title: Acceptance of peer navigators to reduce barriers to cervical cancer screening and treatment among women with HIV infection in Tanzania.
abstract: OBJECTIVE
  To identify barriers to cervical cancer screening and treatment, and determine acceptance toward peer navigators (PNs) to reduce barriers.
  
  
  METHODS
  A cross-sectional study was conducted among women with HIV infection aged 19 years or older attending HIV clinics in Dar es Salaam, Tanzania, between May and August 2012. Data for sociodemographic characteristics, barriers, knowledge and attitude toward cervical cancer screening and treatment, and PNs were collected by questionnaire.
  
  
  RESULTS
  Among 399 participants, only 36 (9.0%) reported previous cervical cancer screening. A higher percentage of screened than unscreened women reported being told about screening by someone at the clinic (25/36 [69.4%] vs 132/363 [36.4%]; P=0.002), knew that screening was free (30/36 [83.3%] vs 161/363 [44.4%]; P<0.001), and obtained "good" cervical screening attitude scores (17/36 [47.2%] vs 66/363 [18.2%]; P=0.001). Most women (382/399 [95.7%]) did not know about PNs. When told about PNs, 388 (97.5%) of 398 women said they would like assistance with explanation of medical terms, and 352 (88.2%) of 399 said they would like PNs to accompany them for cervical evaluation and/or treatment.
  
  
  CONCLUSIONS
  Use of PNs was highly acceptable and represents a novel approach to addressing barriers to cervical cancer screening and treatment.
authors.affiliation: School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Alaya
authors.initials: A
authors.lastname: Koneru
authors.affiliation: School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Pauline E
authors.initials: PE
authors.lastname: Jolly
authors.affiliation: School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Shaundra
authors.initials: S
authors.lastname: Blakemore
authors.affiliation: School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Renicha
authors.initials: R
authors.lastname: McCree
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
authors.forename: Nedra F
authors.initials: NF
authors.lastname: Lisovicz
authors.affiliation: Management and Development for Health, Dar es Salaam, Tanzania.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Aris
authors.affiliation: Management and Development for Health, Dar es Salaam, Tanzania.
authors.forename: Thereza
authors.initials: T
authors.lastname: Mtesigwa
authors.affiliation: Reproductive Health Cancer Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania.
authors.forename: Safina
authors.initials: S
authors.lastname: Yuma
authors.affiliation: Division for Cancer Prevention and Research, Ocean Road Cancer Institute, Dar es Salaam, Tanzania.
authors.forename: Julius D
authors.initials: JD
authors.lastname: Mwaiselage
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D015658:HIV Infections / Q000150:complications*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D062526:Patient Navigation / Q000379:methods; D011230:Precancerous Conditions / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D011795:Surveys and Questionnaires; D013636:Tanzania; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D055815:Young Adult
keywords: Barriers; Cervical cancer; Peer navigators; Screening; Tanzania