Psychological distress and its determinants among HPV-positive women in screening settings of Addis Ababa, Ethiopia: a cross-sectional study

Résumé fourni par la source

Cervical cancer remains a major cause of cancer-related mortality among women in low- and middle-income countries. With the expansion of HPV-based cervical cancer screening in Ethiopia, increasing numbers of women are expected to receive HPV-positive results. However, psychological distress following HPV diagnosis remains poorly understood in this setting. This study assessed the prevalence of psychological distress and its associated factors among HPV-positive women in Addis Ababa, Ethiopia. A cross-sectional study was conducted from February to May 2025 in selected HPV screening facilities. A total of 423 women who screened positive for high-risk HPV were recruited using systematic random sampling, including both women living with HIV and HIV-negative women. Psychological distress was measured using the Kessler Psychological Distress Scale (K10), a 10-item tool assessing anxiety and depressive symptoms over four weeks. The questionnaire was administered in Amharic. Descriptive statistics were used to summarize participant characteristics and distress levels. Factors associated with psychological distress were assessed using bivariable and multivariable logistic regression analyses. Variables with p-value < 0.25 in bivariable analysis were considered for inclusion in the multivariable model, and statistical significance was declared at p-value < 0.05. Of 423 participants, the mean K10 score was 24.2 (SD = 11.1). Overall, 146 (34.5%) had severe distress, 63 (14.9%) moderate, and 40 (9.5%) mild distress. Severe distress was more common among HIV-negative women (47.1%) than women living with HIV (29.5%). Low HPV knowledge (AOR = 5.2; 95% CI: 2.8–9.8), lower partner support (AOR = 4.59; 95% CI: 2.43–8.71), and negative screening and follow-up experiences (AOR = 2.63; 95% CI: 1.43–4.83) were associated with psychological distress. A substantial proportion of HPV-positive women experience severe psychological distress following diagnosis. Knowledge gaps, stigma, lack of partner support, and negative screening experiences contribute to distress. These findings highlight the need for psychosocial support, targeted health education, and partner-inclusive counseling in HPV screening programs.

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