Our paper, “Uptake and correlates of cervical cancer screening among women attending a community-based multi-disease health campaign in Kenya,” is published in the BMC Women’s Health. In this paper, we describe the acceptability and uptake of a model of integrated HPV-based cervical cancer screening as part of a series of multi-disease community health campaigns offered in Kisumu, Kenya. We also describe the prevalence and predictors of both screening and positive HPV results among women attending these campaigns.

Although there is an increased risk of cervical cancer among women living with HIV, many HIV-care programs do not offer integrated cervical cancer screening. To address the cervical cancer screening gap in Kenya, we leveraged the community health campaigns facilitated by the Family AIDS Care & Education Services and provided multi-disease testing to achieve a high population coverage for HIV-testing and HPV-based cervical cancer screening in western Kenya, an area with high rates of HIV. In addition to HIV testing, the campaigns provided screening for TB, malaria, hypertension, diabetes, and referrals for voluntary medical male circumcision. After these services, women aged 25-65 were offered self-collected HPV testing. A total of 2,016 women attended the outreach campaigns. Of those, 749 women (36%) were screened, and 134 women (19%) were HPV-positive. In our bivariate analysis, women who had no children, who were not pregnant, who were using contraceptives, who had sex without using condoms, and who were encouraged by a family member other than their spouse, were more likely to undergo screening. Our findings from bivariate and multivariate analyses suggest that the greatest barrier to cervical cancer screening in multi-disease campaigns may be largely attributable to logistical reasons rather than factors related to the procedure for self-sampling HPV testing, such as fear, discomfort, or pain associated with collecting the HPV specimen. Women who had used contraceptives in the last 12 months were also more likely to undergo screening than those who had not, which suggests that women who use contraceptives are more familiarity with reproductive health services and are more informed about their reproductive health. In addition, our bivariate analyses with participant characteristics and HPV positivity found that women who screened HPV-positive were more likely to be HIV-positive and single. Our cervical cancer screening uptake was low, which may be attributed to implementation challenges including long waiting times for service at the multi-disease campaign and delays in procuring HPV test kits. However, given the potential benefits of integrating HPV testing into HIV outreach campaigns, these challenges should be examined to develop more effective multi-disease outreach interventions.

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