If not treated, HIV infection can lead to a decrease of white blood cells. This makes HIV-positive women six times more vulnerable to developing precancerous cells, leading to a high prevalence of co-infection with other diseases such as human papilloma virus, which can cause cervical cancer. In South Africa, approximately 4.8 million HIV-positive women are at permanent risk of developing cancer of the cervix. Despite efforts to remove barriers to the Papanicolaou test used to detect cervical cancer, commonly known as a pap smear, among HIV-positive women, the uptake of pap smear screening in low- and middle-income countries is unreasonably low.  

This study explored the barriers and facilitators to pap smear screening among HIV-positive women in the Volksrust community in Mpumalanga via semi-structured, one-on-one interviews with 15 participants. The study showed that HIV-positive women have a positive perception of pap smear screening. Educating more women about pap smear screening and standardising health practices further facilitate pap smear tests. On the flipside, breach of confidentiality, stigma and discrimination as well as fear and anxiety are challenges.

The study highlighted the importance of sensitivity training to healthcare workers to enhance their skills and professionalism. It showed the importance of creating a portal for report-back that is accessible to all HIV-positive women. It identified the need to create a welcoming space and support group for HIV-positive women at a women’s clinic where the importance of pap smear screenings is emphasised. Accessible and ongoing pap smear information is needed to curb the lack of knowledge on cervical smear screening among HIV-positive women.