Cervical cancer screening uptake and correlates among HIV-infected women: a cross-sectional survey in Côte d’Ivoire, West Africa

Objectives Despite the increasing number of interventions aiming to integrate cervical cancer screening into HIV clinics in sub-Saharan Africa, Women living with HIV (WLHIV) still have a high risk of developing cervical cancer. The aim of this study was to estimate the coverage of cervical cancer screening and associated factors among WLHIV in Abidjan, Côte d’Ivoire.Design Cross-sectional survey conducted from May to August 2017.Settings Outpatient setting in the four highest volume urban HIV clinics of government’s or non-governmental organisation’s sector in Côte d’Ivoire.Participants All WLHIV, aged 25–55 years, followed since at least 1 year, selected through a systematic sampling procedure.Intervention A standardised questionnaire administered to each participant by trained healthcare workers.Outcome Cervical cancer screening uptake.Results A total of 1991 WLHIV were included in the study, aged in median 42 years (IQR 37–47), and a median CD4 count (last known) of 563 (378-773) cells/mm3. Among the participants, 1913 (96.1%) had ever heard about cervical cancer, 1444 (72.5%) had been offered cervical cancer screening, mainly in the HIV clinic for 1284 (88.9%), and 1188 reported a personal history of cervical cancer screening for an overall coverage of 59.7% (95% CI 57.6 to 62.0). In multivariable analysis, university level (adjusted OR (aOR) 2.1; 95% CI 1.4 to 3.1, p