INTENTION TO RECEIVE CERVICAL CANCER SCREENING AND ITS PREDICTORS AMONG COMMERCIAL SEX WORKERS IN GONDAR CITY, NORTHWEST ETHIOPIA, USING THEORY OF PLANNED BEHAVIOR, 2021

Abstract

Abstract Background: Cervical cancer is a global public health problem & it is the fourth leading cause of cancer morbidity and mortality. In Ethiopia, cervical cancer is the second leading cause of cancer mortality. Commercial sex workers are at a higher risk of developing cervical cancer. However, intention to undergo cervical cancer screening is not studied in the study area. Objectives: To assess intention to receive cervical cancer screening and its predictors among commercial sex workers in Gondar city, northwest Ethiopia, 2021. Methods: A community-based cross-sectional study was conducted from March 27 to May 25, 2021 in Gondar city, northwest Ethiopia. A total of 425 commercial sex workers selected using convenience sampling techniques were included in the study. Data were collected through pretested structured interviewer-administered questionnaire. The data were entered into Epidata version 4.6 and exported to Stata version 16 for analysis. Linear regression with robust standard errors was carried out to identify factors associated with intention to receive cervical cancer screening. A 95% confidence interval and a p-value of less than or equal to 0.05 were used to declare statistical significance. Results: A total of 393 commercial sex workers participated in the study giving a response rate of 92.4%. The mean age of the participants was 27.68+ 6.62 and ranged from 15 to 46 years. The theory of planned behaviour explained 38.51% of the variance in intention to receive cervical cancer screening. The median intention was 4 (interquartile range 3-4.25). Direct subjective norm (?=0.09), 95% CI (0.05, 0.13)), direct Attitude (?=0.087; 95% CI (0.04, 0.13)), past screening behaviour (? =0.27; 95% CI (0.09, 0.46), positive HIV status (?=0.26; 95% CI (0.06, 0.46) were significant predictors of intention. Direct subjective norm was the strongest predictor. Conclusions: The median intention to use cervical cancer screening was high. Behavioral intention to be screened for cervical cancer was a function of attitude, subjective norm, past experience, and positive HIV status. Interventions should target on creating positive social pressure and attitudinal change to enhance intention. Key words: Intention, Cervical cancer screening, commercial sex workers, theory of planned behavior, Gondar