Background Cervical cancer (CaCx) is the most frequently diagnosed cancer in Ugandan women. Forty five out of 100,000 women die annually due to limited availability of information, screening and treatment facilities, and poor health seeking habits. Over 80% of women present when in advanced stages. The risk of CaCx and STIs is doubled among HIV-infected women. STAR-E project instituted an integrated community outreach screening programme targeting WLHIV to accelerate early diagnosis, enhance timely referral for treatment and provide prevention education.
Methods Between March 2011 to April 2012, we reviewed records in 12 HIV care clinics to identify WLHIV at risk of STIs and CaCx. Key health workers were trained in STI diagnosis, and VIA/VILI screening methods. 50 PLHIV mobilisers were identified and oriented on risk factors, prevention, and early warning signs of CaCx and common STIs. During home visits, treatment support meetings and clinic days, and using pre-designed referral forms containing individual questionnaire they sensitised and mobilised community, and made referrals to lower level health centres where screening camps were set.
Results A total of 3500 WLHIV were sensitised and referred for STI and CaCx screening. 3450 (98.5%) were screened for the first time; 3405 (98.7%) tested VIA negative; 45 (1.3%) tested VIA positive and were referred for cryotherapy. of all women screened, 342 (9.9%) presented with different STIs, and were treated. 238 (69.6%) notified their partners who also accessed treatment. Only 20% of the women had heard about CaCx or sought help for any genital infections.
Conclusion Integrated outreach screening programmes are an important access point for people at high risk for both STIs and CaCx. It allows for not only the benefit of treating the STI, or identifying precancerous lesions, but for prevention education, identifying HIV-infected persons in need of care, and partner notification for STIs.
- HIV-infected individuals
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