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Association between Risky Sexual Behavior and Cervical Cancer Screening among Women in Kenya: A Population-Based Study
Authors: Zelalem T. Haile, Caroline Kingori, Bhakti Chavan, John Francescon, and Asli K. Teweldeberhan
Source: Journal of Community Health, 43(2): 238–247; DOI: 10.1007/s10900-017-0410-z
Topic(s): Sexual behavior
Women's health
Country: Africa
Published: APR 2018
Abstract: Women residing in Eastern Africa are disproportionately affected by cervical cancer. Previous studies have identified risky sexual behavior as a major risk factor for cervical cancer. However, population-based studies examining the relationship between sexual behavior and cervical cancer screening are currently lacking. This descriptive cross-sectional study utilized nationally representative secondary data from the 2014 Kenya Demographic and Health Survey (n?=?6104) to examine the association between risky sexual behavior and cervical cancer screening among sexually active women. Both descriptive and inferential statistical methods were utilized. Overall, 20.2% of the study sample reported having cervical cancer examination. Approximately 13.1% of the participants reported involvement in risky sexual behavior. Significantly lower proportion of women engaged in risky sexual behavior reported having cervical cancer examination (14.5 vs. 21.0%; p?=?0.001). In the multivariable model, we found a significant interaction between risky sexual behavior and marital status on cervical cancer examination. Among women who were married/living together, risky sexual behavior was negatively associated with cervical cancer examination after adjusting for potential confounders (Prevalence Ratio, 95% CI) (0.42; 0.24–0.74; p?=?0.002). The prevalence of having visual inspection with VIA or VILI were lower among women who were involved in risky sexual behavior (0.39; 0.18–0.87; p?=?0.022). However, we were unable to detect any significant association between risky sexual behavior and having Papanicolaou test. With increasing incidence of cervical cancer in resource-limited settings, it is critical to identify populations at increased risk of infection and provide effective screening and follow-up services. Keywords Cervical cancer screening Risky sexual behavior Demographic and Health Survey Africa Kenya