title: Self-collection based HPV testing for cervical cancer screening among women living with HIV in Uganda: a descriptive analysis of knowledge, intentions to screen and factors associated with HPV positivity.
abstract: Women living with HIV (WHIV) are disproportionately impacted by cervical dysplasia and cancer. The burden is greatest in low-income countries where limited or no access to screening exists. The goal of this study was to describe knowledge and intentions of WHIV towards HPV self-collection for cervical cancer screening, and to report on factors related to HPV positivity among women who participated in testing.
  
  
  
  A validated survey was administered to 87 HIV positive women attending the Kisenyi Health Unit aged 30-69 years old, and data was abstracted from chart review. At a later date, self-collection based HPV testing was offered to all women. Specimens were tested for high risk HPV genotypes, and women were contacted with results and referred for care. Descriptive statistics, Chi Square and Fischer-exact statistical tests were performed.
  
  
  
  The vast majority of WHIV (98.9%) women did not think it necessary to be screened for cervical cancer and the majority of women had never heard of HPV (96.4%). However, almost all WHIV found self-collection for cervical cancer screening to be acceptable. Of the 87 WHIV offered self-collection, 40 women agreed to provide a sample at the HIV clinic. Among women tested, 45% were oncogenic HPV positive, where HPV 16 or 18 positivity was 15% overall.
  
  
  
  In this group of WHIV engaged in HIV care, there was a high prevalence of oncogenic HPV, a large proportion of which were HPV genotypes 16 or 18, in addition to low knowledge of HPV and cervical cancer screening. Improved education and cervical cancer screening for WHIV are sorely needed; self-collection based screening has the potential to be integrated with routine HIV care in this setting.
authors.affiliation: University of British Columbia, Vancouver, BC, Canada.
authors.forename: Sheona M
authors.initials: SM
authors.lastname: Mitchell
authors.affiliation: University of British Columbia, Vancouver, BC, Canada.
authors.forename: Heather N
authors.initials: HN
authors.lastname: Pedersen
authors.affiliation: University of British Columbia, Vancouver, BC, Canada.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Eng Stime
authors.affiliation: Makerere University, Kampala, Uganda.
authors.forename: Musa
authors.initials: M
authors.lastname: Sekikubo
authors.affiliation: Women's Health Research Institute, Vancouver, BC, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Moses
authors.affiliation: Kisenyi Health Centre, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Mwesigwa
authors.affiliation: Makerere University, Kampala, Uganda.
authors.forename: Christine
authors.initials: C
authors.lastname: Biryabarema
authors.affiliation: BC Women's Hospital and Health Centre, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3 N1, Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Christilaw
authors.affiliation: Makerere University, Kampala, Uganda.
authors.forename: Josaphat K
authors.initials: JK
authors.lastname: Byamugisha
authors.affiliation: Women's Health Research Institute, Vancouver, BC, Canada.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Money
authors.affiliation: University of British Columbia, Vancouver, BC, Canada. gina.ogilvie@cw.bc.ca.|Women's Health Research Institute, Vancouver, BC, Canada. gina.ogilvie@cw.bc.ca.|BC Women's Hospital and Health Centre, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3 N1, Canada. gina.ogilvie@cw.bc.ca.
authors.forename: Gina S
authors.initials: GS
authors.lastname: Ogilvie
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000503:physiopathology / Q000628:therapy; D015497:HIV-1 / Q000472:pathogenicity; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D033182:Intention; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D027383:Papillomaviridae / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000175:diagnosis*; D011203:Poverty / Q000706:statistics & numerical data; D011933:Reagent Kits, Diagnostic / Q000592:standards*; D012648:Self Care / Q000295:instrumentation* / Q000379:methods; D011795:Surveys and Questionnaires; D014454:Uganda; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis
chemical_list: D011933:Reagent Kits, Diagnostic
keywords: Cervical cancer; HIV; Human papillomavirus; Screening; Self-collection