A comprehensive cross-sectional survey to identify barriers and facilitators of cervical cancer screening in women with HIV in Guangxi, China

BACKGROUND: Co-infection with HIV is a strong risk factor for cervical cancer development. It is unknown whether women with HIV in Guangxi, China are utilizing currently available cervical cancer screening services, what barriers they face, and if they are aware of their increased risk of developing cervical cancer. METHODS: Using a cross-sectional design, we administered a survey to women with HIV aged 21–65 years from August to October 2019 in Guangxi, China. A 100-item survey was designed in English and translated into Chinese. We assessed knowledge, attitudes, and beliefs about cervical cancer and cervical cancer screening, identified potential barriers and facilitators of cervical cancer screening programs for women with HIV, and assessed potential risk factors for cervical cancer. RESULTS: A total of 101 participants completed the survey. The median age of participants was 38 years (IQR 34.5–44 years). Forty-seven percent of the women had been screened for cervical cancer at least once. The mean score was 5.6 out of 9 (95% CI 5.3–6.0) on the knowledge about cervical cancer and screening and 6.3 out of 10 (95% CI 5.9–6.6) for cervical cancer risk factors, respectively. Facilitators of participating in cervical cancer screening included trust and openness to healthcare workers having conversations about female health concerns. Barriers identified in our study included knowledge gaps in cervical cancer risk awareness and cervical cancer screening awareness, including the lack of knowledge of available cervical cancer screening services. Women with HIV in Guangxi are under-screened for cervical cancer. CONCLUSION: When designing tailored cervical cancer screening programs for women with HIV in Guangxi, educational programs to address existing knowledge gaps will be needed to increase screening uptake in this high-risk population.