Cervical Cancer Screening and Traditional Medicine use among Indigenous Women in Region 1, Guyana
Abstract:
Cervical cancer disproportionately affects Indigenous women in Guyana's Region 1 (Barima-Waini), a remote, river-dependent area where traditional medicine (TM) is deeply integrated into healthcare decision-making. Drawing on baseline data from 260 Indigenous women across 48 communities enrolled in an ongoing community-based participatory research (CBPR) cohort study, this analysis examined KAP-related proxy indicators regarding cervical cancer screening and TM use, using chi-square tests, Cramer's V effect sizes, and unadjusted pairwise odds ratios (OR) with 95% confidence intervals (CI) to identify factors associated with screening uptake and disclosure behavior (significance set at p < 0.05). Most women (94.2%) were aware of their own Pap smear history, yet lifetime screening uptake was only 32.3%. Screening was most strongly associated with living within 2 km of a health facility (OR = 0.13, 95% CI 0.07–0.25 for those farther away; Cramer's V = 0.421), being 40 years or older (OR = 6.50, 95% CI 3.62–11.69), any use of traditional healers (OR = 3.67, 95% CI 2.08–6.46), and having completed secondary education or higher (OR = 2.57, 95% CI 1.48–4.46). Attitudes followed a non-monotonic pattern: women reporting equal trust in TM and biomedicine were far more likely to combine both approaches (OR = 29.06, 95% CI 13.73–61.49, relative to those favoring biomedicine) and to disclose TM use to a provider (OR = 12.86, 95% CI 6.82–24.24) than women anchored at either extreme of the trust spectrum. While geographic proximity, age, and education remain primary determinants of screening uptake, a balanced trust in both health systems, rather than exclusive alignment with either, shows the strongest unadjusted association with open, integrated care-seeking behavior.References:
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