Table 1a.
Quantitative and mixed-method studies conducted in Western Africa.
| First author, year | Country | Study design | Study setting | Population | Age | Screening status | Type of screening | Patient-reported factors influencing women’s cervical cancer screening experience. The (+/−) signs indicate women’s perception of how these factors influenced their screening experience. | MMAT score |
|---|---|---|---|---|---|---|---|---|---|
| Dim et al. (2009) | Nigeria | Cross-sectional study | Voluntary Counseling and Testing (VCT) clinic of the University of Nigeria Teaching Hospital in Enugu, Nigeria | 150 HIV-positive women and 150 HIV-negative women | 21–54 years, mean age 34.9 year | 0.7% screened at least once | Pap test | Personal low awareness of cervical cancer (78%) (−), low perception about being at risk of cervical cancer among HIV-positive women (12.1%) (−), low awareness of pap-smear among HIV-positive women (4%) (−) | 50% |
| Adibe and Aluh (2018) | Nigeria | Descriptive cross-sectional study | ART clinic at the Nnamdi Azikiwe University Teaching Hospital, tertiary health care in Nnewi, south-eastern Nigeria | 447 HIV-positive women | NR | 10% screened at least once | Pap test |
Personal not heard of cervical cancer screening (61.8%) (−), not heard of HPV (86.4%) (−), not heard of HPV vaccine (88.8%) (−), fear of screening procedure (1.8%) (−), screening not necessary (21%) (−), negative attitude toward screening (56.5%) (−), had a previous Pap test (+), had a previous gynecological visit (+), awareness on cervical cancer (+) Social information sources [media, (23%) and HCP (19.9%)] (+), bad attitude of nurses (0.7%) (−), discouraged by partner (1.3%) (−) Structural too expensive (0.9%) (−) |
75% |
| Ezechi et al. (2013) | Nigeria | Cross-sectional study | HIV treatment center, Nigerian Institute of Medical Research (NIMR), Lagos |
1517 HIV-positive women | 18–57 years, mean age 31 year | 9.4% screened at least once | NR |
Personal awareness of cervical cancer (OR: 1.53) (+), fear of test outcome (4.2%) (−), pregnant/recently delivered (10.7%) (−) Social need to obtain partner’s approval (12.4%) (−), religious denial (14.0%) (−) Structural expensive cervical cancer screening (35.2%) (−), long waiting time (12.7%) (−) |
75% |
| Rabiu et al. (2011) | Nigeria | Descriptive cross-sectional study | ART clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria | 300 HIV-positive women | 17–60 years, mean age 34 year | 31.3% screened at least once | Pap test |
Personal never heard of cervical cancer (74.7%) (−), never heard of the Pap test (84%) (−), fear of the result (9.1), does not feel susceptible to cervical cancer (12.1) (−) Social information sources [media electronic and printed (33.3%), friends and relatives (20.8%), medical personnel (16.7%)] (+) Structural expensive cervical cancer screening (9.1%) (−) |
50% |
| Tchounga et al. (2019) | Ivory Coast (Côte d’Ivoire) | Cross-sectional study | Outpatient setting in the four highest volume urban HIV clinics of government’s or non-governmental organisation’s sector in Côte d’Ivoire | 1991 HIV-positive women | Inter Quartile Range of 37–47 years, median age 42 | 59.7% screened at least once | Pap test and VIA |
Personal being informed on cervical cancer at the HIV clinic (OR: 1.5) (+), clarity of information on cervical cancer (OR: 1.7) (+), identifying HIV as a risk factor for cervical cancer (OR: 1.4) (+), being proposed cervical cancer screening in the HIV clinic (OR: 10.1) (+), receiving advise for repeated cervical cancer screening over time (65.5%) (+), accept screening as part of a research project (15.8%) (+), lack of information about cervical cancer (54%) (−), fear of the result of screening (22%) (−), negligence (15%) (−) Structural fear of cervical cancer screening cost (10%) (−) |
75% |
| Ebu and Ogah (2018) | Ghana | Descriptive cross-sectional study | HIV health facilities in the Central Region of Ghana | 660 HIV-positive women | 20–65 years | NR | NR | Personal perceived Benefits of cervical cancer screening (OR: 1.68) (+), perceived Seriousness of cervical cancer (OR: 2.02) (+), cues about cervical cancer screening (OR :3.48) (+) | 100% |
| Stuart et al. (2019) | Ghana | Mixed methods | Cape Coast Teaching Hospital in Cape Coast, Ghana |
55 HIV-positive women and 76 HIV-negative women | Mean age 42.9 year | NR | NR |
Personal embarrassing (35.6%) (−), not painful examination based on previous experience with cervical cancer screening (85.0%) (+), worried about the results of screening (43.3%) (−) Social given enough information about HPV, cervical cancer, and screening before the screening (88.3%) (+) Structural would have cervical cancer screening again if it was free (91.4%) (+) |
50% |
ART anti-retroviral therapy, HCP healthcare provider, HIV human immunodeficiency virus, MMAT mixed methods appraisal tool, NR not reported, OR odds ratio, VIA visual inspection with acetic acid.