Leveraging sexually transmitted infection clinics for cervical cancer screening: evidence from India

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SETTING Four government-run sexually transmitted infection/reproductive tract infection (STI/RTI) clinics at secondary and tertiary care hospitals in Nagpur district, Maharashtra, India. OBJECTIVE To assess readiness and provider knowledge for Papanicolaou (Pap) smear–based cervical cancer screening (CCS), and to explore willingness, enablers, and barriers to CCS and integrating CCS into STI/RTI clinics. DESIGN This was a convergent parallel mixed-methods study. Facility readiness and provider knowledge were assessed quantitatively. In-depth interviews explored implementation perspectives among purposively selected women clients, providers, and programme managers. RESULTS Three out of four clinics met readiness standards, but only one clinic scored well in provider knowledge. Of 28 female clients, 27 (96%) were willing for CCS after counselling. Key enablers for clients to undergo CCS were respectful communication, and female-friendly and affordable services. Barriers included fear, embarrassment, low awareness, and poor family support. Providers (n = 9) highlighted well-equipped facilities, female staff availability, and permission from authorities to be key enablers for integration. They identified high workload and lack of training, staff, and programme-level support as constraints. The two programme managers perceived integration to be of less value. CONCLUSION STI/RTI clinics could serve as a complementary platform for opportunistic CCS among high-risk women, provided human resources, training, awareness generation, and programme-level engagement are strengthened.

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