Precancerous Cervical Lesions among HIV Infected Women in Referral Hospitals of Amhara Region, Northwest Ethiopia
Simachew Kassa, Mulugeta Dile, Kahsay Zenebe, Marta Berta
Background: Cancer of the cervix is a major public health problems facing women in Ethiopia. Its magnitude is higher in HIV infected women than non HIV infected women. Thus, screening targeting HIV infected women is being undertaken in low and middle income countries, including Ethiopia. However, its magnitude and determinants among women living with human immune deficiency syndrome in Amhara region is lacking. Therefore, this study aimed to assess the magnitude of and factors associated with precancerous cervical lesion. Methods: An institution based cross-sectional study was conducted from 1st September to 30th December 2015. Four hundred and thirty-five systematically selected women were included in the study. The data were collected by using a pre-tested and structured questionnaire. Data was collected through face to face interview and patient chart review. Visual inspection with acetic acid was applied for screening and treatment. Data were entered into Epi-info version 7, cleaned and analysed using SPSS version 20. Logistic regression analysis was fited and odds ratio with 95% confidence interval were computed. Results: This study revealed that the overall prevalence of precancerous cervical lesions was 20.2% (95% CI: 13%, 29%). Having more than one lifetime sexual partner (AOR=2.91, 95% CI: 1.13, 7.52), history of sexually transmitted disease (AOR=4.04, 95% CI: 2.19, 7.44), age at first birth less than 18 years (AOR=3.36, 95% CI: 1.79, 5.01) and baseline CD4 count less than 200 cells/mm3 (AOR=7.51, 95% CI: 3.58, 15.68) were factors associated with precancerous cervical lesion. Conclusions: This study revealed that the prevalence of precancerous cervical lesions in Amhara region is found to be high. Interventions to create a screening strategy for cervical intraepithelial neoplasia for all women living with HIV and family planning promotion to delay age for first birth should be undertaken. In addition, awareness creation about impact of multiple sexual partner, promotion of early HIV diagnosis and timely base line CD 4 cell count testing, and organize community based campaign to stem the continuinig rise of STI in HIV positive women are important.
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