Abstract:
Purpose Cervical cancer is one of the most common malignancies among women in low resource setting. The objective of
this study was to assess the acceptability of prenatal cervical cancer screening using visual inspection with acetic acid
(VIA) in a low resource setting.
Methods This was a cross-sectional study conducted at Moi Teaching and Referral Hospital. Over a period of 12 months,
we enrolled 331 women who were attending antenatal care clinic with a gestation of age of less than 22 weeks. We
screened them for cervical cancer by applying 5% acetic acid to the cervix (VIA Method). Visualization of aceto-white
lesions was interpreted as a positive VIA test. A cervicography was obtained for independent review by two clinicians. A
repeat VIA test or colposcopy and biopsy were recommended at 6 weeks postpartum for those with a positive VIA test.
Results Mean gestational age was 16 weeks. Seventy five percent of participants (n= 247) had used contraceptives, 31.1%
(n= 103) had previously been screened for cervical cancer and 9.1% (n= 14) were HIV positive. The study clinician
detected 11.3% VIA positive while first and second independent reviewers reported 22.5% and 7.7% VIA-positive results,
respectively. About 85.7% of the participants did not experience any immediate adverse reaction as a result of the
procedure. However, 3.8%, 38.4% and 0.7% experienced pain, burning sensation and bleeding respectively. Overall,
98.4% (n= 306) indicated that they would recommend the test, and 99% (n= 307) indicated that they would return for a
repeat test 6 weeks postpartum. HIV status had no influence on VIA-positive rates (p= 0.909).
Conclusion The rate of VIA positive was 13.8% among the pregnant women. It is acceptable to use VIA to screen pregnant
women for cervical cancer
