Barriers to annual cervical screening for women living with HIV infection in the Auckland/Northland region

Abstract

Background Cervical cancer is still a significant cause of mortality among women worldwide, despite the availability of screening and prevention programmes in many countries. Women living with human immunodeficiency virus (HIV) infection are at an increased risk of cervical abnormalities and cervical cancer than women without HIV infection. Because of this increased risk, the New Zealand National Cervical Screening Programme recommends annual cervical screening for women living with HIV infection. The Infectious Disease Service at Auckland City Hospital care for a large proportion of the women living with HIV throughout New Zealand. An audit of the cervical screening histories of women under the care of Auckland Sexual Health Services and Auckland Hospital Infectious Disease Service in 2007, showed that of the 123 women who were audited, only 56 % met the definition for annual cervical screening. Considering the negative health implications of not attending regular cervical screening, this research sought to identify barriers to annual cervical screening for women with HIV infection under the care of the Auckland City Hospital Infectious Disease Service. Method Survey was used to gather quantitative data. One hundred and twenty four women with HIV, aged 20- 69, under the care of the Infectious Disease Service, were invited to participate when they attended their regular HIV outpatient clinic appointment. Anonymous questionnaires were administered and either filled out and returned in a ‘Drop Box’ at clinic or returned in a stamped addressed envelope which was given out with the questionnaire. Findings Ninety three of the eligible 124 women returned the questionnaire. Chi-squared analyses performed on the data found that results differed from the international literature. Women aged 40-49 years were less likely than women in other age groups to attend annual cervical screening. Other common barriers identified in previous research were not identified as barriers for this participant group. Conclusion Further research is required to identify factors associated with non-adherence to the recommended annual cervical screening interval in this high risk population group.