Co-morbidity of Cervical Cancer and Its associated factors among HIV-Positive Women on Antiretroviral Therapy in Awi zone, Northwest Ethiopia

Abstract

Background Women living with HIV face an increased burden of AIDS-defining malignancies, particularly invasive cervical cancer. The risk of developing cervical cancer (CC) is six times higher in women with HIV compared to their counterparts. However, evidences on the co-morbidity of cervical cancer CC and its associated factors in this high-risk group were scarce in Ethiopia. Therefore, this study aimed to explore the prevalence and factors associated with the co-morbidity of CC in women living with HIV in Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from January to May 2023, among 583 adult women living with HIV/AIDS in Awi Zone, Northwest Ethiopia. Both primary and secondary data collection methods were carried out to address the objectives of the study. The data were entered into Epi data version 4.6 and exported to SPSS version 26 software for analysis. A binary logistic regression model was fitted to identify factors associated with the outcome variable. Level of statistical significance was declared at p-value < 0.05. Results The comorbidity of cervical cancer among women living with HIV was 24.9% (95% CI: 21.3–28.1). Factors that increased the risk of co-morbidity include a baseline CD4 cell⁺<200 cell/mm3 (AOR = 3.82, 95% CI: 2.44–5.39), a history of sexually transmitted infections other than HIV (AOR = 3.97, 95% CI: 1.97–5.70), oral contraceptive use (AOR = 2.18, 95% CI: 1.40–3.40), the number of sexual partners (AOR = 2.86, 95% CI: 1.79–4.55), and poor/fair adherence to ART drugs (AOR = 3.25, 95% CI: 1.87–7.43, AOR = 2.81, 95% CI: 1.39–5.64). Conclusion and recommendation In this study, the comorbidity of CC among women living with HIV was found to be high relative to the previous studies in Ethiopia. History of sexually transmitted infection other than HIV, baseline CD4⁺ cell < 200 cell/mm3, poor and fair adherence, history of long-term oral contraceptive use, and having two and above sexual partners were factors associated with co-morbidity of cervical cancer. Hence, targeted cervical cancer screening by giving due emphasis to those high-risk women, and addressing identifying factors helps to reduce this malignancy.