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Linking communicable and non-communicable diseases: A case study of the determinants of cervical cancer screening among HIV patients in Zimbabwe

Authors: Joseph Kangmennaang*, University of North Carolina at Charlotte
Topics: Medical and Health Geography, Human-Environment Geography, Africa
Keywords: HIV, HIV-associated NCDs, Cervical cancer, integrated care, Zimbabwe
Session Type: Paper
Presentation File: No File Uploaded

People living with HIV can now have nearly normal lifespans, however they are more likely to die from HIV-related comorbidities, co-infections, and complications than from HIV. In sub-Saharan Africa, cervical cancer is the second most common cause of cancer related deaths and it closely intersects with the HIV. Despite benefits of early cervical cancer screening in reducing HIV related cervical cancer deaths, uptake remains limited, with wide disparities in access across low to middle income countries. As part of a larger study, this paper examines and compares the determinants of cervical cancer screening between HIV-positive and HIV-negative women of reproductive age (15–49 years) in Zimbabwe. We conducted a multilevel analysis of cervical cancer screening among total of 6, 859 women who completed the HIV questionnaire and whose blood was tested for HIV using the 2015 Zimbabwe Demographic and Health Survey (KDHS). Results show that only 17% of the sample reported ever testing for cervical cancer and about 19% of the sample were HIV positive. The multivariate results show that HIV status is an important determinant of cervical cancer screening. Women who were HIV-positive (OR=1.34, p≤0.01) were more likely to report screening for cervical cancer compared to HIV-negative women. Socioeconomic factors such as wealth, health insurance, employment and educational level predicted cervical cancer screening. We argue for HIV and HIV-associated NCDs integrated care and management of in Eastern Africa due to the legacy of HIV in the region. The paper concludes with policy recommendations and directions for future research.

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