Prevalence and correlates of cervical cancer screening among injection drug users.
OBJECTIVE
Access to cervical cancer screening may be lower among lower income and socially disadvantaged populations. However, few studies have specifically examined factors associated with cervical cancer screening among socially marginalized populations, especially in settings with free health care systems.


METHODS
The present study was conducted to examine the prevalence and correlates of cervical cancer screening among injection drug users. We examined rates of Papanicolaou (Pap) smear testing among female participants in the Vancouver Injection Drug Users Study (VIDUS). Univariate and logistic regression analyses were used to evaluate factors associated with cervical cancer screening.


RESULTS
During the period from December 2004 to May 2005, 297 female injection drug users were seen. In logistic regression analyses, age (adjusted odds ratio [AOR]=0.70; 95% confidence intervals [CI] 0.53, 0.92, P=0.010), HIV infection (AOR=2.46; 95% CI 1.41,4.26, P=0.001), hepatitis C infection (AOR=0.25; 95% CI 0.09,0.71, P=0.010), and having visited a family physician in the prior six months (OR=3.10; 95% CI 1.58, 6.07, P=0.001) were independently associated with recent cervical cancer screening.


CONCLUSIONS
After adjustment for regular physician visits, HIV infection was associated with elevated rates of cervical screening. This is reassuring, given the elevated risk of cervical cancer among this population. Interventions may be required to improve uptake of screening among older injection drug users and drug users infected with hepatitis C.
McKnight
Bruce
B
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver BC.
McKnight
Ian
I
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver BC.
Kerr
Thomas
T
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver BC; Department of Medicine, University of British Columbia, Vancouver BC.
Li
Kathy
K
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver BC.
Montaner
Julio
J
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver BC; Department of Medicine, University of British Columbia, Vancouver BC.
Wood
Evan
E
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver BC; Department of Medicine, University of British Columbia, Vancouver BC.
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001955:British Columbia / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D065006:Papanicolaou Test; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D014626:Vaginal Smears