Prevalence and correlates of cervical cancer screening among injection drug users.

OBJECTIVE Access to cervical cancer screening may be lower among lower income and socially disadvantaged populations. However, few studies have specifically examined factors associated with cervical cancer screening among socially marginalized populations, especially in settings with free health care systems. METHODS The present study was conducted to examine the prevalence and correlates of cervical cancer screening among injection drug users. We examined rates of Papanicolaou (Pap) smear testing among female participants in the Vancouver Injection Drug Users Study (VIDUS). Univariate and logistic regression analyses were used to evaluate factors associated with cervical cancer screening. RESULTS During the period from December 2004 to May 2005, 297 female injection drug users were seen. In logistic regression analyses, age (adjusted odds ratio [AOR]=0.70; 95% confidence intervals [CI] 0.53, 0.92, P=0.010), HIV infection (AOR=2.46; 95% CI 1.41,4.26, P=0.001), hepatitis C infection (AOR=0.25; 95% CI 0.09,0.71, P=0.010), and having visited a family physician in the prior six months (OR=3.10; 95% CI 1.58, 6.07, P=0.001) were independently associated with recent cervical cancer screening. CONCLUSIONS After adjustment for regular physician visits, HIV infection was associated with elevated rates of cervical screening. This is reassuring, given the elevated risk of cervical cancer among this population. Interventions may be required to improve uptake of screening among older injection drug users and drug users infected with hepatitis C.