马拉维艾滋病毒/艾滋病妇女宫颈癌筛查状况:一项横断面研究

Jasintha T. Mtengezo, Haeok Lee, M. Cooley, Ling Shi, M. Makin
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摘要

在世界范围内,宫颈癌(CC)是女性中第四大常见癌症。大约90%的宫颈癌病例发生在资源有限的国家。马拉维是世界上宫颈癌发病率最高(每100 000人中有67.9人)和死亡人数最高(每100 000人中有51.5人)的发展中国家之一。超过80%被诊断患有CC的马拉维妇女处于无法手术的癌症阶段,并同时感染艾滋病毒。本研究的目的是研究马拉维艾滋病毒支持团体中18-50岁艾滋病毒感染妇女的宫颈癌筛查状况及影响筛查状况的因素。采用两阶段比例分层整群随机抽样法,抽取291名调查对象。调查结果显示,宫颈癌筛查率为27.8%;女性对宫颈癌筛查的知识水平较高,态度积极。虽然市民对筛检的认识和态度都很积极,但子宫颈癌的筛检率仍然很低。与HIV阳性妇女宫颈癌筛查独立相关的因素有:就业OR = 6.37 (95% CI: 1.32, 30.80),知识OR =1.11 (95% CI: 1.03, 1.20),态度OR = 1.43 (95% CI: 1.04, 1.97),社会支持网络OR =6.8 (95% CI: 1.41, 32.76)。在马拉维设计促进宫颈癌筛查的干预措施时,以社区为基础的干预措施和有文化针对性的健康教育信息至关重要,其中包括关于宫颈癌、艾滋病毒和筛查的常见误解。
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Cervical Cancer Screening Status Among Women Living With HIV/AIDs in Malawi: A Cross-Sectional Study
Worldwide, cervical cancer (CC) is the fourth most common cancer among women. Approximately 90% of cervical cancer cases occur in resource limited countries. Malawi is one of the developing countries with the highest incidence (ASR 67.9 per 100,000) of cc and the highest number of deaths (ASR 51.5 per 100,000) from cervical cancer in the world. More than 80% of Malawian women diagnosed with CC are at the inoperable cancer stage and suffer from co-infection with HIV. The purpose of this situation-specific theory guided study was to examine the cervical cancer screening status and factors affecting the screening status among Malawian women living with HIV infection aged 18-50 from HIV support groups in Malawi. A two stage proportionate stratified cluster random sampling method was used to select 291 respondents. The findings indicated that the prevalence of cervical cancer screening rate was 27.8%; and women had a high knowledge level and had a positive attitude towards cervical cancer screening. Despite a high knowledge level and positive attitude regarding screening, the cervical cancer screening rate was still low. The factors independently associated with cervical cancer screening in HIV positive women were: employment, OR = 6.37 (95% CI: 1.32, 30.80), knowledge OR =1.11 (95% CI: 1.03, 1.20), attitude, OR = 1.43 (95% CI: 1.04, 1.97) and social support networks OR =6.8 (95% CI: 1.41, 32.76). Community-based interventions and culturally tailored health education messages which include common myths about cervical cancer, HIV, and screening are critical when designing interventions to promote cervical cancer screening uptake in Malawi.
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