Abstract
BACKGROUND: Precancerous and suspicious cervical cancer lesions refer to abnormal changes in cervical cells that may develop into malignancy if left untreated. Women living with Human Immunodeficiency Virus (HIV) face a significantly higher burden of AIDS-defining malignancies, particularly invasive cervical cancer. Their risk of developing cervical cancer is approximately six times greater than that of HIV-negative women. Despite the elevated risk, there is limited evidence in understanding the prevalence of cervical lesions among women living with HIV (WLHIV) who undergo cervical cancer screening in Ethiopia. This gap underscores the need for further research to inform targeted interventions and improve health outcomes for these high-risk populations. METHODS: A facility-based cross-sectional study was conducted among 583 adult WLHIV in the Awi Zone, Northwest Ethiopia. Both primary and secondary data were collected between January and May 2023 to address the study objectives. Data were entered into Epidata version 4.6 and exported to SPSS version 26 for analysis. A bivariable and multivariable binary logistic regression model was fitted to identify factors associated with the outcome variable. Statistical significance was determined at a p-value of less than 0.05 and a 95% confidence interval (CI). RESULTS: The magnitude of precancerous and/or suspicious cervical cancer lesions (PCCLs) among women living with HIV was 24.9% (95% CI: 21.3-28.1%). The likelihood of developing precancerous and suspicious cervical cancer lesions was higher among individuals with a baseline CD4 + cell count of < 200 cells/mm³ (AOR = 3.82, 95% CI: 2.44-5.39), a history of sexually transmitted infections other than HIV (AOR = 3.97; 95% CI: 1.97-5.70), use of oral contraceptives (AOR = 2.18; 95% CI: 1.40-3.40), having two or more sexual partners (AOR = 2.86; 95% CI: 1.79-4.55), fair adherence to antiretroviral therapy (ART) (AOR = 2.81; 95% CI: 1.39-5.64), and poor ART adherence (AOR = 3.25; 95% CI: 1.87-7.43). CONCLUSION: In this study, a relatively high prevalence of precancerous lesions was found among WLHIV compared to previous studies in Ethiopia. Behavioral, clinical, and reproductive health-related factors were linked to the occurrence of the disease. These findings underscore the importance of giving special attention to high-risk women through targeted screening and preventive interventions.