{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:08:08Z","timestamp":1788847688034,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"University of Wisconsin Department of Family Medicine and Community Health Primary Care Research Fellowship","award":["T32HP10010"],"award-info":[{"award-number":["T32HP10010"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer is a global health issue, particularly Sub-Saharan Africa, including Uganda, where it poses a severe burden. Despite the availability of screening methods, uptake remains low due to various barriers, such as limited resources and a lack of awareness. This study primarily aimed to assess the knowledge, attitudes, and practices related to cervical cancer screening among men and women in the Gulu District of Northern Uganda, with secondary objectives on understanding gender differences, the impact of HIV status, and identifying barriers to screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted in December 2021 using a structured questionnaire administered in both English and Acholi to evaluate participants\u2019 knowledge of cervical cancer, attitudes toward the disease, and screening practices. We described knowledge, attitudes, and practices, and applied logistic regression to explore the associations between gender, HIV status, and correctness of responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 379 participants aged 18\u2009years and above were included. Most respondents self-reported low overall knowledge of cervical cancer (n\u2009=\u2009298 of 376 responses, 79.3%), which is reflected in the low percentage of correct responses to questions related to the recommended age for screening (1.9%) and the frequency of screening for HIV-negative\/unknown (4.5%), and HIV-positive (9.8%) persons. Gender and HIV status among female respondents were not associated with knowledge levels. Stigma related to cervical cancer was reported among 40.8% of participants (n\u2009=\u2009147 out of 360 responses). Most participants never had a pelvic exam for cervical cancer (n\u2009=\u2009183 out of 258 responses, 70.9%) or testing for HPV (n\u2009=\u2009198 out of 246 responses, 80.5%). Among women living with HIV\u2212, 41.7% (n\u2009=\u200920 of 48 respondents) reported having received a pelvic examination for cervical cancer screening, and 18.6% (n\u2009=\u20098 of 43 respondents) reported having been screened for HPV. The majority identified cost (n\u2009=\u2009166 out of 273 responses, 60.8%) and access to healthcare facilities (n\u2009=\u2009246 out of 373 responses, 66%) as barriers to screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study highlights a low level of knowledge, understanding, and practice concerning cervical cancer screening, emphasizing the need for targeted interventions to reduce stigma and increase awareness of recommended screening intervals and risk reduction methods in Northern Uganda. Improving accessibility and affordability of screening services may also help reduce persistent structural barriers to screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/intqhc\/mzag118","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:25:57Z","timestamp":1787570757000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessment of knowledge, attitudes, and practices around cervical cancer screening in the Gulu district of Northern Uganda: a cross-sectional study"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1129-0942","authenticated-orcid":false,"given":"Tana","family":"Chongsuwat","sequence":"first","affiliation":[{"name":"School of Medicine & Public Health, University of Wisconsin-Madison , Madison, WI,","place":["United States"]},{"name":"Northwestern University Feinberg School of Medicine, Department of Family Medicine and Community Health , Chicago, IL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Nana","sequence":"additional","affiliation":[{"name":"Independent Researcher , Baltimore, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaliyah O","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Gulu Women\u2019s Economic Development & Globalization (GWED-G) , Gulu,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann E","family":"Evensen","sequence":"additional","affiliation":[{"name":"School of Medicine & Public Health, University of Wisconsin-Madison , Madison, WI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H","family":"Conway","sequence":"additional","affiliation":[{"name":"School of Medicine & Public Health, University of Wisconsin-Madison , Madison, WI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumba O","family":"Pius","sequence":"additional","affiliation":[{"name":"Makerere University School of Public Health , Kampala,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Sseddangira","sequence":"additional","affiliation":[{"name":"Makerere University School of Public Health , Kampala,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University , Robina QLD,","place":["Australia"]},{"name":"Evidence-Based Practice Professorial Unit, Gold Coast Hospital & Health Service (GCHHS) , Robina QLD,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Oloya","sequence":"additional","affiliation":[{"name":"Gulu Women\u2019s Economic Development & Globalization (GWED-G) , Gulu,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"2026090801423911500_mzag118-B1","author":"International Agency for Research on Cancer","year":"2024"},{"key":"2026090801423911500_mzag118-B2","author":"International Agency for Research on Cancer","year":"2024"},{"key":"2026090801423911500_mzag118-B3","author":"ICO\/IARC HPV Information Centre on HPV and Cancer","year":"2023"},{"key":"2026090801423911500_mzag118-B4","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1080\/01443615.2019.1634030","article-title":"Human papillomavirus and cervical cancer","volume":"40","author":"Okunade","year":"2020","journal-title":"J Obstet Gynaecol"},{"key":"2026090801423911500_mzag118-B5","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1007\/s10147-023-02337-7","article-title":"Carcinogenesis and management of human papillomavirus-associated cervical cancer","volume":"28","author":"Kusakabe","year":"2023","journal-title":"Int J Clin Oncol"},{"key":"2026090801423911500_mzag118-B6","author":"World Health Organization","year":"2021"},{"key":"2026090801423911500_mzag118-B7","doi-asserted-by":"publisher","first-page":"e0000785","DOI":"10.1371\/journal.pgph.0000785","article-title":"Health facility assessments of cervical cancer prevention, early diagnosis, and treatment services in Gulu, Uganda","volume":"3","author":"Chongsuwat","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"2026090801423911500_mzag118-B8","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1186\/s12889-024-17842-1","article-title":"Barriers to cervical cancer screening in Africa: a systematic review","volume":"24","author":"Mantula","year":"2024","journal-title":"BMC Public Health"},{"key":"2026090801423911500_mzag118-B9","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.puhe.2021.04.014","article-title":"Cervical cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis","volume":"195","author":"Yimer","year":"2021","journal-title":"Public Health"},{"key":"2026090801423911500_mzag118-B10","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/phcfm.v15i1.3776","article-title":"Early cervical cancer screening: the influence of culture and religion","volume":"15","author":"Gutusa","year":"2023","journal-title":"Afr J Prim Health Care Fam Med"},{"key":"2026090801423911500_mzag118-B11","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1186\/s12905-022-02019-y","article-title":"Factors explaining men\u2019s intentions to support their partner\u2019s participation in cervical cancer screening","volume":"22","author":"Dsouza","year":"2022","journal-title":"BMC Womens Health"},{"key":"2026090801423911500_mzag118-B12","doi-asserted-by":"publisher","first-page":"e0224692","DOI":"10.1371\/journal.pone.0224692","article-title":"Male support for cervical cancer screening and treatment in rural Ghana","volume":"14","author":"Binka","year":"2019","journal-title":"PLoS One"},{"key":"2026090801423911500_mzag118-B13","doi-asserted-by":"publisher","first-page":"A632","DOI":"10.1016\/j.jval.2016.09.1647","article-title":"Knowledge, attitudes and practices of cervical cancer screening among women attending a childhood immunization clinic in Uganda","volume":"19","author":"Nuwasiima","year":"2016","journal-title":"Value in Health"},{"key":"2026090801423911500_mzag118-B14","doi-asserted-by":"publisher","first-page":"611","DOI":"10.2147\/ijwh.s404845","article-title":"Knowledge, attitude, and practice toward cervical cancer screening among female university students in Ishaka Western Uganda","volume":"15","author":"Usman","year":"2023","journal-title":"Int J Womens Health"},{"key":"2026090801423911500_mzag118-B15","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/1472-6874-14-84","article-title":"Understanding cervical cancer: an exploration of lay perceptions, beliefs and knowledge about cervical cancer among the Acholi in Northern Uganda","volume":"14","author":"Mwaka","year":"2014","journal-title":"BMC Womens Health"},{"key":"2026090801423911500_mzag118-B16","author":"Uganda Bureau of Statistics","year":"2019"},{"key":"2026090801423911500_mzag118-B17","doi-asserted-by":"publisher","first-page":"108S","DOI":"10.1097\/01.AOG.0000514997.63843.b7","article-title":"Cervical cancer risk perceptions and justifications among women in rural El Salvador [22J]","volume":"129","author":"Rosenbaum","year":"2017","journal-title":"Obstet Gynecol"},{"key":"2026090801423911500_mzag118-B18","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1007\/s10654-019-00494-6","article-title":"Principles of confounder selection","volume":"34","author":"VanderWeele","year":"2019","journal-title":"Eur J Epidemiol"},{"key":"2026090801423911500_mzag118-B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"Mice: multivariate imputation by chained equations in R","volume":"45","author":"van Buuren","year":"2011","journal-title":"J Stat Soft"},{"key":"2026090801423911500_mzag118-B20","author":"R Core Team","year":"2024"},{"key":"2026090801423911500_mzag118-B21","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1007\/s13187-022-02163-x","article-title":"\u201cWe shall tell them with love, inform them what we have learnt and then allow them to go\u201d - men\u2019s perspectives of Self-Collected cervical cancer screening in rural Uganda: a qualitative inquiry","volume":"38","author":"Rawat","year":"2023","journal-title":"J Cancer Educ"},{"key":"2026090801423911500_mzag118-B22","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1186\/s12885-024-12671-2","article-title":"Understanding women\u2019s and men\u2019s perspectives on cervical cancer screening in Uganda: a qualitative study","volume":"24","author":"Bouskill","year":"2024","journal-title":"BMC Cancer"},{"key":"2026090801423911500_mzag118-B23","author":"The Republic of Uganda Ministry of Health","year":"2018"},{"key":"2026090801423911500_mzag118-B24","doi-asserted-by":"publisher","first-page":"e020343","DOI":"10.1136\/bmjopen-2017-020343","article-title":"Awareness of cervical cancer among women attending an HIV treatment Centre: a cross-sectional study from Morocco","volume":"8","author":"Belglaiaa","year":"2018","journal-title":"BMJ Open"},{"key":"2026090801423911500_mzag118-B25","doi-asserted-by":"publisher","first-page":"1274734","DOI":"10.1155\/2016\/1274734","article-title":"Knowledge and awareness of cervical cancer among HIV-Infected women in Ethiopia","volume":"2016","author":"Shiferaw","year":"2016","journal-title":"Obstet Gynecol Int"},{"key":"2026090801423911500_mzag118-B26","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s12905-024-02953-z","article-title":"HIV status and knowledge of cervical cancer among women in Ghana","volume":"24","author":"Enyan","year":"2024","journal-title":"BMC Womens Health"}],"container-title":["International Journal for Quality in Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/intqhc\/advance-article-pdf\/doi\/10.1093\/intqhc\/mzag118\/70770782\/mzag118.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/intqhc\/article-pdf\/38\/3\/mzag118\/70770782\/mzag118.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/intqhc\/article-pdf\/38\/3\/mzag118\/70770782\/mzag118.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:42:43Z","timestamp":1788846163000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/intqhc\/article\/doi\/10.1093\/intqhc\/mzag118\/8769512"}},"subtitle":[],"editor":[{"given":"Elom","family":"Otchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7,8]]}},"URL":"https:\/\/doi.org\/10.1093\/intqhc\/mzag118","relation":{},"ISSN":["1353-4505","1464-3677"],"issn-type":[{"value":"1353-4505","type":"print"},{"value":"1464-3677","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]},"article-number":"mzag118"}}