In Burkina Faso, cervical cancer remains the second deadliest cancer among women. According to the World Health Organization, 11 percent of new cancer cases in 2022 were cervical cancer, and of the 6,654 cancer deaths, 775 were attributed to cervical cancer.
Cervical cancer affects women living with HIV more severely; cervical precancer is six times more likely to develop into cancer. Due to limited accessibility to screening services, women with HIV are at higher risk of discovering their cancer at an advanced stage, with limited and costly treatment options.
“We used to see women [coming in for HIV/AIDS care] who had advanced cervical cancer,” said Dr. Ousséini Gansonré, a physician at the Association Laafi La Viim (ALAVI), a community organization fighting HIV/AIDS in Burkina Faso. “If we had had the technical skills and adequate material resources, we could have saved many of these women through early detection and treatment of the precancerous lesions they were developing.”
With the aim of ensuring women have equitable access to quality health care provided by competent and caring professionals, Jhpiego, through the Scale Up Cervical Cancer Elimination with Secondary Prevention Strategy (SUCCESS) Project funded by the Unitaid investment and in partnership with Expertise France and the International Union Against Cancer (UICC), implemented services in Burkina Faso.
SUCCESS has contributed to reducing morbidity and mortality related to cervical cancer in six regions of Burkina Faso by improving access to cervical cancer screening services, including human papillomavirus (HPV) testing, visual inspection with acetic acid (VIA)—a low-cost cervical cancer screening method, and treatment by thermal ablation of precancerous lesions of the cervix.
In Ouagadougou, ALAVI is one of nine community organizations that received capacity-building training from the SUCCESS Project to:
"In our communities, especially among the vast majority of women with HIV, when we brought up the issue of cancer with them, fear immediately set in because, if they tested positive, it would be another burden they would have to bear,” said Ms. Francine Ouédraogo, ALAVI Coordinator. “But thanks to the training provided by SUCCESS, we were able to easily raise awareness in communities, which helped to dispel their fears and encouraged them to agree to be tested at our health facility or by themselves, using the self-sampling technique we taught them.”
Many women opt to self-sample, and it is recommended by health workers because of its many advantages.
"Self-sampling not only avoids long queues at health centers but also removes barriers that prevent some women from going to the hospital, including the fear that a male provider will perform the vaginal swab,” said Dr. Claude Linda Traoré, Jhpiego’s Project Manager for the SUCCESS Project in Burkina Faso.
After women participate in an awareness session, they are eligible for self-sampling and conduct the procedure at home.
“The health workers showed me how to take a vaginal sample myself, which I did,” said Jeanne*, a 48-year-old woman living with HIV. “I then took the sample to the ALAVI health center for analysis.”
After testing positive and undergoing VIA to reveal precancerous lesions, Jeanne was treated with thermal ablation. "I am already living with HIV, and if cervical cancer had been added to that, I would have been heading for certain death,” said Jeanne. “The test saved my life."
Collaboration with the SUCCESS Project has enabled ALAVI's medical staff to improve their expertise in managing precancerous lesions. With enhanced skills and equipment for detecting and treating precancerous lesions, ALAVI's medical staff now welcome women for cervical cancer screening. They diagnose precancerous lesions in women living with HIV who come to them. Those who test positive receive appropriate care, including thermocoagulation, if needed.
"In addition to our own patients, we also receive patients referred by other health centers for treatment by thermocoagulation because our expertise is recognized by these centers," says Dr. Gansonré. "Thermocoagulation has revolutionized the treatment of precancerous lesions of the cervix. It is easy to perform, and our patients are very receptive to it."
Recommended by the World Health Organization for the treatment of precancerous lesions, thermocoagulation is a life-saving technology because it is portable, runs on inexpensive batteries, and is easy to use.
The ALAVI medical team has screened more than 1,000 women, 200 of whom were treated using thermal ablation to remove precancerous lesions.
*Name has been changed for confidentiality.
Souleymane Zare is a communications specialist for Jhpiego in Burkina Faso. Tracey Shissler, the SUCCESS/Jhpiego Program Director, reviewed this story.
