1. Advocacy for services to address cervical cancer in women living with HIV in Zambia Eunice Sinyemu Treatment Advocacy and literacy Campaign (TALC) ARASA AFP-15 th -16 th April 2015

2. Cervical Cancer Prevention Background Cervical cancer- cancer of the cervix caused by HPV In SSA, a woman dies from cervical cancer every 10 minutes 1. Cervical cancer is the second most common cancer in women worldwide Cervical cancer is the leading cause of cancer mortality 55,000 women die each year from cervical cancer 1 1. CIDRZ 2014 http://www.cidrz.orghttp://www.cidrz.org

3. Link between HIV and Cervical Cancer Due to weakened immune system  women who are HIV-infected are 4-5 times more likely to develop cervical cancer than women who are HIV negative (CIDRZ 2013)  develop cervical cancer at younger age But if diagnosed and treated early, more likely to have good response

4. Cervical Cancer in Zambia Zambia has the world’s second highest rate of cervical cancer and deaths Despite this Screening remains a major challenge Knock on effect on treatment Only one treatment centre- Lusaka Accurate information not readily available especially in rural areas

5. CancerNo.% Cervical63235 Breast1578 Kaposi’s sarcoma1116 Prostate905 Oesophagus513 Lymphoma463 Eye402 Colorectal301.6 Keloids301.6 Bladder291.5 Top Ten Cancers in Zambia Treated at Cancer Diseases Hospital of Zambia in 2012

6. For women living with HIV Standard is yearly screening for cervical cancer- According to National Treatment Guidelines 3 areas of advocacy Education and awareness Clean and safe equipment Availability of and accessible services

7. How have we done it Education and awareness Congregate settings- schools, churches Radio programme Women living with HIV Clean and safe equipment CIRDZ Clinics Availability and accessible services MCDMCH, MoH

8. Successes Churches have started including SRHR in their sermon programmes- once a month in Chililabombwe Of the 35 women living with HIV reached, 20 have gone for screening and 3 on treatment Kafue clinic to follow up on equipment with CIRDZ and other partners Radio programme to start next week-1 doctor, Cervical cancer nurse and a cervical cancer survivor

9. Challenges Personnel shortages e.g 25 gynecologists in the nation- mostly urban based Lack of surgical facilities, skilled providers Structural problems- inadequate laboratory facilities One chemo-radiation treatment center Distance to and limited screening sites especially in rural areas

11. Challenges cont.. Cultural barriers Tradition and faith healing Language/literacy Behaviour change still a problem Raging HIV epidemic

12. Thank you