Demographic and Social Determinants of HIV Status Among Women with Cervical Cancer in a Low-Resource Setting

Ahmed O. Elmehrath; Bernadette Njala; Dyness Sakala; Graciela M. Nogueras-Gonzalez; Mark F. Munsell; Dorothy Chilambe Lombe; Swali Fundafunda; Mwando Chitula; Susan Peterson; Elizabeth Y. Chiao; Susan Msasdabwe; Lilie L. Lin

doi:10.1016/j.ijgc.2025.102867

Demographic and Social Determinants of HIV Status Among Women with Cervical Cancer in a Low-Resource Setting

Ahmed O. Elmehrath, Bernadette Njala, Dyness Sakala, Graciela M. Nogueras-Gonzalez, Mark F. Munsell, Dorothy Chilambe Lombe, Swali Fundafunda, Mwando Chitula, Susan Peterson, Elizabeth Y. Chiao, …

International journal of gynecological cancer, 102867

26/12/2025

: https://doi.org/10.1016/j.ijgc.2025.102867

https://hdl.handle.net/10523/49482

Objective: Zambia faces one of the world’s highest cervical cancer and HIV burdens, yet how demographics and social determinants of health relate to HIV status among women with cervical cancer remains unclear. Methods: We conducted a prospective IRB approved cross-sectional study of women aged ≥18 years with newly diagnosed cervical cancer at the Cancer Diseases Hospital in Lusaka, Zambia from June 2022 to April 2025. Participants completed a culturally-adapted Accountable Health Communities Health-Related Social Needs questionnaire. Demographic and social need variables were compared by HIV status, with associated factors evaluated via univariable and multivariable logistic regression. Results: Among 290 women, 160 (55.2%) were living with HIV. They were younger (median age 48 vs. 53 years, p=0.002), more often unmarried (49% vs. 31%, P=0.002) and more likely to live in urban areas (62% vs. 43%, p=0.003), than women living without HIV. They reported greater prior cervical cancer screening (48% vs 28%, p<0.001) and knowledge (40% vs 25%, p=0.008). Social needs were high across both groups: food insecurity (77%), transport barriers (82%), financial hardship (88%), loneliness (65%) and perceived stress (75%), with no HIV-related differences. In multivariable analysis, younger age (adjusted odds ratio [aOR] 0.76 per 5 years, 95% CI 0.66–0.87), unmarried status (aOR 3.06, 1.79–5.35), urban residence (aOR 2.00, 1.21–3.32) and prior knowledge of cervical cancer (aOR 1.86, 1.08–3.23) were associated with HIV. No social need domain showed an independent association. Conclusion: In Zambian women with cervical cancer, HIV status is linked to demographic factors and cancer awareness, but not social needs which were uniformly high across patients. This highlights the need to expand education and screening, especially for younger and unmarried women, and integrate socioeconomic support to improve outcomes in Zambia and similar high-burden settings.

: 9926832798001891
: Demographic and Social Determinants of HIV Status Among Women with Cervical Cancer in a Low-Resource Setting
: Ahmed O. Elmehrath
Bernadette Njala
Dyness Sakala
Graciela M. Nogueras-Gonzalez
Mark F. Munsell
Dorothy Chilambe Lombe
Swali Fundafunda
Mwando Chitula
Susan Peterson
Elizabeth Y. Chiao
Susan Msasdabwe
Lilie L. Lin
: Office of the Dean (UOW)
: International journal of gynecological cancer, 102867
: Elsevier
: 26/12/2025
: National Cancer Institute (R01CA284623-02); Varian Medical Systems; National Cancer Institute, Cancer Center Support (Core) Grant (P30 CA016672)
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: English
: Journal article