Cervical cancer is the most common and deadly cancer among women in Uganda. Women living with HIV (WLHIV) are particularly at risk of developing cervical cancer and dying from it.
The Ministry of Health Guidelines for the Prevention and Treatment of HIV and AIDS in Uganda (2022) recommend cervical cancer screening for WLHIV using human papillomavirus (HPV) testing. If HPV testing is not available, screening with visual inspection with acetic acid (VIA) or Pap smear is recommended.
The PEPFAR-funded Department of Defense HIV/AIDS Prevention Program Uganda (DoD Uganda URC Project) supported the successful accreditation of 12 military health facilities to provide cervical cancer screening and treatment services.
Aida Nambuusi, a registered midwife at the Uganda National Defense Force (UPDF)’s 2nd Division Mbarara Military Hospital, is among the 52 healthcare workers trained by URC to provide cervical cancer screening services to WLHIV.
Prior to her training, Aida shared, “I used to feel incompetent, but the training opened my eyes. I gained confidence to carry out these services and provide quality screening to mothers.”
Through URC’s comprehensive training initiatives, Aida’s insecurities were transformed into confidence. The social and behavior change communications materials introduced in the training quickly became her guide, offering detailed procedures that not only kept her updated on the latest cervical cancer screening guidelines but also improved her skills in practice.
Thanks to tools and job aids for cervical cancer screening, Aida now confidently and accurately manages data, ensuring efficient follow-ups and timely screenings for her patients.
Community Outreach Engages Local Communities to Improve Screening Uptake
URC supports community outreach in Uganda making it easier for women to access screening services, and continuous health education efforts have shifted attitudes towards cervical cancer screening. Public speakers on local radios and engagement with Village Health Teams (VHTs) empower community engagement in cervical cancer screening campaigns.
“Women living with HIV now turn up willingly because they understand the importance of screening for their health,” Aida shared.
“When I was screened for cancer, I was told I don’t have cancer and was informed to return after some years. The procedure was not painful at all, and I encourage other women to take up the service,” Babirye, a beneficiary at 2nd Division, Mbarara mentioned.
“It’s good to know your status and the procedure for screening was not painful. It was quick and the procedure did not take long,” Beatrice said about her experience.
Since URC supported this cervical cancer initiative, Aida has noticed positive changes in her community, with more WLHIV seeking screening. From October 2020 to October 2023, the 31 URC-supported UPDF health facilities have screened 7,325 WLHIV – 72% of the 10,188 WLHIV who received care from those facilities in that time period. A total of 862 women had abnormal results, with 96.3% of these women receiving treatment for precancerous lesions per national guidelines. The remaining 3.7% of these women were diagnosed with cervical cancer and referred to oncology services for further management.
URC continues to work to improve uptake of cervical cancer screening by WLHIV, and the results achieved to date are promising. UPDF, with URC’s support, is achieving comprehensive screening and appropriate cervical cancer treatment for all WLHIV in the project’s target areas.
