{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:29:36Z","timestamp":1793104176975,"version":"4.5.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer poses a substantial global health challenge, disproportionately affecting low- and middle-income nations. Women living with HIV are disproportionately affected compared to the general population. Our study explored the acceptance and preferences of participants regarding cervical cancer screening procedures during their HIV clinic visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Consolidated Framework for Implementation Research (CFIR) to inform questions, we conducted semi-structured in-depth qualitative interviews with 85 people with HIV (PWH), across six southern Ghana sites, to identify factors that could promote or impede the integration of cervical cancer screening into HIV care in Ghana. We also explored the acceptability of self-sampling versus provider-sampling among respondents. Thematic analysis was performed on the data using the MAXQDA software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most participants demonstrated a strong willingness to participate in cervical cancer screening, were motivated by the desire to know their health status, protect themselves, benefit from early detection and access timely treatment. We identified potential for early detection and treatment, improved health outcomes, increased health awareness, better management of multiple health conditions, and empowerment through health knowledge as facilitators. Participants articulated a multifaceted approach to screening integration, conceptualizing leadership as a collaborative effort involving multiple stakeholders, including healthcare providers, government agencies, non-governmental organizations, HIV program coordinators, and researchers. Our finding suggests that women living with HIV (WLWH) were comfortable with trained nurses administering thermal ablation for cervical cancer, even if they had no prior knowledge of the procedure. Acceptability of cervical cancer screening integration into routine care could be high when barriers were addressed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1679325","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T06:26:39Z","timestamp":1764570399000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Barriers and facilitators of integrating cervical cancer screening into routine HIV care and acceptability of self-sampling for HPV DNA testing among people with HIV: an exploratory study in southern Ghana"],"prefix":"10.3389","volume":"13","author":[{"given":"Evelyn Yayra","family":"Bonney","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel Frimpong","family":"Gyekye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Klutse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dzidzor Aku","family":"Attoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeena Abla","family":"Tay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas Ekow","family":"Thomford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Amoakoh-Coleman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwadwo Ansah","family":"Koram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Boateng","family":"Kyei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collins Stephen","family":"Ahorlu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e197","DOI":"10.1016\/S2214-109X(22)00501-0","article-title":"Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO global cervical cancer elimination initiative","volume":"11","author":"Singh","year":"2023","journal-title":"Lancet Glob Heal"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e191","DOI":"10.1016\/S2214-109X(19)30482-6","article-title":"Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis","volume":"8","author":"Arbyn","year":"2025","journal-title":"Lancet Glob Heal."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"18","DOI":"10.3332\/ecancer.2024.1663","article-title":"Survival rate of cervical cancer: a five year review at a major teaching Hospital in Ghana, West Africa","volume":"18","author":"Daniels","year":"2024","journal-title":"Ecancermedicalscience"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e0172548","DOI":"10.1371\/journal.pone.0172548","article-title":"Recent trends in racial and regional disparities in cervical cancer incidence and mortality in United States","volume":"12","author":"Yoo","year":"2017","journal-title":"PLoS One"},{"key":"ref6","volume-title":"Estimates of the global burden of cervical cancer associated with HIV","year":"2020"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e161","DOI":"10.1016\/S2214-109X(20)30459-9","article-title":"Estimates of the global burden of cervical cancer associated with HIV","volume":"9","author":"Stelzle","year":"2021","journal-title":"Lancet Glob Heal."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e0263920","DOI":"10.1371\/journal.pone.0263920","article-title":"Cervical cancer screening and treatment, HIV infection, and age: program implementation in seven regions of Namibia","volume":"17","author":"Korn","year":"2022","journal-title":"PLoS One"},{"key":"ref9","volume-title":"National HIV estimates and projections. Accra, Ghana: Ghana AIDS Commission.","year":"2019"},{"key":"ref10","year":"2020"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"10732748221094721","DOI":"10.1177\/10732748221094721","article-title":"Prevalence and distribution of vaccine-preventable genital human papillomavirus (HPV) genotypes in Ghanaian women presenting for screening","volume":"29","author":"Donkoh","year":"2022","journal-title":"Cancer Control"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1002\/ijgo.14158","article-title":"Determinants of cervical cancer screening uptake among women with access to free screening: a community-based study in peri-urban Ghana","volume":"159","author":"Tawiah","year":"2022","journal-title":"Int J Gynaecol Obstet"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12905-020-00915-9","article-title":"Cervical cancer screening practices among women in Ghana: evidence from wave 2 of the WHO study on global AGEing and 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survey","volume":"16","author":"Waller","year":"2009","journal-title":"J Med Screen"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1093\/intqhc\/mzy034","article-title":"The relationship between healthcare workers\u2019 attachment styles and patient outcomes: a systematic review","volume":"30","author":"Mimura","year":"2018","journal-title":"Int J Qual Health Care"},{"key":"ref21","first-page":"214","article-title":"Screening for cervical cancer","volume":"20","author":"Wilson","year":"1961","journal-title":"Mon Bull Minist Health Public Health Lab Serv"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1186\/s12905-023-02554-2","article-title":"Knowledge, willingness, uptake and barriers of cervical cancer screening services among Chinese adult females: a national cross-sectional survey based on a large e-commerce platform","volume":"23","author":"Zhang","year":"2023","journal-title":"BMC Womens 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gap?","volume":"23","author":"Douglas","year":"2016","journal-title":"J Med Screen"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1407008","DOI":"10.3389\/fonc.2024.1407008","article-title":"Bridging the gap in cervical cancer screening for underserved communities: MCED and the promise of future technologies","volume":"4","author":"Alshammari","year":"2024","journal-title":"Front Oncol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/1472-6963-13-107","article-title":"Multifaceted intervention to enhance the screening and care of hospitalised malnourished children: study protocol for the PREDIRE cluster randomized controlled trial","volume":"13","author":"Touzet","year":"2013","journal-title":"BMC Health Serv Res"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2035","DOI":"10.31557\/APJCP.2020.21.7.2035","article-title":"Cervical cancer screening among women receiving antiretroviral therapy in a resource-limited 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