Factors Influencing Uptake of Cervical Cancer Screening Among Female Sex Workers at New Africa House New Start Centre, Harare

Abstract

Cervical cancer is the fourth most common cancer globally and it is caused by the Human Papillomavirus (HPV). In low- and medium-income countries (LMIC), cervical cancer is the second most common type of cancer in women after breast cancer. Transmission is mainly through sexual contact. Consistent with global statistics which put new cervical cancer cases at 580 000 new cases in 2018 incidence and deaths from cervical cancer have been on the rise in Zimbabwe. The main aim of this study was to analyse individual, structural, and healthsystem- related factors influencing the uptake of cervical cancer screening by Female Sex Workers at the New Start Centre at New Africa House from October 2021 to March 2022. The study was conducted at the New Start Centre clinic at New Africa House in Harare central business district. The clinic is owned by Populations Solutions for Health (PSH) and offers HIV prevention and treatment and sexual reproductive health services with a focus on key populations. An analytical cross sectional study design was employed, and data was collected by the use of an interviewer administered questionnaire after the researcher had sought and received approval from PSH leadership and Africa University Research Ethics Committee (AUREC). A total of 52 study participants were interviewed. All of them were Female Sex Workers aged between 18 and 51 with a median age of 33. Twenty-seven (55%) of the participants reported that they had received cervical cancer screening services at least once in their lifetime while the other 25 had not. Female Sex Workers who were Christians (65%) were found statistically significantly associated with uptake of cervical cancer. Other variables that scored high, even though not statistically significant included one’s perception of risk of cancer, knowledge about the screening method (88%), and provider preferences. Almost two thirds of the participants reported that they preferred being served by female providers. For those who reported that they had never been screened for cervical cancer 27 (52%), reasons given included fear of the procedure and fear of the screening result. Cost of the service as a structural factor was an enabler of uptake of the service. It can be concluded that, consistent with other available literature locally, regionally, and globally, cervical cancer screening uptake is equally a function of individual as well as it is of structural and health system related factors. Female sex workers are a high-risk group for developing cervical cancer due to their sexual practices. As a recommendation, cervical cancer screening should be easily accessible at health facilities that serve key populations through providing various screening modalities and ensuring that there are competent key population friendly service providers.