ArticleInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society2026
Demographic and social determinants of human immunodeficiency virus status among women with cervical cancer in a low-resource setting.
Article in International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveZambia faces one of the world's highest cervical cancer and human immunodeficiency virus (HIV) burdens, yet how demographics and social determinants of health relate to HIV status among women with cervical cancer remains unclear.
methodsWe conducted a prospective, Institutional Review Board-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 multi-variable logistic regression.
resultsAmong 290 women, 160 (55.2%) were living with HIV. They were younger (median age 48 vs 53 years, p = .002), more often unmarried (49% vs 31%, p = .002), and more likely to live in urban areas (62% vs 43%, p = .003) than women living without HIV. They reported greater prior cervical cancer screening (48% vs 28%, p < .001) and knowledge (40% vs 25%, p = .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 multi-variable analysis, younger age (adjusted odds ratio [aOR] 0.76 per 5 years, 95% confidence interval [CI] 0.66 to 0.87), unmarried status (aOR 3.06, 95% CI 1.79 to 5.35), urban residence (aOR 2.00, 95% CI 1.21 to 3.32), and prior knowledge of cervical cancer (aOR 1.86, 95% CI 1.08 to 3.23) were associated with HIV. No social need domain showed an independent association.
conclusionsIn 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.
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