Prevalence of cervical cancer and its associated factors among women living with HIV attending public referral hospitals in Amhara Region, Ethiopia, 2025, a cross-sectional study

Abstract

Cervical cancer remains a leading cause of morbidity and mortality among women living with HIV worldwide, particularly in developing countries. In Ethiopia, this population faces a substantial burden of cervical cancer, marked by high rates of precancerous cervical lesions and low uptake of screening services. Therefore, this study aims to determine the prevalence of cervical cancer and identify its associated factors among women living with HIV attending referral hospitals in the Amhara Region, Northwest Ethiopia, to inform effective prevention and control strategies. An institution-based cross-sectional study was conducted among women living with HIV who attended selected referral hospitals in the Amhara Region, Northwest Ethiopia, from August to October 2025. Study participants were selected using a systematic random sampling technique. Data were collected using a pretested, interviewer-administered questionnaire. The collected data were entered and analyzed using SPSS software. Descriptive statistics were used to summarize the data, while binary logistic regression analysis was employed to assess the prevalence of cervical cancer and identify associated factors. Statistical significance was determined at a p-value of less than 0.05. Among the total study participants, 48 (15.5%) of women living with HIV were diagnosed with cervical cancer. In the final analysis, the number of sexual partners and a history of sexually transmitted infections were found to be significantly associated with cervical cancer. Women with multiple sexual partners had higher odds of developing cervical cancer [AOR = 2.41; 95% CI: 1.49–4.07], and those with a history of sexually transmitted infections were also at increased risk [AOR = 2.92; 95% CI: 1.28–3.12]. This study found that the overall prevalence of cervical cancer among women living with HIV attending referral hospitals in the Amhara region was high. Having multiple sexual partners and a history of sexually transmitted infections were associated with an increased likelihood of developing cervical cancer. Therefore, promoting monogamous sexual partnerships and preventing sexually transmitted infections are key strategies to protect women living with HIV from cervical cancer.