Journal of Cancer Education

, Volume 30, Issue 3, pp 567–572 | Cite as

Cervical Cancer Screening Knowledge and Behavior among Women Attending an Urban HIV Clinic in Western Kenya

  • Joelle I. RosserEmail author
  • Betty Njoroge
  • Megan J. Huchko


Cervical cancer is a highly preventable disease that disproportionately affects women in developing countries and women with HIV. As integrated HIV and cervical cancer screening programs in Sub-Saharan Africa mature, we have an opportunity to measure the impact of outreach and education efforts and identify areas for future improvement. We conducted a cross-sectional survey of 106 women enrolled in care at an integrated HIV clinic in the Nyanza Province of Kenya 5 years after the start of a cervical cancer screening program. Female clinic attendees who met clinic criteria for cervical cancer screening were asked to complete an oral questionnaire assessing their cervical cancer knowledge, attitudes, and screening history. Ninety-nine percent of women had heard of screening, 70 % felt at risk, and 84 % had been screened. Increased duration of HIV diagnosis was associated with feeling at risk and with a screening history. Nearly half (48 %) of women said they would not get screened if they had to pay for it.


HIV/AIDS Cervical cancer screening Knowledge and attitudes Behavior Sub-Saharan Africa 



This work was supported by a grant from the Doris Duke Charitable Foundation to the University of California, San Francisco to fund Clinical Research Fellow Joelle Rosser. While working on this project, M.J.H. was supported through a National Institutes of Health career development award (KL2 RR024130-04).

Conflict of Interest

The authors have no conflicts of interest.


  1. 1.
    Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61(2):69–90CrossRefPubMedGoogle Scholar
  2. 2.
    De Vuyst H, Ndirangu G, Moodley M et al (2012) Prevalence of human papillomavirus in women with invasive cervical carcinoma by HIV status in Kenya and South Africa. Int J Cancer 131(4):949–955CrossRefPubMedGoogle Scholar
  3. 3.
    Ntekim A (2012) Cervical Cancer in Sub Sahara Africa, Topics on Cervical Cancer With an Advocacy for Prevention. Available from:
  4. 4.
    Louie KS, de Sanjose S, Mayaud P (2009) Epidemiology and prevention of human papillomavirus and cervical cancer in sub-Saharan Africa: a comprehensive review. Trop Med Int Health 14(10):1287–1302CrossRefPubMedGoogle Scholar
  5. 5.
    Gichangi P, De Vuyst H, Estambale B, Rogo K, Bwayo J, Temmerman M (2002) HIV and cervical cancer in Kenya. Int J Gynaecol Obstet 76(1):55–63CrossRefPubMedGoogle Scholar
  6. 6.
    Belhadj H, Rasanathan JJ, Denny L, Broutet N (2013) Sexual and reproductive health and HIV services: integrating HIV/AIDS and cervical cancer prevention and control. Int J Gynaecol Obstet 121(Suppl 1):S29–S34CrossRefPubMedGoogle Scholar
  7. 7.
    Memiah P, Mbuthia W, Kiiru G et al (2012) Prevalence and risk factors associated with precancerous cervical cancer lesions among HIV-infected women in resource-limited settings. AIDS Res Treat 2012:953743PubMedCentralPubMedGoogle Scholar
  8. 8.
    Huchko MJ, Bukusi EA, Cohen CR (2011) Building capacity for cervical cancer screening in outpatient HIV clinics in the Nyanza province of western Kenya. Int J Gynaecol Obstet 114(2):106–110PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    WHO. Cervical cancer screening in developing countries: report of a WHO consultation 2002.
  10. 10.
    Kimanga DO, Ogola S, Umuro M, et al (2014) Prevalence and incidence of HIV infection, trends, and risk factors among persons aged 15–64 years in Kenya: results from a nationally representative study. J Acquir Immune Defic SyndrGoogle Scholar
  11. 11.
    Francis SA, Nelson J, Liverpool J, Soogun S, Mofammere N, Thorpe RJ Jr (2010) Examining attitudes and knowledge about HPV and cervical cancer risk among female clinic attendees in Johannesburg, South Africa. Vaccine 28(50):8026–8032CrossRefPubMedGoogle Scholar
  12. 12.
    McFarland DM (2009) Beliefs about the causes of cervical cancer in Botswana: implications for nursing. Int Nurs Rev 56(4):426–432CrossRefPubMedGoogle Scholar
  13. 13.
    White HL, Mulambia C, Sinkala M et al (2012) ‘Worse than HIV’ or ‘not as serious as other diseases’? Conceptualization of cervical cancer among newly screened women in Zambia. Soc Sci Med 74(10):1486–1493PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Maree JE, Wright SC (2011) Cervical cancer: does our message promote screening? A pilot study in a South African context. Eur J Oncol Nurs 15(2):118–123CrossRefPubMedGoogle Scholar
  15. 15.
    Turan JM, Bukusi EA, Onono M, Holzemer WL, Miller S, Cohen CR (2011) HIV/AIDS stigma and refusal of HIV testing among pregnant women in rural Kenya: results from the MAMAS Study. AIDS Behav 15(6):1111–1120PubMedCentralCrossRefPubMedGoogle Scholar
  16. 16.
    Rosser JI, Njoroge B, Huchko MJ (2014) Knowledge about cervical cancer screening and perception of risk among women attending outpatient clinics in rural Kenya. Int J Gynaecol ObstetGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Joelle I. Rosser
    • 1
    Email author
  • Betty Njoroge
    • 2
  • Megan J. Huchko
    • 3
  1. 1.Department of Internal MedicineUniversity of WashingtonSeattleUSA
  2. 2.Centre for Microbiology ResearchKenya Medical Research Institute (KEMRI)Mbagathi WayKenya
  3. 3.Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive HealthUniversity of CaliforniaSan FranciscoUSA

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