Barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow-up clinics for women living with HIV in Northwest Ethiopia: a qualitative study
BackgroundWomen living with HIV (WLHIV) face a significantly elevated risk of invasive cervical cancer, an AIDS-defining malignancy. Integrated cervical cancer screening (CCS) and HIV care are essential for optimal management; however, these services remain largely unintegrated in Ethiopia, resultin...
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| Format: | Article |
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1552524/full |
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| author | Kelemework Gashinet Ferede Addisu Gasheneit Ferede Asiya Mohammed Abdu Birhaneslasie Gebeyehu Yazew Zewdu Bishaw Aynalem Eneyew Talie Fenta Daniel Shitu Mekonnen Berihun Bantie Gebiyaw Wudie Tsegaye |
| author_facet | Kelemework Gashinet Ferede Addisu Gasheneit Ferede Asiya Mohammed Abdu Birhaneslasie Gebeyehu Yazew Zewdu Bishaw Aynalem Eneyew Talie Fenta Daniel Shitu Mekonnen Berihun Bantie Gebiyaw Wudie Tsegaye |
| author_sort | Kelemework Gashinet Ferede |
| collection | DOAJ |
| description | BackgroundWomen living with HIV (WLHIV) face a significantly elevated risk of invasive cervical cancer, an AIDS-defining malignancy. Integrated cervical cancer screening (CCS) and HIV care are essential for optimal management; however, these services remain largely unintegrated in Ethiopia, resulting in low screening coverage. This study aimed to explore the barriers and facilitators to integrating CCS and preventive treatment services within antiretroviral therapy (ART) follow-up clinics for WLHIV in Northwest Ethiopia.MethodsA phenomenological study was conducted from January to April 2023 among 33 participants across nine purposively selected health facilities in Northwest Ethiopia. Data were collected using focus group discussions and in-depth key informant interviews. Audio-recorded data were transcribed, translated, and coded, followed by thematic analysis using Atlas. Ti 7 software.ResultsKey barriers to integration included inadequate facilities, a shortage of dually trained clinicians, low healthcare provider motivation, the absence of integration policies, and a lack of evidence on integration effectiveness. Facilitators included the accessibility of free ART and CCS services, the simplicity of the visual inspection with acetic acid (VIA) screening method, the availability of staff trained in either ART or CCS, and patient familiarity with ART providers.ConclusionIntegrating cervical cancer screening with HIV care in Northwest Ethiopia encounters substantial obstacles, including facility limitations, clinician training deficits, motivational issues, policy gaps, and a lack of evidence. However, accessible services, the VIA method’s simplicity, and existing staff training provide opportunities for successful integration. Addressing these barriers and leveraging facilitators is crucial to improve integrated service delivery and reduce related mortality among WLHIV. |
| format | Article |
| id | doaj-art-210c69c331c6494a8f4adb3a4e4c77db |
| institution | DOAJ |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-210c69c331c6494a8f4adb3a4e4c77db2025-08-20T03:22:08ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.15525241552524Barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow-up clinics for women living with HIV in Northwest Ethiopia: a qualitative studyKelemework Gashinet Ferede0Addisu Gasheneit Ferede1Asiya Mohammed Abdu2Birhaneslasie Gebeyehu Yazew3Zewdu Bishaw Aynalem4Eneyew Talie Fenta5Daniel Shitu Mekonnen6Berihun Bantie7Gebiyaw Wudie Tsegaye8Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaInstitute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaDepartment of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, EthiopiaDepartment of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, EthiopiaDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, EthiopiaDepartment of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaDepartment of Comprehensive Nursing, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaBackgroundWomen living with HIV (WLHIV) face a significantly elevated risk of invasive cervical cancer, an AIDS-defining malignancy. Integrated cervical cancer screening (CCS) and HIV care are essential for optimal management; however, these services remain largely unintegrated in Ethiopia, resulting in low screening coverage. This study aimed to explore the barriers and facilitators to integrating CCS and preventive treatment services within antiretroviral therapy (ART) follow-up clinics for WLHIV in Northwest Ethiopia.MethodsA phenomenological study was conducted from January to April 2023 among 33 participants across nine purposively selected health facilities in Northwest Ethiopia. Data were collected using focus group discussions and in-depth key informant interviews. Audio-recorded data were transcribed, translated, and coded, followed by thematic analysis using Atlas. Ti 7 software.ResultsKey barriers to integration included inadequate facilities, a shortage of dually trained clinicians, low healthcare provider motivation, the absence of integration policies, and a lack of evidence on integration effectiveness. Facilitators included the accessibility of free ART and CCS services, the simplicity of the visual inspection with acetic acid (VIA) screening method, the availability of staff trained in either ART or CCS, and patient familiarity with ART providers.ConclusionIntegrating cervical cancer screening with HIV care in Northwest Ethiopia encounters substantial obstacles, including facility limitations, clinician training deficits, motivational issues, policy gaps, and a lack of evidence. However, accessible services, the VIA method’s simplicity, and existing staff training provide opportunities for successful integration. Addressing these barriers and leveraging facilitators is crucial to improve integrated service delivery and reduce related mortality among WLHIV.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1552524/fullAwicervical cancerHIVintegrationscreeningEthiopia |
| spellingShingle | Kelemework Gashinet Ferede Addisu Gasheneit Ferede Asiya Mohammed Abdu Birhaneslasie Gebeyehu Yazew Zewdu Bishaw Aynalem Eneyew Talie Fenta Daniel Shitu Mekonnen Berihun Bantie Gebiyaw Wudie Tsegaye Barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow-up clinics for women living with HIV in Northwest Ethiopia: a qualitative study Frontiers in Public Health Awi cervical cancer HIV integration screening Ethiopia |
| title | Barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow-up clinics for women living with HIV in Northwest Ethiopia: a qualitative study |
| title_full | Barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow-up clinics for women living with HIV in Northwest Ethiopia: a qualitative study |
| title_fullStr | Barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow-up clinics for women living with HIV in Northwest Ethiopia: a qualitative study |
| title_full_unstemmed | Barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow-up clinics for women living with HIV in Northwest Ethiopia: a qualitative study |
| title_short | Barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow-up clinics for women living with HIV in Northwest Ethiopia: a qualitative study |
| title_sort | barriers and facilitators to the integration of cervical cancer screening and treatment service with antiretroviral therapy follow up clinics for women living with hiv in northwest ethiopia a qualitative study |
| topic | Awi cervical cancer HIV integration screening Ethiopia |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1552524/full |
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