Table 1b.
Quantitative and mixed-method studies conducted in Southern 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 |
|---|---|---|---|---|---|---|---|---|---|
| Godfrey et al. (2019) | South Africa | Cross-sectional study | Secondary referral obstetrics and gynecology hospital, Lower Umfolozi District War Memorial Hospital, in rural KwaZulu-Natal | 79 HIV-positive women and 155 HIV-negative women | 18–70 years, mean age 29 year | 32.5% screened at least once | Pap test |
Personal never heard of a Pap test (27.1%) (−), too scared/too painful (19.4%) (−), never offered cervical cancer screening (12.9%) (−), feel well so do not need cervical cancer screening (being asymptomatic) (5.8%) (−), do not want to know the result (1.9%) (−), not old enough for cervical cancer screening (1.9%) (−), being symptomatic 57.9% (+) Social Offered to them by HCP (42.1%) (+) Structural did not know where or when to have cervical cancer screening (6.5%) (−), not enough time to get screened (5.8%) (−) |
75% |
| Lieber et al. (2019) | South Africa | Mixed-methods* | Rural HIV clinic in Limpopo Province, South Africa | 403 HIV-positive women for quantitative and 12 HIV-positive women for qualitative study | NR | NR | VIA and Pap test |
Personal discomfort with the position required for undergoing cervical cancer screening (−), knowledgeable about the purpose of VIA and pap test (+), left behind in follow-up care (−) Structural understaffing (−), long waiting time (−) |
25% |
| Maree and Moitse (2014) | South Africa | Descriptive cross-sectional study | Adult HIV unit at a publichospital in Johannesburg, South Africa | 315 HIV-positive women | 27–54 years, mean age 38.9 year | NR | Pap test |
Personal fear of the procedure (39.3%) (−), not ill so screening not necessary (7.4%) (−) Social information sources [nurse or doctor (61%), community health worker (50.8%), classmates (9.8%) and relative and parents (7.6%)] (+), bad attitude of nurses and doctors (8.1%) (−) |
50% |
| Wake et al. (2009) | South Africa | Cross-sectional study | ART clinic at GF Jooste Hospital, Cape Town, South Africa | 100 HIV-positive women | 21–64 years, mean age 32.8 year | 59% screened at least once | Pap test |
Personal had never been asked to get cervical cancer screening (35.7%) (−), had never heard of the Pap test (28.6%) (−), fear and misunderstanding of cervical cancer screening (−) Structural unable to attend cervical cancer screening due to inappropriate time and place (19.6%) (−) |
50% |
| Mingo et al. (2012) | Botswana | Cross-sectional study | Two public health clinics in Gaborone, Botswana | 163 HIV-positive women and 117 HIV-negative women | 20–84 years | 72% screened at least once | Pap test | Personal ever heard of cervical cancer (OR: 3.28) (+), to know if cervix is healthy (56%) (+), to get early treatment (34%) (+), improve overall health (33%) (+), being symptomatic (10%) (+), protecting future fertility/pregnancy (8%) (+) | 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
*Quantitative data of this mix-methods study is not presented since it was not patient-reported factors and it only reported patients’ medical records data.