This integration should have started yesterday. It is sometimes too much work,” Healthcare workers in HIV clinics in Uganda

Introduction Cervical cancer (CC) is the top cancer among women in Uganda and HIV infection increases its risk six-fold. This study aimed at describing acceptability of implementation of cervical screening as part of integrated HIV care and referral of women who screen positive using a modified referral protocol among health workers (HWs) in HIV clinics in Kampala, Uganda. Methods Key Informant Interviews (KIIs) were conducted with (HWs) in HIV clinics six months after introducing cervical screening and referral of women with positive screening results using a modified referral protocol. The theoretical framework of acceptability (TFA) of healthcare interventions was applied during data analysis. Its constructs namely, affective attitude, burden, ethicality, opportunity costs, perceived effectiveness, self-efficacy and intervention coherence become the thematic areas Results A total of 23 KIIs were conducted with representatives from each category of HWs in HIV care. All participants reported strong support for the intervention but identified challenges which must be addressed to increase its acceptability. Under the themes of affective attitude, ethicality and perceived effectiveness of implementing the intervention, it was highly accepted. Under the theme of intervention coherence, acceptability was good among the doctors and nurses/midwives but poor among other categories of HWs. Under burden, opportunity costs and self-efficacy, challenges of increased workload, inadequate knowledge and skills, and compromising the quality of HIV care, were identified as greatly limiting the intervention’s acceptability. The HWs recommended integrating the intervention in all HIV clinics while addressing the challenges to increase its acceptability Conclusion Integrating cervical screening in HIV care and modifying the usual care referral protocol for women who screen positive is strongly supported by HWs in HIV clinics. Inadequate human resources, limited knowledge and skills to implement the intervention, and compromising the quality of HIV care among other barriers should be addressed to increase its acceptability.