--- title: "Adherence to Follow-Up Cervical Cancer Screening Among Women Living with HIV in Moshi, Tanzania" id: "bmj-open-1-adherence-to-follow-up-cervical-cancer-screening-and-its-predictors-among-women" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-1-adherence-to-follow-up-cervical-cancer-screening-and-its-predictors-among-women" content_type: "clinical_feed_article" specialty: "Infectious Disease" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e113748?rss=1" published_at: "2026-09-15T12:32:32.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # Adherence to Follow-Up Cervical Cancer Screening Among Women Living with HIV in Moshi, Tanzania ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-1-adherence-to-follow-up-cervical-cancer-screening-and-its-predictors-among-women - **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e113748?rss=1) - **Published At:** 2026-09-15T12:32:32.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - This retrospective cohort study evaluated **adherence** to recommended follow-up cervical cancer screening among 2,030 women living with HIV (**WLHIV**) who had their first screening between 2019 and 2021 in Moshi municipality, northern Tanzania. - Overall adherence to any follow-up screening was low: only 33.2% of WLHIV obtained a subsequent screening after their first test. - Timing of adherence was further categorised; only 21.4% (95% CI 18.4% to 24.7%) of those who adhered demonstrated **good adherence**, defined as attendance within one month after the scheduled follow-up date. - Multivariable Poisson regression identified facility type and first-screening result as strong predictors: higher adherence in **private healthcare** facilities (ARR=1.57; 95% CI 1.35–1.82) and markedly lower adherence among women screened at **outreach** facilities (ARR=0.28; 95% CI 0.19–0.39). - Women with an abnormal result at their first screening had substantially higher likelihood of follow-up (ARR=2.62; 95% CI 2.26–3.05). - Adherence increased with advancing age and higher parity; younger women and those with fewer or no children were less likely to attend follow-up. - The authors conclude that adherence is suboptimal and recommend strengthening recall systems, especially in public and outreach settings, and targeting interventions to younger WLHIV, women with no or fewer children, and those with normal initial screening results. - Study setting: healthcare facilities in Moshi municipality, Kilimanjaro region. Design: hospital-based retrospective cohort, 2019–2021. Analysis: multivariable Poisson regression with robust standard errors reporting adjusted risk ratios (ARRs) and 95% CIs. ## Clinical Analysis & Structured Key Points Objective The effectiveness of cervical cancer screening as a preventive strategy for cervical cancer substantially depends on timely and consistent adherence to recommended follow-up screenings. This study aimed to determine adherence to the recommended follow-up cervical cancer screening, characterise the timing of adherence and determine its associated predictors among women living with HIV (WLHIV) who undertook their first screening between 2019 and 2021 in Moshi Municipality, northern Tanzania. Design We conducted a retrospective cohort study between 2019 and 2021. Setting Healthcare facilities in Moshi municipality, Kilimanjaro region, northern Tanzania. Participants 2030 WLHIV who undertook their first screening in healthcare facilities in Moshi municipality between 2019 and 2021. Primary outcome measures Adherence to a follow-up cervical cancer screening, defined as the subsequent screening test conducted to detect precancerous development in the cervix carried out after the first screening. For the sub-analysis assessing the timing of adherence to a follow-up screening, this outcome was further categorised into four distinct categories: early adherence, good adherence, poor adherence, extremely poor adherence based on the time elapsed between the first screening and subsequent follow-up screening. Predictors of adherence were assessed using multivariable Poisson regression models with robust SEs and reported as adjusted risk ratios (ARR) with 95% CIs. Results Among 2030 WLHIV who undertook the first screening, only 33.2% adhered to a follow-up screening. Among these, only 21.4% (95% CI 18.4% to 24.7%) demonstrated good adherence, meaning they attended a follow-up within a month after the scheduled date. Also, adherence was higher in private healthcare facilities (ARR=1.57; 95% CI 1.35 to 1.82), lower for WLHIV who had their first screening at outreach facilities (ARR=0.28; 95% CI 0.19 to 0.39) and higher for those who were diagnosed with an abnormal screening outcome in their first screening (ARR=2.62; 95% CI 2.26 to 3.05). Adherence also increased with age and parity. Conclusion Adherence to follow-up cervical cancer screening among WLHIV in Moshi municipality was suboptimal, with only one-third of WLHIV adhering to these screenings. Strengthening recall systems particularly in public and outreach facilities and implementing targeted interventions for younger WLHIV, those with no or fewer children and those who had normal screening outcomes in the first screening is essential to improve adherence to recommended follow-up screening. ## Related Clinical Research - [COVID-19 mortality among people with HIV in Florida before and after COVID-19 vaccine availability](https://medichelpline.com/clinical-feed/plos-one-13-covid-19-mortality-risk-among-people-with-hiv-in-florida-before-and-after-the.md) - [HIV-1 Transmitted Drug Resistance in Shanghai (2018–2024): Mobility Fuels Cross-Population Spread](https://medichelpline.com/clinical-feed/pubmed-42758933.md) (DOI: 10.1080/22221751.2026.2731504) - [ADAMTS13 as a thromboinflammatory brake at the vascular–immune interface — article content not pre](https://medichelpline.com/clinical-feed/frontiers-in-immunology-18-adamts13-as-a-thromboinflammatory-brake-at-the-vascular-immune-interface-from.md) - [Progress toward measles and rubella elimination in Lesotho, 2011–2025](https://medichelpline.com/clinical-feed/plos-one-4-progress-towards-measles-and-rubella-elimination-in-lesotho-2011-2025.md) - [HIV self-testing (HIVST) and the diagnostic gap: a decade of missed scale-up](https://medichelpline.com/clinical-feed/plos-medicine-0-hiv-self-testing-and-the-global-diagnostic-gap-addressing-a-decade-of-missed.md) ## Navigation - [← Back to Infectious Disease Feed](https://medichelpline.com/clinical-feed/infectious-disease.md) - [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md) ## Medical & Regulatory Disclaimer > [!CAUTION] > MedicHelpline content is structured for research, educational, and professional discovery purposes. 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