Olakunde BO, Itanyi IU, Olawepo JO et al.
Despite an increased cervical cancer risk among women living with HIV, screening and treatment rates remain low across Africa, and evidence on effective implementation strategies for integrating these services into HIV programs is limited. This paper describes the protocol for the ACCESS study, a cluster-randomized hybrid type III trial using the EPIS framework, comparing core and enhanced implementation strategy packages selected through stakeholder engagement and drawn from Expert Recommendations for Implementing Change, at 12 HIV treatment sites in Nigeria randomized 1:1 by region. The RE-AIM framework will assess reach, adoption, fidelity, clinical effectiveness, and sustainment, while organizational readiness and implementation climate will be explored as potential mechanisms. The study aims to generate evidence-based strategies for integrating cervical cancer screening and treatment into routine HIV care, supporting global elimination targets.
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