Factors associated with uptake and acceptability of cervical cancer screening among female sex workers in Northeastern Uganda: A cross-sectional study

dc.contributor.authorRonald Opito
dc.contributor.authorEmmanuel Tiyo Ayikobua
dc.contributor.authorHellen Akurut
dc.contributor.authorSusan Alwedo
dc.contributor.authorSaadick Mugerwa Ssentongo
dc.contributor.authorWalter Drake Erabu
dc.contributor.authorLazarus Oucul
dc.contributor.authorMusa Kirya
dc.contributor.authorLameck Lumu Bukenya
dc.contributor.authorElly Ekwamu
dc.contributor.authorAbraham Ignatius Oluka
dc.contributor.authorSamuel Kabwigu
dc.contributor.authorEmmanuel Othieno
dc.contributor.authorAmos Deogratius Mwaka
dc.date.accessioned2025-02-19T13:35:01Z
dc.date.available2025-02-19T13:35:01Z
dc.date.issued2025-01-24
dc.descriptionAcknowledgments The authors acknowledge the contribution of Professor JR Odong Ikoja, the Soroti Univer sity Vice Chancellor who acquired the funds for the research activities and Professor Francis Ejobi, the Soroti University Director of Research and Innovation for his administrative sup port and oversight on the management of this research project
dc.description.abstractBackground Cervical cancer screening program in Uganda is opportunistic and focuses mainly on women aged 25–49 years. Female sex workers (FSWs) are at increased risk of developing invasive cervical cancer. There is limited data regarding the uptake and acceptability of cervical cancer screening among FSWs in Uganda. This study aimed at identifying factors associated with uptake and acceptability of cervical cancer screening among FSWs in Eastern Uganda. Methods This was a cross-sectional study conducted among 423 FSWs aged 18–49 years attending care at six health facilities serving Key Populations (FSWs, Men who have sex with men, transgender people, people who inject drugs and people in prisons) in the Teso sub-region. Data was collected using structured investigator administered questionnaire and analyzed using Stata statistical software version 15.0 (Stata Corp, Texas, USA). The primary outcome was uptake of cervical cancer screening measured as the proportion of female sex workers who have ever been screened for cervical cancer. Chi-square test was used to compare the differences in uptake of cervical cancer screening by HIV status. Modified Poisson regres sion model with a robust variance estimator was used to determine association between the outcome variables and selected independent variables including demographic charac teristics. Prevalence ratios (PR) with accompanying 95% confidence intervals have been reported. Statistical significance was considered at two-sided p-values ≤ 0.05. Results The mean age of the participants was 28.1 (±SD = 6.6) years. The self-reported HIV prevalence was 21.5% (n = 91). There were 138 (32.6%) participants who had ever been screened for cervical cancer (uptake), while 397 (93.9%) were willing to be screened (acceptability). There was a significant difference in cervical cancer screening uptake between women living with HIV (WLHIV) and those who were HIV negative, 59.3% vs 26.9% respectively (P < 0.001). The significant factors associated with uptake of cervical cancer screening included living with HIV, adjusted prevalence ratio (aPR) = 1.53 (95%CI: 1.15–2.07), increasing number of biological children, aPR = 1.14 (1.06–1.24) living near a private not for profit (PNFP) facility, aPR = 2.84 (95% CI; 1.68–4.80) and availability of screening services at the nearest health facility, aPR = 1.83 (95% CI, 1.30–2.57). Factors significantly associated with acceptability of cervical cancer screening included being 40 years or older, aPR = 1.22 (95%CI: 1.01–1.47), having a family history of cervical cancer, aPR = 1.05 (1.01–1.10), and living near a PNFP facility, aPR = 1.17 (95% CI, 1.09–1.27) and having ever screened before, aPR = 0.92 (0.86–0.98). Conclusion Female sex workers living with HIV are more likely to screen for cervical cancer than the HIV negative clients. Cervical cancer screening uptake is relatively low among the female sex workers. However, majority of the FSWs are willing to be screened for cervical cancer if the services are provided in the nearby healthcare facilities. There is need to make cer vical cancer screening services available to all eligible women especially the female sex workers and integrate the services with sexual reproductive health services in general and not just HIV/ART clinics services
dc.description.sponsorshipGovernment of Uganda. Soroti University Research and Innovation Funds (SUNRIF)
dc.identifier.citationOpito R, Tiyo Ayikobua E, Akurut H, Alwedo S, Ssentongo SM, Erabu WD, et al. (2025) Factors associated with uptake and acceptability of cervical cancer screening among female sex workers in Northeastern Uganda: A cross-sectional study. PLoS ONE 20(1): e0312988. https://doi.org/10.1371/ journal.pone.031298
dc.identifier.issnhttps://doi.org/10.1371/journal.pone.0312988
dc.identifier.urihttps://ir.sun.ac.ug/handle/123456789/131
dc.language.isoen
dc.publisherPLOS One
dc.titleFactors associated with uptake and acceptability of cervical cancer screening among female sex workers in Northeastern Uganda: A cross-sectional study
dc.typeArticle

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