Knowledge, attitudes, and cervical cancer screening practices among HIV-positive female sex workers in Benue State, Nigeria

Abstract

Cervical cancer is a leading cause of cancer-related deaths in sub-Saharan Africa, and women with human immunodeficiency virus (HIV) are at significantly increased risk. However, information on cervical cancer screening among female sex workers (FSWs) in parts of Nigeria remains limited. This study assessed knowledge, attitudes, and screening practices relating to cervical cancer among HIV-positive FSWs in Benue State, Nigeria, and examined variables associated with screening behaviour. A facility-based descriptive cross sectional study was conducted among 215 HIV-positive FSWs receiving care at Key Population One-Stop Shop (KP-OSS) facilities in Makurdi, Gboko, and Otukpo. Data were collected using interviewer-administered questionnaires. The mean age of the participants was 32.1 ± 6.7 years, and 74.6% lived in urban areas. Overall, 77.2% had previously undergone cervical cancer screening, most commonly by visual inspection with acetic acid (VIA). In addition, 76.9% understood how cervical cancer could be prevented, whereas 66.5% demonstrated general awareness of the disease. Nevertheless, fear of the screening procedure (44.2%), fear of a positive diagnosis (49.8%), and embarrassment about genital exposure (42.3%) were reported. Knowledge was not a significant predictor of screening behaviour (β = 0.002, p > 0.05), whereas attitude was significant (β = −0.32, p < 0.01). Screening behaviour was negatively correlated with age and number of pregnancies (p < 0.01). Negative attitudes and psychosocial barriers persisted and significantly influenced screening behaviour. Culturally tailored behavioural interventions and psychosocial support should therefore be integrated into HIV care platforms to enhance cervical cancer screening uptake in this high-risk population.