Table 3.

Participant thematic quotes

Domain/themes	MPT phase	Exemplary quotes (in addition to those listed in the text)
Limited awareness of screening as prevention	Appraisal	Higher awareness: When you test [the] first time and you are negative it does not mean you it will never be there. You have to keep on going back to test for whether it is there or it is not (Early-50 s, PLWH) Lower awareness: According to what I heard; unprotected sex can cause cervical cancer. To prevent it you can consult with the doctors so they can identify whether you have the illness or not and give you treatment such as chemotherapy or radiation (Late-40 s, PLWH)
Limited knowledge about HPV	Appraisal	Yes ma’am. I am disappointed to say this. I do not understand about the [HPV] virus…I have not come to know of it (Early-50 s, PLWH) What I have heard is that cervical cancer can be caused by having sex at a younger age...Cervical cancer can be prevented by refraining from sex while still young...I have no idea what causes HPV and how it can be prevented (Early-50 s, PLWH) I would not want to lie to you and say I have heard anything [about what causes cervical cancer]. What I know is while listening to people with cervical cancer, us women, most people thought it was witchcraft (Late-60 s, PLWH)
High HIV-related awareness	Appraisal	With HIV I it is an issue I could say is like a national anthem we always hear about on the radio. Every time even on the radio we are taught about it. (Late 60 s, PLWH) HIV is transmitted through unprotected sexual intercourse, having multiple sexual partners, and getting into marriages without getting tested…It is desirable that when realize that children are starting to mature we teach them about HIV transmission and that it can be prevented through protected sex and going for testing. Now we can prevent it through being keen on testing and protecting ourselves. (Early-50 s, PLWH) I have heard that it is caused by having multiple sex partners, sharing needles with HIV positive individuals…It can be prevented by sticking to one partner and avoiding sharing needles. (Early-40 s, PLWH) Yes, ma’am it can be prevented by not having unprotected sexual intercourse. When you have sex you have to use condoms. (Early-40 s, PLWH)
Cancer fear and fatalism	Appraisal/help-seeking	I am not someone who visits hospitals regularly [and] hear people speaking ill of [hospital]. As if to say when you go to [the hospital] you are lost. (Late-60 s, PLWH)
	Help-seeking	[After hearing my diagnosis] my emotions became low, and I would ask myself what the way forward is. What is going to happen in future? Am I going to find that it has become worse? Or at what stage is it going to be in future? (Early-30 s, PLWH) After I was told the results, I became emotionally mixed up. I lost faith. I just saw death in me because we are used to knowing that when you hear that someone has cancer you know that they are going to die. This is what I thought of until I received treatment…that is when I had hope (Late 40 s, PLWOH)
Structural and individual barriers to seeking care	Help seeking	I do not know how to explain those reasons, but I kept on postponing. I couldn’t get leave days from my employer because she complained of my absence in the workplace. In one instance I lost my job because I had to go for check-ups and the employer could not keep up with it (Late-40 s, PLWH)
	Diagnostic	It is difficult [to get healthcare services] because I have to use public transport. I see that I just have to make a decision and appeal to my children… It is slightly difficult because I have to first tell my children that this is when [my appointment is] and then they would then rush to assist (Early-70 s, PLWOH)
Delays in receipt of results	Diagnostic	But I had tested because I was unwell and was not feeling well. My results were unavailable. I then remained for a while. I continued to feel that my health was deteriorating (Early-60 s, PLWOH) I had spent a long time waiting for results because I had spent years testing for this virus trying to find out what it is whether it is AIDS or it is the cancer… They tested me and the papers disappeared. The result had also disappeared. This and that… I was not receiving the results [of the screening tests]. (Late-60 s, PLWOH)
Social and religious sources of support	All phases	I was so scared thinking that was the end of my life…[but] I received very great support from my family and the health providers. (Early-50 s, PLWH) “I was sad but soon told myself, “Nowadays it is better it is no longer like the old days.” … “Nowadays the doctors are here.” My emotions then became better. I became faithful and thought of God. I thought of God that God is here. When they were treating me and put me where they put me, I will accept. But I was saying this to myself while also praying (Late-60 s, PLWOH)
System-level support	All phases	I do not experience any difficulty because if I want services, I seek them…. I just go and receive consultation…Because I do not hide. (Late-50 s, PLWOH) “It is very easy [to seek health services] … My health comes first, and it is my main concern” (Late-60 s, PLWOH)

MPT, model of pathways to treatment; PLWH, person living with HIV; PLWOH, person living without HIV