.59). The results suggest that participants who were females (AOR 2.35; 95% CI 2.07-2.66), married (AOR 1.13; 95% CI 1.00-1.27), separated/divorced/widowed (AOR 1.74; 95% CI 1.54-1.96), of middle school level education (AOR 1.24; 95% CI 1.06-1.44), sharing needles/syringes (AOR 1.78; 95% CI 1.61-1.98) and receiving a regular monthly income were positively associated with HIV infection. Condom use with a regular partner (AOR 0.77; 95% CI 0.70-0.85) was high among PWID. Despite targeted interventions under MSACS to reduce HIV in Mizoram, the prevalence of HIV/AIDS among PWID remained high between 2007 and 2021. Policymakers and stakeholders should tailor future interventions based on the factors identified in this study that are associated with HIV infection. Our findings highlight the importance of socio-cultural factors in HIV epidemiology among PWID in Mizoram.
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Affiliation(s)
- Lucy Ngaihbanglovi Pachuau
- School of Health Science, Western Sydney University, Campbelltown Campus, Campbelltown, NSW 2560, Australia
| | - Caterina Tannous
- School of Health Science, Western Sydney University, Campbelltown Campus, Campbelltown, NSW 2560, Australia
| | | | - Kingsley Emwinyore Agho
- School of Health Science, Western Sydney University, Campbelltown Campus, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Campbelltown Campus, Penrith, NSW 2571, Australia
- Faculty of Health Sciences, University of Johannesburg, Doornfontein Campus, Johannesburg 2094, South Africa
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da Cunha AP, da Cruz MM. Analysis of trend in mortality due to HIV/AIDS-defining and non-HIV/AIDS defining illnesses according to sociodemographic characteristics, by Federative Unit and Brazil, 2000-2018. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2022093. [PMID: 36197407 PMCID: PMC9887950 DOI: 10.1590/s2237-96222022000200021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/25/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To analyze the temporal trend of mortality rate due to HIV/AIDS defining and non-HIV/AIDS defining illnesses in Brazil between 2000 and 2018. METHODS This was an ecological time series study, using data from the Mortality Information System, in Brazil and the Federative Units. Trend analysis was performed by means of Prais-Winsten regression model, according to overall mortality rate, sex, age group, marital status and race/skin color. RESULTS A total of 237,435 deaths were recorded in the period. In the country, defining illnesses showed higher rates (7.4 to 4.4 deaths/100,000 inhabitants in the period) than those observed among non-defining diseases (0.4 to 0.8 death/100,000 inhabitants in the period). It could be seen a decrease in overall mortality due to defining diseases (-6.3%; 95%CI -8.8;-3.8); while it increased due to non-defining diseases (11.0%; 95%CI 6.5;15.7). CONCLUSION There was a change in HIV/AIDS mortality profile over the years, with a decrease in deaths due to HIV/AIDS-defining diseases.
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Affiliation(s)
- Ana Paula da Cunha
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio
Arouca, Rio de Janeiro, RJ, Brazil
| | - Marly Marques da Cruz
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio
Arouca, Rio de Janeiro, RJ, Brazil
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Bedaso NG, Debusho LK. Clinics register based HIV prevalence in Jimma zone, Ethiopia: applications of likelihood and Bayesian approaches. BMC Infect Dis 2022; 22:281. [PMID: 35331136 PMCID: PMC8944036 DOI: 10.1186/s12879-021-06965-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022] Open
Abstract
Background The distribution of HIV is not uniform in Ethiopia with some regions recording higher prevalence than others. However, reported regional HIV prevalence estimates mask the heterogeneity of the epidemic within regions. The main purpose of this study was to assess the district differences in HIV prevalence and other factors that affect the prevalence of HIV infection in Jimma zone, Oromia region of Ethiopia. We aimed to identify districts which had higher or lower than zone average HIV prevalence. Such in-depth analysis of HIV data at district level may help to develop effective strategies to reduce the HIV transmission rate. Methods Data collected from 8440 patients who were tested for HIV status in government clinics at the 22 Districts between September 2018 to August 2019 in Jimma zone were used for the analyses. A generalized linear mixed effects model with district random effects was applied to assess the factors associated with HIV infection and the best linear unbiased prediction was used to identify districts that had higher or lower HIV infection. Both likelihood and Bayesian methods were considered. Results The statistical test on district random effects variance suggested the need for district random effects in all the models. The results from applying both methods on full data show that the odds of HIV infection are significantly associated with covariates considered in this study. Disaggregation of prevalence by gender also highlighted the persistent features of the HIV epidemic in Jimma zone. After controlling for covariates effects, the results from both techniques revealed that there was heterogeneity in HIV infection prevalence among districts within Jimma zone, where some of them had higher and some had lower HIV infection prevalence compared to the zone average HIV infection prevalence. Conclusions The study recommends government to give attention to those districts which had higher HIV infection and to conduct further research to improve their intervention strategies. Further, related to those districts which had lower infection, it would be advantageous to identify reasons for their performance and may apply them to overcome HIV infection among residents in those districts which had higher HIV infection. The approach used in this study can also help to assess the effect of interventions introduced by the authorities to control the epidemic and it can easily be extended to assess the regions HIV infection rate relative to the rate at the national level, or zones HIV infection rate relative to the rate at a region level. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06965-0.
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Affiliation(s)
- Nemso Geda Bedaso
- Department of Statistics, College of Natural and Computational Science, Madda Walabu University, Bale Robe, Ethiopia
| | - Legesse Kassa Debusho
- Department of Statistics, College of Science, Engineering and Technology, University of South Africa, Johannesburg, South Africa.
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Ferreira GRON, de Oliveira IS, Freitas WLS, Lira ALBDC, Reis RK, Gir E, Ramos AMPC, Gonçalves LHT, Botelho EP. Factors associated with low knowledge about sexually transmitted infections in subnormal agglomerate, in the Brazilian Amazon. Prim Health Care Res Dev 2021; 22:e70. [PMID: 34763742 PMCID: PMC8628559 DOI: 10.1017/s1463423621000700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/30/2021] [Accepted: 10/17/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Populations living in subnormal agglomerates in urban areas are more vulnerable to infections, including sexually transmitted infections (STIs). In these groups, inadequate knowledge about sexually transmitted infections can further increase the risk of contracting STIs. AIM We investigated the factors associated with low knowledge about STIs in a peripheral population in the Brazilian Amazon. METHODS This cross-sectional study was conducted in Belém, in the Amazon region that has a high percentage of subnormal agglomerates in an urban area and a high incidence of STIs. Random sampling was adopted which resulted in a sample of 320 participants. To assess knowledge about STIs, the self-administered Sexually Transmitted Disease Knowledge Questionnaire was used. To assess aspects of vulnerability, a questionnaire was constructed which is linked to individual, social, and programmatic factors. The chi-square test, G test, and ordinal regression analyses were all performed. FINDINGS The sample of this study was composed of 320 participants. The mean age of the participants was 46.09 years. 37.5% (120), 50.6% (162), and 11.9% (38) showed low, medium, and high knowledge, respectively. Multiple analysis revealed that the factors associated with higher chance of having smaller knowledge about sexually transmitted infections were single/separated/divorced/widow(er) marital status (AOR: 1.80, CI: 1.15-2.84, P = 0.01); income equal to or less than one minimum wage (1.98, CI: 1.21-3.17, P = 0.00); equal to or over than 52 years old (AOR: 1.99, CI: 1.25-3.17, P = 0.00); lack of guidance by a health professional (AOR: 1.59, CI: 1.01-2.51, P = 0.04). Our results show that this community suffer from suboptimal levels of knowledge on STIs, which are linked to individual, social, and programmatic factors. Characterising the risk and vulnerabilities factors allows for carrying out appropriate interventions for populations living in subnormal agglomerates in urban area.
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Affiliation(s)
| | | | | | | | - Renata Karina Reis
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Elucir Gir
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
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Enyan NIE, Akaba S, Amoo SA. Women diagnosed with HIV and unknown HIV status perceived susceptibility to cervical cancer and perceived benefits of cervical cancer screening in Ghana: a cross-sectional study. BMC Womens Health 2021; 21:367. [PMID: 34657607 PMCID: PMC8522230 DOI: 10.1186/s12905-021-01509-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cervical cancer is an issue of global health concern, and it seems to be the next epidemic in Sub-Saharan Africa after Human Immunodeficiency Virus (HIV). This study compared the perceptions of susceptibility to cervical cancer and benefits of cervical cancer screening among women diagnosed and those with unknown HIV status and determined the association between socio-demographic factors and HIV status. METHODS A cross-sectional study was conducted with 600 women diagnosed with HIV and 600 women with unknown HIV status in the Central Region of Ghana. Convenience sampling was used and a structured interview schedule was the main data collection instrument. Data were analysed using frequencies, percentages, chi-square test and independent samples t-test. RESULTS A high proportion of women diagnosed with HIV 94.8% (n = 569) and those with unknown HIV status 93.5% (n = 561) agreed that "screening can find cervical changes". Also, 58.0% (n = 348) of women diagnosed with HIV agreed that they have been in polygamous relationships so they may get cervical cancer. There was a statistically significant association between marital status (X2 = 167.071, p = 0.001), religion (X2 = 57.720, p = 0.001), level of education (X2 = 118.997, p = 0.001), employment status (X2 = 782.646, p = 0.001) and HIV status. A comparison of the mean difference for women diagnosed and those with unknown HIV status in relation to perceived benefits of cervical cancer screening showed a statistically significant difference (t = 7.418, df = 1198, p = 0.001). Nonetheless, there was no statistically significant difference in the means for women diagnosed and those with unknown HIV status regarding perceived susceptibility to cervical cancer (t = 0.935, df = 1198, p = 0.351). CONCLUSIONS Women with HIV perceived higher benefits of cervical cancer screening. Perception of susceptibility to cervical cancer by women with and those without HIV need to be addressed in efforts to improve their health. Furthermore, interventions for women with HIV should consider some important sociodemographic factors.
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Affiliation(s)
- Nancy Innocentia Ebu Enyan
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Selorm Akaba
- Department of Agricultural Economics and Extension, School of Agriculture, University of Cape Coast, Cape Coast, Ghana
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Merzouki A, Styles A, Estill J, Orel E, Baranczuk Z, Petrie K, Keiser O. Identifying groups of people with similar sociobehavioural characteristics in Malawi to inform HIV interventions: a latent class analysis. J Int AIDS Soc 2020; 23:e25615. [PMID: 32985772 PMCID: PMC7521110 DOI: 10.1002/jia2.25615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 08/19/2020] [Accepted: 08/26/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Within many sub-Saharan African countries including Malawi, HIV prevalence varies widely between regions. This variability may be related to the distribution of population groups with specific sociobehavioural characteristics that influence the transmission of HIV and the uptake of prevention. In this study, we intended to identify groups of people in Malawi with similar risk profiles. METHODS We used data from the Demographic and Health Survey in Malawi (2015 to 2016), and stratified the analysis by sex. We considered demographic, socio-behavioural and HIV-related variables. Using Latent Class Analysis (LCA), we identified groups of people sharing common sociobehavioural characteristics. The optimal number of classes (groups) was selected based on the Bayesian information criterion. We compared the proportions of individuals belonging to the different groups across the three regions and 28 districts of Malawi. RESULTS We found nine groups of women and six groups of men. Most women in the groups with highest risk of being HIV positive were living in female-headed households and were formerly married or in a union. Among men, older men had the highest risk of being HIV positive, followed by young (20 to 25) single men. Generally, low HIV testing uptake correlated with lower risk of having HIV. However, rural adolescent girls had a low probability of being tested (48.7%) despite a relatively high HIV prevalence. Urban districts and the Southern region had a higher percentage of high-prevalence and less tested groups of individuals than other areas. CONCLUSIONS LCA is an efficient method to find groups of people sharing common HIV risk profiles, identify particularly vulnerable sub-populations, and plan targeted interventions focusing on these groups. Tailored support, prevention and HIV testing programmes should focus particularly on female household heads, adolescent girls living in rural areas, older married men and young men who have never been married.
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Affiliation(s)
- Aziza Merzouki
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
| | | | - Janne Estill
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
- Institute of Mathematical Statistics and Actuarial ScienceUniversity of BernBernSwitzerland
| | - Erol Orel
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
| | - Zofia Baranczuk
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
- Department of PsychologyUniversity of ZurichZurichSwitzerland
- Institute of MathematicsUniversity of ZurichZurichSwitzerland
| | | | - Olivia Keiser
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
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