Faktor Prediktif Partisipasi Wanita Usia Subur dalam Skrining IVA dan Deteksi DNA HPV di Kedungmundu

Novita Nining Anggraini; Siti Nurjanah; Roja Sekar Arum

doi:10.62027/praba.v4i3.949

Authors

Novita Nining Anggraini Universitas Muhammadiyah Semarang
Siti Nurjanah Universitas Muhammadiyah Semarang
Roja Sekar Arum Universitas Muhammadiyah Semarang

DOI:

https://doi.org/10.62027/praba.v4i3.949

Keywords:

Cervical Cancer, HPV DNA, PRECEDE-PROCEED, Social Support, VIA Screening

Abstract

Cervical cancer remains a major public health issue in Indonesia. Despite the move towards high-performance HPV DNA testing, screening rates still fall short of global targets. This study examines the factors influencing screening participation among women of childbearing age (WUS) using the PRECEDE-PROCEED framework. A quantitative cross-sectional study was carried out with 100 women aged 20–49 in the Kedungmundu Community Health Center area, Semarang. Data collection involved validated questionnaires that evaluated predisposing, enabling, and reinforcing factors. Analysis employed Chi-Square tests and Multivariate Binary Logistic Regression to identify key predictors while adjusting for demographic factors. Significant links were found between screening participation and factors such as knowledge (p=0.039), attitude (p=0.039), social support (p=0.024), and distance (p=0.032). The multivariate analysis (Nagelkerke R²=0.412) identified social support as the strongest predictor (Adjusted Odds Ratio [AOR] = 4.30; 95% CI: 1.30–14.18), followed by positive attitude (AOR=3.47; 95% CI: 1.27–9.48). Findings suggest that social reinforcement and psychological readiness are more influential on participation than knowledge alone. To meet the WHO 90-70-90 targets in Indonesia, strategies should focus on involving husbands and health workers, and incorporating HPV DNA self-sampling to address physical and emotional barriers.

References

Abamecha, F., Tena, A., & Kiros, G. (2019). Psychographic predictors of intention to use cervical cancer screening services among women attending maternal and child health services in Southern Ethiopia: the theory of planned behavior (TPB) perspective. BMC Public Health, 19(1), 434. https://doi.org/10.1186/s12889-019-6745-x

Al‐Ani, A., Hammouri, M., Sultan, H., Al‐Huneidy, L., Mansour, A., & Al‐Hussaini, M. (2024). Factors affecting cervical screening using the health belief model during the last decade: A systematic review and meta‐analysis. Psycho-Oncology, 33(1). https://doi.org/10.1002/pon.6275

Ampofo, A. G., Adumatta, A. D., Owusu, E., & Awuviry-Newton, K. (2020). A cross-sectional study of barriers to cervical cancer screening uptake in Ghana: An application of the health belief model. PLOS ONE, 15(4), e0231459. https://doi.org/10.1371/journal.pone.0231459

Bogale, A. L., Teklehaymanot, T., Kassie, G. M., Medhin, G., Ali, J. H., & Belay, N. B. (2022). Performance of visual Inspection With Acetic Acid for Cervical Cancer Screening as Compared to Human papillomavirus Deoxyribonucleic acid Testing Among Women With HIV in Ethiopia: A Comparative Cross-sectional Study. Cancer Control, 29. https://doi.org/10.1177/10732748221114980

Dsouza, J. P., Broucke, S. Van den, Pattanshetty, S., & Dhoore, W. (2022). A comparison of behavioural models explaining cervical cancer screening uptake. BMC Women’s Health, 22(1), 235. https://doi.org/10.1186/s12905-022-01801-2

Ferdous, J., . A., Munshi, S., Khan, M. M. H., Parvin, M., . H., Bushra, T., & Haseen, F. (2025). Diagnostic Evaluation of HPV DNA Test in Detecting Cervical Pre-Cancer: A Systematic Review. Journal of Posthumanism, 5(9), 658–672. https://doi.org/10.63332/joph.v5i9.3601

Fuzzell, L. N., Perkins, R. B., Christy, S. M., Lake, P. W., & Vadaparampil, S. T. (2021). Cervical cancer screening in the United States: Challenges and potential solutions for underscreened groups. Preventive Medicine, 144, 106400. https://doi.org/10.1016/j.ypmed.2020.106400

Gizaw, M., Teka, B., Ruddies, F., Abebe, T., Kaufmann, A. M., Worku, A., Wienke, A., Jemal, A., Addissie, A., & Kantelhardt, E. J. (2019). Uptake of Cervical Cancer Screening in Ethiopia by Self-Sampling HPV DNA Compared to Visual Inspection with Acetic Acid: A Cluster Randomized Trial. Cancer Prevention Research, 12(9), 609–616. https://doi.org/10.1158/1940-6207.CAPR-19-0156

Griffin-Mathieu, G., Haward, B., Tatar, O., Zhu, P., Perez, S., Shapiro, G. K., McBride, E., Thompson, E. L., Smith, L. W., Lofters, A. K., Daley, E. M., Guichon, J. R., Waller, J., Steben, M., Decker, K. M., Mayrand, M.-H., Brotherton, J. M. L., Ogilvie, G. S., Zimet, G. D., … Rosberger, Z. (2022). Ensuring a Successful Transition From Cytology to Human Papillomavirus–Based Primary Cervical Cancer Screening in Canada by Investigating the Psychosocial Correlates of Women’s Intentions: Protocol for an Observational Study. JMIR Research Protocols, 11(6), e38917. https://doi.org/10.2196/38917

Hamid, M. K. I., Hasneen, S., Lima, A. K., Shawon, S. R., Shahriar, M., & Anjum, R. (2025). Cervical cancer trends, HPV vaccine utilization, and screening in low- and lower-middle-income countries: an updated review. Therapeutic Advances in Vaccines and Immunotherapy, 13. https://doi.org/10.1177/25151355251356646

Haward, B., Tatar, O., Zhu, P., Griffin-Mathieu, G., Perez, S., Shapiro, G. K., McBride, E., Zimet, G. D., & Rosberger, Z. (2022). Development and validation of the cervical cancer knowledge scale and HPV testing knowledge scale in a sample of Canadian women. Preventive Medicine Reports, 30, 102017. https://doi.org/10.1016/j.pmedr.2022.102017

Ikeliya, A., Harokan, A., & Gustina, E. (2025). FACTOR ANALYSIS OF THE IMPLEMENTATION OF VISUAL INSPECTION OF ACETIC ACID (VIA) EXAMINATION IN WOMEN OF FERTILE AGE AT UJAN MAS HEALTH CENTER. Cendekia Medika: Jurnal Stikes Al-Ma`arif Baturaja, 10(2), 231–240. https://doi.org/10.52235/cendekiamedika.v10i2.503

Indarti, J. (2023). The Role of Social Obstetrics and Gynecology in the Coverage of Cervical Cancer Screening in the Era of Health Transformation in Indonesia. Indonesian Journal of Obstetrics and Gynecology, 198–200. https://doi.org/10.32771/inajog.v11i4.2181

Ji, X., Hao, M., Wang, Y., Kong, W., Pan, Z., Sun, Q., & Miao, J. (2025). Human papillomavirus self-sampling in Asia: a systematic review. Frontiers in Microbiology, 16. https://doi.org/10.3389/fmicb.2025.1540609

Juwita, L., & Ayu Prabasari, N. (2023). The Precede-Proceed Model Concept Analysis on The Uptake of Visual Inspection with Acetic Acid Method (VIA) Test. Babali Nursing Research, 4(3), 492–501. https://doi.org/10.37363/bnr.2023.43242

Kamath Mulki, A., & Withers, M. (2021). Human Papilloma Virus self-sampling performance in low- and middle-income countries. BMC Women’s Health, 21(1), 12. https://doi.org/10.1186/s12905-020-01158-4

Luizaga, C. T. de M., Câmara, A. B., Cury, L. C. P. B., Lopez, R. V. M., Contreras, C. A. H., Basu, P., Wünsch-Filho, V., & Carvalho, A. L. (2025). Barriers and attitudes toward cervical cancer screening among eligible women. Cancer Causes & Control, 36(12), 1763–1774. https://doi.org/10.1007/s10552-025-02058-4

Mantula, F., Toefy, Y., & Sewram, V. (2024). Barriers to cervical cancer screening in Africa: a systematic review. BMC Public Health, 24(1), 525. https://doi.org/10.1186/s12889-024-17842-1

Mekuria, S. F., Timmermans, S., Borgfeldt, C., Jerkeman, M., Johansson, P., & Linde, D. S. (2023). HPV self-sampling versus healthcare provider collection on the effect of cervical cancer screening uptake and costs in LMIC: a systematic review and meta-analysis. Systematic Reviews, 12(1), 103. https://doi.org/10.1186/s13643-023-02252-y

Morgan, K., Azzani, M., Khaing, S. L., Wong, Y.-L., & Su, T. T. (2019). Acceptability of Women Self-Sampling versus Clinician-Collected Samples for HPV DNA Testing: A Systematic Review. Journal of Lower Genital Tract Disease, 23(3), 193–199. https://doi.org/10.1097/LGT.0000000000000476

Paripurna, Y., & Cahyati, W. H. (2025). Knowledge, Perceptions, and Practices in Cervical Cancer Screening Among Female Nurses and Midwives. Journal of Creativity Student, 8(1), 77–84. https://doi.org/10.15294/jcs.v8i1.25088

Paula-Pinto, M., Amaral, M., Norton, L., Vilas-Boas, F., & Santos-Silva, I. (2025). Vaginal self-versus clinician sampling on cervical cancer screening: an accuracy and acceptability systematic review and meta-analysis. Revista Portuguesa de Clínica Geral, 41(1), 52–64. https://doi.org/10.32385/rpmgf.v41i1.13988

Petersen, Z., Jaca, A., Ginindza, T. G., Maseko, G., Takatshana, S., Ndlovu, P., Zondi, N., Zungu, N., Varghese, C., Hunting, G., Parham, G., Simelela, P., & Moyo, S. (2022). Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Women’s Health, 22(1), 486. https://doi.org/10.1186/s12905-022-02043-y

Riya, R., & Rosida, R. (2023). Faktor-faktor yang Mempengaruhi Wanita Usia Subur (WUS) dalam Keikutsertaan Pemeriksaan Inspeksi Visual Asam Asetat (IVA) di Wilayah Kerja Puskesmas Muara Tembesi Kabupaten Batang Hari Jambi. Jurnal Ilmiah Universitas Batanghari Jambi, 23(1), 575. https://doi.org/10.33087/jiubj.v23i1.3221

Robbers, G. M. L., Bennett, L. R., Spagnoletti, B. R. M., & Wilopo, S. A. (2021). Facilitators and barriers for the delivery and uptake of cervical cancer screening in Indonesia: a scoping review. Global Health Action, 14(1). https://doi.org/10.1080/16549716.2021.1979280

Selvi, S., Geetha, K. T., & Devadasan, J. (2025). Validating knowledge and attitude for cervical cancer screening among rural women: A rasch and factor analysis approach. Annals of the National Academy of Medical Sciences (India), 1. https://doi.org/10.25259/ANAMS_20_2025

Serrano, B., Ibáñez, R., Robles, C., Peremiquel-Trillas, P., de Sanjosé, S., & Bruni, L. (2022). Worldwide use of HPV self-sampling for cervical cancer screening. Preventive Medicine, 154, 106900. https://doi.org/10.1016/j.ypmed.2021.106900

Setiawan, D., Andrijono, Hadinegoro, S. R., Meyta, H., Sitohang, R. V., Tandy, G., Perwitasari, D. A., & Postma, M. J. (2020). Cervical cancer prevention in Indonesia: An updated clinical impact, cost-effectiveness and budget impact analysis. PLOS ONE, 15(3), e0230359. https://doi.org/10.1371/journal.pone.0230359

Solomon, K., Tamire, M., & Kaba, M. (2019). Predictors of cervical cancer screening practice among HIV positive women attending adult anti-retroviral treatment clinics in Bishoftu town, Ethiopia: the application of a health belief model. BMC Cancer, 19(1), 989. https://doi.org/10.1186/s12885-019-6171-6

Sun, Y., Ma, Y., Cao, M., Hu, Z., Lin, W., Chen, M., & He, Y. (2022). Breast and cervical cancer screening adherence in Jiangsu, China: An ecological perspective. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.967495

Wollancho, W., Amdissa, D., Bamboro, S., Wasihun, Y., Tareke, K. G., & Gizaw, A. T. (2020). Determining behavioral intention and its predictors towards cervical cancer screening among women in Gomma district, Jimma, Ethiopia: Application of the theory of planned behavior. PLOS ONE, 15(11), e0238472. https://doi.org/10.1371/journal.pone.0238472

Yirsaw, A. N., Tefera, M., Bogale, E. K., Anagaw, T. F., Tiruneh, M. G., Fenta, E. T., Endeshaw, D., Adal, O., Tareke, A. A., Jemberu, L., Getachew, E., Belayneh, A. G., Andarge, G. A., Seid, K., & Lakew, G. (2024). Applying the Health Belief Model to cervical cancer screening uptake among women in Ethiopia: a systematic review and meta-analysis. BMC Cancer, 24(1), 1294. https://doi.org/10.1186/s12885-024-13055-2