Meeting Abstracts

16	 www.thelancet.com/lancetgh

Published Online 
March 31, 2022

Medical College of Wisconsin, 
Wauwatosa, WI, USA 

(N Anumolu BS, 
K Lechleitner BA, N Patel BS, 

C Jankowksi MPH, R Anguzu PhD, 
J Dickson-Gomez PhD, 

R Weber BS, K BeyerPhD); 
Makerere University, Kampala, 

Uganda (R Anguzu, 
S Kasasa PhD, C Banura PhD)

Correspondence to: 
Ms Natalie Anumolu, Medical 

College of Wisconsin, 
Wauwatosa, WI 53226, USA 

nanumolu@mcw.edu

Professional views on priorities for cervical cancer policy in 
Uganda: a qualitative study
Natalie Anumolu, Kia Lechleitner, Nisha Patel, Courtney Jankowksi, Ronald Anguzu, Simon Kasasa, Julia Dickson-Gomez, Cecily Banura, 
Rachel Weber, Kirsten Beyer

Abstract
Background Cervical cancer incidence in Uganda is three-times that of the global average, and is a leading cause of 
mortality for women. The main cause is human papillomavirus (HPV). Women living with HIV have a greater risk of 
acquiring HPV and need better cervical cancer care than their HIV-negative counterparts. Although funding and 
infrastructure exist for HIV control, they are not in place for cervical cancer. We aimed to assess Ugandan health 
professionals’ knowledge of and perspectives regarding cervical cancer among women with HIV to identify perceived 
barriers and facilitators, and to guide potential interventions to reduce the burden of cervical cancer.

Methods We used qualitative interviews to obtain primary data from professionals working in the HIV field in 
Uganda, identified through purposive and snowball sampling, and through consultation with colleagues at The AIDS 
Support Organisation (TASO) and Makerere University in Kampala. Inclusion criteria required the respondent to be 
a provider, researcher, community health worker, or other authority on cervical cancer and HPV and to be conversant 
in English. Exclusion criteria included being younger than 18 years. Written and verbal informed consent were 
obtained in accordance with the Medical College of Wisconsin and Makerere University human subjects protection 
protocols. Virtual, 1 h-long interviews were conducted and recorded. Interviews consisted of open-ended questions 
exploring perspectives on, knowledge about, and practices surrounding HPV and cervical cancer among women with 
HIV in Uganda. Institutional review board approval was obtained from TASO, the Uganda National Council for 
Science and Technology, and Medical College of Wisconsin. Transcripts were analysed and coded via MaxQDA 
software for common themes; emerging codes were generated from meaningful quotes as used in specific interviewee 
contexts of facilitators and barriers to HPV vaccination, cervical cancer screening, and treatment.

Findings To date, we have conducted 50 interviews of health professionals with experience across Uganda. Common 
themes regarding barriers to cervical cancer control include misconceptions about treatment cost and effectiveness, 
scarce access to and distance to cervical cancer services, transient funding for cervical cancer screening and treatment 
supplies, and fears of social exclusion and death. Potential solutions offered by participants include decentralising 
care through integration with existing health programmes, and prioritising education that targets misconceptions 
surrounding cervical cancer.

Interpretation Professionals indicated numerous misconceptions and fears held by women with HIV and 
inaccessibility of care due to lack of funding and integration of services. Priorities should include increasing mass 
media campaigns that target misconceptions, decentralising care through integration with existing health-care 
infrastructure and HIV screening and treatment programmes, and training more professionals in rural areas.

Funding Medical College of Wisconsin Cancer Center and Dr Elaine Kohler Global Health Research.

Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Contributors
KB, CJ, and KL conceived the study. NA, KL, NP, AM, and CJ collected the data. NA, NP, and KL analysed the data. NA wrote the first draft. 
All authors reviewed manuscript drafts, provided input, and approved the final version.

Declaration of interests
We declare no competing interests.

Acknowledgments
We are grateful to all the participants for giving us their time and information for this study.

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