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. Author manuscript; available in PMC: 2017 Jan 1.
Published in final edited form as: J Low Genit Tract Dis. 2016 Jan;20(1):31–37. doi: 10.1097/LGT.0000000000000165

Table 1.

Survey Questions

  1. What type of clinic is your program? (multiple choice: antenatal clinic, clinical research site, family planning, HIV care site, primary care clinic, other; more than one answer may be appropriate)

  2. Is cervical cancer screening available to your patients (either on site or via referral)? (Yes, No)

  3. If cervical cancer screening is available on site:

    • Does your program screen HIV-infected women? (Yes, No)

    • Does your program screen HIV-uninfected women? (Yes, No)

    • Does your program maintain electronic records on women screened? (Yes, No)

    • Cervical cancer screening is done by: (multiple choice: clinical officer, nurse, lay health worker, physician, other; more than one answer may be appropriate)

    • The method(s) used for cervical cancer screening are: (multiple choice: Pap, VIA, HPV DNA, VILI; more than one answer may be appropriate)

    • Treatments available for premalignant lesions and cervical cancer: (multiple choice: cryotherapy, conization, loop electrocautery excisional procedure [LEEP], radical hysterectomy, radiation therapy, chemotherapy, other; more than one answer may be appropriate)

    • Patients are referred to our facility for cervical cancer screening (Yes, No)

    • Patients are referred from: (multiple choice: antenatal clinic, clinical research site, family planning, HIV care site, primary care clinic, other)

  4. If cervical cancer screening is available at referral site:

    • Distance to referral site

Surveys were emailed to the affiliated sites and completed by a site representative. Some questions permitted more than one answer.