Cervical Dysplasia And Associated Risk Factors Among HIV –Infected Women Attending Hands –Care Center In Brikama,The Gambia

Abstract

Background: Cervical cancer is the second most common cancer worldwide after breast cancer and is an example of a disease of global inequity in health as majority of the deaths occurs in sub-Saharan Africa. With the increase in HIV pandemic, its incidence has increased three fold .In the Gambia, the true burden of cervical dysplasia in HIV infected women is not known and this shows an important gap in the management of cervical cancer and HIV.This study aims to determine the burden and associated risk factors of cervical dysplasia in HIV infected women attending Hands-on –care Medical Centre at Brikama, The Gambia. Method: A cross-sectional quantitative study was conducted at Hands-on –care center in Brikama, The Gambia on HIV- infected women between the ages of ≥18 years and ≤60 years. Patients were selected using a systematic random sampling from the out-patient department. A standardized questionnaire was used to interview, hospital records were reviewed and visual inspection with acetic acid (VIA) screening was also done. Data was analyzed in STATA 13.0. Descriptive statistics were used to determine prevalence, chi- square test of proportions and multiple logistic regression models were used to test for level of significance between cervical dysplasia and the associated risk factors. Findings: A total of 322 HIV infected women were interviewed and screened, the mean ages (±SD) were 39(±8.0) years. The prevalence of cervical dysplasia was 22 %( 70/322). Significant risk factors associated with cervical dysplasia in this study were age group 26-35 years (OR:2.7; 95% CI:0.3-23.6 ;p-value: 0.02),first sexual intercourse at ages between 16-20 years(OR:2.7 ;95% CI :1.2-6.1 ;p-value:0.001) , first birth between 16- 20 years (OR: 0.4 ;95%CI :0.2-0.8 ;P-value: 0.002) and having 4 or more children(OR:16.6 ;95% CI :2.2-124.4 ;p-value:0.002). Conclusion: cervical dysplasia is a problem in HIV infected women seeking care at Brikama Hands-on care. Age group between 16-20 years at first sexual intercourse and birth, increased parity and middle age woman are significant risk factors, therefore screening is recommended for HIV infected women seeking health care at Hands on care medical center.