Cervical cancer prevention and care in HIV clinics across sub‐Saharan Africa: results of a facility‐based survey

• Published in: Journal of the International AIDS Society 2024-07, Vol.27 (7), p.e26303-n/a
• Main Authors: Asangbeh‐Kerman, Serra Lem, Davidović, Maša, Taghavi, Katayoun, Dhokotera, Tafadzwa, Manasyan, Albert, Sharma, Anjali, Jaquet, Antoine, Musick, Beverly, Twizere, Christella, Chimbetete, Cleophas, Murenzi, Gad, Tweya, Hannock, Muhairwe, Josephine, Wools‐Kaloustian, Kara, Technau, Karl‐Gunter, Anastos, Kathryn, Yotebieng, Marcel, Jousse, Marielle, Ezechi, Oliver, Orang'o, Omenge, Bosomprah, Samuel, Pierre Boni, Simon, Basu, Partha, Bohlius, Julia
• Format: Article
• Language: English
• Subjects: Adult; Africa South of the Sahara - epidemiology; Cancer; Cervical cancer; cervical cancer prevention; Clinics; Data collection; Disease prevention; Epidemiology; Female; Health aspects; Health Services Accessibility; HIV; HIV (Viruses); HIV Infections - epidemiology; HIV Infections - prevention & control; Human immunodeficiency virus; Human papillomavirus; Humans; Immunization; Life Sciences; Medical informatics; Medical screening; Middle Aged; monitoring; Mortality; NGOs; Nongovernmental organizations; outcomes; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines - administration & dosage; Prevention; prevention and care cascades; Santé publique et épidémiologie; sub‐Saharan Africa; Surveys and Questionnaires; Teenagers; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - prevention & control; Vaccination; Women; Womens health; World health; Young Adult
• ISSN: 1758-2652; 1758-2652
• DOI: 10.1002/jia2.26303

INTRODUCTION To eliminate cervical cancer (CC), access to and quality of prevention and care services must be monitored, particularly for women living with HIV (WLHIV). We assessed implementation practices in HIV clinics across sub‐Saharan Africa (SSA) to identify gaps in the care cascade and used aggregated patient data to populate cascades for WLHIV attending HIV clinics. METHODS Our facility‐based survey was administered between November 2020 and July 2021 in 30 HIV clinics across SSA that participate in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We performed a qualitative site‐level assessment of CC prevention and care services and analysed data from routine care of WLHIV in SSA. RESULTS Human papillomavirus (HPV) vaccination was offered in 33% of sites. Referral for CC diagnosis (42%) and treatment (70%) was common, but not free at about 50% of sites. Most sites had electronic health information systems (90%), but data to inform indicators to monitor global targets for CC elimination in WLHIV were not routinely collected in these sites. Data were collected routinely in only 36% of sites that offered HPV vaccination, 33% of sites that offered cervical screening and 20% of sites that offered pre‐cancer and CC treatment. CONCLUSIONS Though CC prevention and care services have long been available in some HIV clinics across SSA, patient and programme monitoring need to be improved. Countries should consider leveraging their existing health information systems and use monitoring tools provided by the World Health Organization to improve CC prevention programmes and access, and to track their progress towards the goal of eliminating CC.