title: Cervical cancer screening practices, knowledge of screening and risk, and highly active antiretroviral therapy adherence among women living with human immunodeficiency virus in Lima, Peru.
abstract: Cervical cancer (CC) is the leading cause of cancer death among Peruvian women. Awareness shown by women living with HIV (WLHIV) of their increased risk and Papanicoloau (Pap) smear frequency is understudied, particularly in Peru. We assessed the uptake of guidelines-based CC screening practices and its associations with two predictors, knowledge of CC screening and risk and highly active antiretroviral therapy (HAART) adherence, among WLHIV. Collected by self-administered questionnaires from 2014 to 2016, we analyzed the data of 71 WLHIV. Most WLHIV (77.5%, n = 55/71) were overdue to CC screening by not having a Pap smear within the prior 12 months. WLHIV who had on-time Pap smears had a higher median composite 'knowledge' score of 3.0 ([interquartile range] 1.5-4) compared to 2.0 (IQR 1-3) for overdue WLHIV. On-time and overdue WLHIV had the same median composite 'HAART adherence' score of 3.0 (IQR 2-4). Bivariate analysis found no association between knowledge nor adherence with on-time Pap smears. Although on-time WLHIV were more knowledgeable about CC screening and risk, overall CC screening uptake was poor. Larger studies of this population are needed to assess the educational, social, and structural barriers contributing to this low prevalence of screening.
authors: 1 Department of Medicine, Division of Infectious Disease, University of California, Los Angeles, USA.|2 The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
authors: Jeanne R
authors: JR
authors: Delgado
authors: 3 Asociación Civil Vía Libre, Lima, Peru.
authors: Luis
authors: L
authors: Menacho
authors: 1 Department of Medicine, Division of Infectious Disease, University of California, Los Angeles, USA.|4 Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
authors: Eddy R
authors: ER
authors: Segura
authors: 3 Asociación Civil Vía Libre, Lima, Peru.
authors: Fernando
authors: F
authors: Roman
authors: 3 Asociación Civil Vía Libre, Lima, Peru.
authors: Robinson
authors: R
authors: Cabello
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001294:Attitude to Health; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D010568:Peru / Q000453:epidemiology; D012306:Risk; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D016387:Women's Health; D055815:Young Adult
keywords: Highly active antiretroviral therapy; human immunodeficiency virus; human papillomavirus; prevention; women