title: Cervical Cancer Screening among HIV-Positive Women in Nigeria: An Assessment of Use and Willingness to Pay in the Absence of Donor Support.
abstract: BACKGROUND
  The sustainability of donor-supported cervical cancer screening for HIV-positive women in underresourced setting is a concern. The authors aimed to determine the willingness of HIV-positive women for out-of-pocket payment for the cancer screening, if necessary.
  
  
  METHODS
  Questionnaires were administered to 400 HIV-positive women at the Adult HIV clinic, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.
  
  
  RESULTS
  In all 11 (2.8%) respondents were aware of Pap smear, but only 1 (9.1%) of them had used it. After cervical cancer screening counseling, 378 (94.5%) respondents were willing to pay for Pap smear, irrespective of the cost. This willingness showed no trend across marital or educational groups. Younger age of respondents was not associated with willingness to pay for Pap smear (odds ratio = 1.24; confidence interval 95%: 0.52, 2.94).
  
  
  CONCLUSIONS
  Willingness to pay for Pap smear by HIV-positive women in Enugu, Nigeria, is high. This has implication for the program sustainability.
authors.affiliation: Departments of Obstetrics & Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria dyme72@yahoo.com.
authors.forename: Cyril C
authors.initials: CC
authors.lastname: Dim
authors.affiliation: Internal Medicine/Adult retroviral clinic, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: Cajetan C
authors.initials: CC
authors.lastname: Onyedum
authors.affiliation: Radiation Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: Ngozi R
authors.initials: NR
authors.lastname: Dim
authors.affiliation: Internal Medicine/Adult retroviral clinic, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: Judith C
authors.initials: JC
authors.lastname: Chukwuka
mesh_terms: D000328:Adult; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000191:economics* / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D005102:Health Expenditures; D006801:Humans; D008875:Middle Aged; D009549:Nigeria; D065006:Papanicolaou Test / Q000191:economics / Q000523:psychology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000191:economics* / Q000523:psychology; D055815:Young Adult
keywords: HIV-positive women; Nigeria; cervical cancer screening; willingness to pay