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Bennett KF, Waller J, Bailey JV, Marlow LAV. Exploring the psychosexual impact and disclosure experiences of women testing positive for high-risk cervical human papillomavirus. Br J Health Psychol 2023; 28:62-79. [PMID: 35819012 PMCID: PMC10084302 DOI: 10.1111/bjhp.12612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To examine the psychosexual impact and disclosure experiences of women testing HPV-positive following cervical screening. DESIGN In-depth semi-structured interviews. METHODS Interviews were conducted with 21 women of screening age (i.e. those aged 24-65 years) in England who self-reported testing HPV-positive in the context of cervical screening in the last 12 months. Data were analysed using Framework Analysis. RESULTS The sexually transmitted nature of HPV, and aspects relating to the transmission of HPV and where their HPV infection had come from, had an impact on women's current, past and future interpersonal and sexual relationships. Most women had disclosed their HPV infection to others, however the factors influencing their decision, and others' reactions to disclosure differed. The magnitude and extent of psychosexual impact was influenced by how women conceptualized HPV, their understanding of key aspects of the virus, concerns about transmitting HPV and having a persistent HPV infection. CONCLUSIONS Increasing knowledge of key aspects of HPV, such as its high prevalence and spontaneous clearance, and the differences between HPV and other STIs, may increase women's understanding of their screening result and reduce any negative psychosexual consequences of testing HPV-positive. Referring to HPV as an infection that is passed on by skin-to-skin contact during sexual activity, rather than an STI, may help to lessen any psychosexual impact triggered by the STI label.
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Affiliation(s)
- Kirsty F Bennett
- Cancer Communication and Screening Group, Department of Behavioural Science and Health, University College London, London, UK
| | - Jo Waller
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Julia V Bailey
- e-Health Unit, Department of Primary Care and Population Health, University College London, London, UK
| | - Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
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2
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Galeshi M, Shirafkan H, Yazdani S, Motaghi Z. Reproductive health needs of Human papillomavirus (HPV) positive women: A systematic review. PLoS One 2022; 17:e0266819. [PMID: 36095006 PMCID: PMC9467316 DOI: 10.1371/journal.pone.0266819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 08/26/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Human papillomavirus is one of the most important causes of cervical cancer. Participating in an HPV test and receiving an HPV diagnosis can create questions about the needs and preferences. The present systematic review was conducted to determine the reproductive health needs of women with HPV. METHODS We searched PubMed, Scopus, Web of Science, Google Scholar and Magiran, SID and Iranmedex. Without language restrictions and time constraints. We also searched the grey literature and carried out forward/backward citation searches. RESULTS In the first, 1056 articles were retrieved, and, after removing them, 13 articles published were entered. The studies were qualitative (N = 9), quantitative (N = 3), and one was unclear. Most qualitative studies collected data using individual interviews (N = 7), two qualitative studies, narratives of HPV patients from a website of patient experiences and questions. Women wanted further information on different HPV viral types, transmission, implications for sexual partners, prevalence, latency and regression of HPV, their management options and the implications of infection for cancer risk and fertility. Women's experience of searching the Internet for further information about HPV was reported as difficult, anxiety provoking and contributing to the stigma of the infection because information was often located in the context of other sexually transmitted infections, with multiple sexual partners highlighted as a risk factor for infection. CONCLUSION Surveys showed that the majority of women had unanswered questions about their HPV test results. The information that women thought was helpful in interpreting their test results included having a high-risk type of HPV, and cancer survival statistics for the virus. Women also needed information about sexual transmission, how HPV tested positive in a long-term relationship, and the potential consequences for their partners and the risk of re-infection. Younger women had questions about whether HPV could affect fertility.
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Affiliation(s)
- Mina Galeshi
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hoda Shirafkan
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shahla Yazdani
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Motaghi
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Dellino M, Cascardi E, Tomasone V, Zaccaro R, Maggipinto K, Giacomino ME, De Nicolò M, De Summa S, Cazzato G, Scacco S, Malvasi A, Pinto V, Cicinelli E, Carriero C, Di Vagno G, Cormio G, Genco CA. Communications Is Time for Care: An Italian Monocentric Survey on Human Papillomavirus (HPV) Risk Information as Part of Cervical Cancer Screening. J Pers Med 2022; 12:1387. [PMID: 36143172 PMCID: PMC9505682 DOI: 10.3390/jpm12091387] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Human papilloma virus (HPV) infection could be considered a social disease, both for its high incidence, especially in younger subjects, and for the risk of neoplastic evolution linked to viral infection. Therefore, the National Health System, in collaboration with the state, must help women to understand the oncological risk of HPV and suitable methods of prevention. We conducted an Italian monocentric survey on HPV risk information as part of cervical cancer screening. An anonymous questionnaire was administered to 200 women with high-risk positive HPV and low-grade cervical lesions during second-level cervical cancer screening at the Gynecology and Obstetrics Unit of the "San Paolo" Hospital. From this survey, the need to improve communication for patients has emerged, as currently it is not exhaustive. In response to this need, organizational changes have been implemented to centralize the moment of counseling in the second levels of screening and to improve the training of health workers in level I as well as family doctors. In addition, psychological support was also proposed to patients who requested it, as was the dissemination of material such as that produced by GISCI (Italian Cervico-Carcinoma Screening Group) and updated in May 2018, which provides 100 answers to questions on HPV in order to achieve effective and comprehensive communication. This investigation requires further development, and the expansion of this investigation to the multicenter level is already underway. Therefore, this survey will represent a cornerstone for further discussion on the topic considering the necessity of appropriate communication in the oncological context.
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Affiliation(s)
- Miriam Dellino
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
- Clinic of Obstetrics and Gynecology, "San Paolo" Hospital, 70121 Bari, Italy
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142 km 3.95, 10060 Candiolo, Italy
| | - Valentina Tomasone
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Rosanna Zaccaro
- Clinic of Obstetrics and Gynecology, "San Paolo" Hospital, 70121 Bari, Italy
| | - Katia Maggipinto
- Clinic of Obstetrics and Gynecology, "San Paolo" Hospital, 70121 Bari, Italy
| | - Maria Elena Giacomino
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Miriana De Nicolò
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Simona De Summa
- Bioinformatician-Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", 70124 Bari, Italy
| | - Gerardo Cazzato
- Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Salvatore Scacco
- Department of Basic Medical Sciences and Neurosciences, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Antonio Malvasi
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Vincenzo Pinto
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Ettore Cicinelli
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Carmine Carriero
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Giovanni Di Vagno
- Clinic of Obstetrics and Gynecology, "San Paolo" Hospital, 70121 Bari, Italy
| | - Gennaro Cormio
- Gynecologic Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, Department of Interdisciplinary Medicine (DIM), University of Bari "Aldo Moro", 70121 Bari, Italy
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Consensos em HPV Masculino da Sociedade Portuguesa de Andrologia, Medicina Sexual e Reprodução: Seguimento. Rev Int Androl 2022; 20:237-239. [DOI: 10.1016/j.androl.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 05/17/2020] [Accepted: 02/14/2021] [Indexed: 11/20/2022]
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Mulcahy Symmons S, Waller J, McBride E. Testing positive for Human Papillomavirus (HPV) at primary HPV cervical screening: A qualitative exploration of women’s information needs and preferences for communication of results. Prev Med Rep 2021; 24:101529. [PMID: 34976606 PMCID: PMC8683976 DOI: 10.1016/j.pmedr.2021.101529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/17/2021] [Accepted: 08/12/2021] [Indexed: 12/04/2022] Open
Abstract
Human Papillomavirus (HPV) primary cervical screening was implemented across England during 2019, where cervical cell samples are first tested for HPV and cytology is used to triage HPV-positive results. Around 8.5% of women who attend test HPV-positive with normal cytology (HPV+/normal). We aimed to explore women’s information needs and suggestions for improvements to result communication following an HPV+/normal result, among those with higher and lower levels of education. In‐depth interviews were conducted with 30 women aged 24–63 who had tested HPV+/normal at routine screening. Secondary qualitative data, not previously reported, were analysed using Framework Analysis to compare themes between those with education lower-than-degree-level vs. degree-level-or-higher (n = 15 in each group). Regardless of education level, women had unanswered questions about their result meaning and the HPV primary screening protocol. Expectations of cervical screening did not always match the service provided, especially regarding content of letters and mode of result delivery. Women with lower education were less clear about the meaning of normal cytology and its link to HPV; and had difficulty sourcing information after their result. Pragmatic suggestions were made for preferences in content, wording, format, and delivery of information in patient communications. Overall, our findings point to areas which can be used by policymakers and healthcare professionals to inform content and communication of results, as HPV primary screening continues to be implemented and refined worldwide. Future research should use these suggestions to develop patient materials and then test them to assess content engagement and information recall.
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Marlow L, Forster AS, McBride E, Rockliffe L, Kitchener H, Waller J. Information needs among women taking part in primary HPV screening in England: a content analysis. BMJ Open 2020; 10:e044630. [PMID: 33323451 PMCID: PMC7745520 DOI: 10.1136/bmjopen-2020-044630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/09/2020] [Accepted: 11/25/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Introducing primary human papillomavirus (HPV) testing to cervical screening programmes means changes to the results women receive. We explored additional information needs among women undergoing HPV primary screening. DESIGN Women were sent a postal questionnaire shortly after receiving their results and 6 and 12 months later. Each questionnaire asked if women had any unanswered questions about cervical screening or HPV testing. Free-text responses constituted the data. Themes were identified using content analysis. SETTING National Health Service (NHS) Cervical Screening Programme, England. PARTICIPANTS 381 women who recorded one or more free-text responses. RESULTS The most common theme represented women's emotional responses and attempts to understand their results. This theme was raised by 45% of women overall, but was as high as 59% in the HPV cleared group. General questions about the cause and epidemiology of HPV were raised by 38% of women and were more common among those testing HPV positive with normal cytology (52%). Questions about the purpose and procedure for HPV testing were most common among HPV-negative women (40%, compared with 16%-24% of the other results groups). Questions about future implications of test results were raised by 19% of women, and this theme was most common among those with persistent HPV. CONCLUSIONS Despite provision of information alongside screening invitations, women can still have unanswered questions following receipt of their results. Details about the epidemiology of HPV and why cervical screening procedures are changing should be included with screening invitations. Some results groups may benefit from additional tailored information with their results letter.
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Affiliation(s)
- Laura Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Alice S Forster
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Emily McBride
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Lauren Rockliffe
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Henry Kitchener
- Women's Cancer Centre, Institute of Cancer Sciences, University of Manchester, Manchester, Greater Manchester, UK
| | - Jo Waller
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Research Department of Behavioural Science and Health, University College London, London, UK
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Victoria SA, Racquel E K, Lucila S, Melisa P, Viswanath K, Silvina A. Knowledge and perceptions regarding triage among human papillomavirus-tested women: A qualitative study of perspectives of low-income women in Argentina. ACTA ACUST UNITED AC 2020; 16:1745506520976011. [PMID: 33264086 PMCID: PMC7716054 DOI: 10.1177/1745506520976011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Among cancer prevention studies, little is known about knowledge, attitudes, and beliefs toward triage adherence in the context of the human papillomavirus self-collection test. This formative research aims to identify knowledge, attitudes, and beliefs related to human papillomavirus and cervical cancer prevention specifically about adherence to Pap triage among women residing in a low-income province in Argentina. Methods: We conducted six focus groups, stratified by residence and age. All participants were aged 30 or older and had performed human papillomavirus self-collection. Data collection and thematic analysis were carried out using constructs from the Health Belief Model. Results: Misinformation regarding human papillomavirus and cervical cancer was common and was a source of distress. Women could not distinguish Pap screening from triage; human papillomavirus risk perception was limited but cervical cancer was perceived as a threatening disease. Women were willing to follow-up after receiving an abnormal screening result. Negative views about clinician-collected screening/triage were common, defined as painful and shameful, and comes with an economic cost (transport/time). Lack of help from family/friends was an obstacle to adhering to triage. Health issues in the family’s records and a physician’s recommendation were a cue to adhere to triage. Conclusion: Lack of knowledge or misinformation of the causes of cervical cancer, human papillomavirus, and the multi-step screening and triage process are barriers to follow-up adherence. Interventions to improve communication between women and health providers about screening results and follow-up are needed. Also, health services should be organized to respond to women’s needs and reduce access barriers to follow-up.
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Affiliation(s)
| | - Kohler Racquel E
- Cancer Health Equity, Cancer Institute of New Jersey, Rutgers-The State University of New Jersey, New Brunswick, NJ, USA
| | - Szwarc Lucila
- Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y Técnicas Buenos Aires, Buenos Aires, Argentina
| | - Paolino Melisa
- Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y Técnicas Buenos Aires, Buenos Aires, Argentina
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Arrossi Silvina
- Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y Técnicas Buenos Aires, Buenos Aires, Argentina
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McBride E, Marlow LA, Forster AS, Ridout D, Kitchener H, Patnick J, Waller J. Anxiety and distress following receipt of results from routine HPV primary testing in cervical screening: The psychological impact of primary screening (PIPS) study. Int J Cancer 2020; 146:2113-2121. [PMID: 31251820 PMCID: PMC7065242 DOI: 10.1002/ijc.32540] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/14/2019] [Accepted: 06/24/2019] [Indexed: 11/08/2022]
Abstract
We used a cross-sectional survey to examine short-term anxiety and distress in women receiving different results following routine human papillomavirus (HPV) primary testing at cervical screening. Participants were women aged 24-65 (n = 1,127) who had attended screening at one of five sites piloting HPV primary screening in England, including a control group with normal cytology who were not tested for HPV. Women completed a postal questionnaire ~2 weeks after receiving their screening result. Unadjusted mean anxiety scores ranged from 32.9 (standard deviation [SD] = 12.2) in HPV-negative women to 42.1 (SD = 14.9) in women who were HPV-positive with abnormal cytology. In adjusted analyses, anxiety was significantly higher in women testing HPV-positive with either normal cytology (mean difference [MD] = 3.5, CI: 0.6-6.4) or abnormal cytology (MD = 7.2, CI: 3.7-10.6), than the control group. Distress was slightly higher in women who tested HPV-positive with abnormal cytology (MD = 0.9, CI: 0.02-1.8), than the control group. We also found increased odds of very high anxiety in women who tested HPV-positive with normal or abnormal cytology compared to the control group. This pattern of results was only observed among women receiving their first HPV-positive result, not among women found to have persistent HPV at 12-month follow-up. Testing HPV-positive with normal cytology for the first time, is associated with elevated anxiety despite carrying very low immediate cervical cancer risk. However, receiving the same test result at 12-month early recall does not appear to be associated with higher anxiety, suggesting anxiety may normalise with repeated exposure and/or over time.
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Affiliation(s)
- Emily McBride
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUnited Kingdom
| | - Laura A.V. Marlow
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUnited Kingdom
| | - Alice S. Forster
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUnited Kingdom
| | - Deborah Ridout
- Population, Policy and Practice ProgrammeUCL Great Ormond Street Institute of Child HealthLondonUnited Kingdom
| | - Henry Kitchener
- Women's Cancer Centre, Institute of Cancer SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Julietta Patnick
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Jo Waller
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUnited Kingdom
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9
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Stuart A, Obiri-Yeboah D, Adu-Sarkodie Y, Hayfron-Benjamin A, Akorsu AD, Mayaud P. Knowledge and experience of a cohort of HIV-positive and HIV-negative Ghanaian women after undergoing human papillomavirus and cervical cancer screening. BMC WOMENS HEALTH 2019; 19:123. [PMID: 31647013 PMCID: PMC6813105 DOI: 10.1186/s12905-019-0818-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/23/2019] [Indexed: 01/30/2023]
Abstract
Background Cervical cancer is the most common cancer in women in Ghana, but knowledge and experience of women who have had cervical screening is under-evaluated. This study examined knowledge and understanding of HPV and cervical cancer and evaluated experiences of screening in a cohort of women of mixed HIV status. Methods This was a mixed methods study using questionnaires and focus group discussions, with a knowledge score constructed from the questionnaire. HIV-positive and HIV-negative women were recruited from a larger cervical screening study in Ghana and were interviewed 6 months after receiving screening. Quantitative data was analyzed and triangulated with qualitative data following thematic analysis using the framework approach. Results A total of 131 women were included (HIV-positive, n = 60). Over 80% of participants had a knowledge score deemed adequate. There was no difference between HIV-status groups in overall knowledge scores (p = 0.1), but variation was seen in individual knowledge items. HIV-positive women were more likely to correctly identify HPV as being sexually-transmitted (p = 0.05), and HIV negative women to correctly identify the stages in developing cervical cancer (p = < 0.0001). HIV-positive women mostly described acquisition of HPV in stigmatising terms. The early asymptomatic phase of cervical cancer made it difficult for women to define “what” cancer was versus “what” HPV infection was. All women expressed that they found it difficult waiting for their screening results but that receiving information and counselling from health workers alleviated anxiety. Conclusions Knowledge of women who had participated in a cervical screening study was good, but specific misconceptions existed. HIV-positive women had similar levels of knowledge to HIV-negative, but different misconceptions. Women expressed generally positive views about screening, but did experience distress. A standardized education tool explaining cervical screening and relevance specifically of HPV-DNA results in Ghana should be developed, taking into consideration the different needs of HIV-positive women.
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Affiliation(s)
- Arabella Stuart
- University Hospital, Lewisham, London, UK.,Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, CoHAS, University of Cape Coast, Private Mail Bag, Cape Coast, Ghana.
| | - Yaw Adu-Sarkodie
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anna Hayfron-Benjamin
- Department of Maternal and Child Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Angela D Akorsu
- Institute of Development Studies, University of Cape Coast, Cape Coast, Ghana
| | - Philippe Mayaud
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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10
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Dodd RH, Forster AS, Marlow LAV, Waller J. Psychosocial impact of human papillomavirus-related head and neck cancer on patients and their partners: A qualitative interview study. Eur J Cancer Care (Engl) 2019; 28:e12999. [PMID: 30677190 PMCID: PMC6559265 DOI: 10.1111/ecc.12999] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/18/2018] [Accepted: 12/22/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Increasing numbers of patients face the psychosocial challenge of a diagnosis of oropharyngeal squamous cell carcinoma (OSCC) caused by human papillomavirus (HPV). We explored the psychosocial impact of an HPV-OSCC diagnosis for patients and their partners. METHODS In-depth interviews were conducted with patients (n = 20) and a subset of their partners (n = 12), identified through medical records at two UK hospitals. Interviews were recorded, transcribed verbatim and analysed using thematic Framework Analysis. RESULTS Only 12/20 patients interviewed (and five partners) were aware of their HPV status and the main analysis focused on this sub-sample. In discussing the cause of their cancer, patients and their partners talked about not wanting to know; whether they disclosed the cause of their cancer to others; their reactions to being diagnosed with HPV; the prognosis information they were given and the questions they had about HPV. Most concerns were cancer-related rather than HPV-related, but some patients (n = 3) described feelings of embarrassment and perceived stigma about HPV. CONCLUSION Some patients and partners who are told HPV is the cause of their OSCC have questions about HPV and seek further information. Concerns and uncertainties about the sexually transmitted nature of HPV need to be addressed by health professionals.
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Affiliation(s)
- Rachael H. Dodd
- The University of Sydney, Faculty of Medicine and HealthSchool of Public HealthSydneyNew South WalesAustralia
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Alice S. Forster
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Laura A. V. Marlow
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Jo Waller
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
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11
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Tatar O, Thompson E, Naz A, Perez S, Shapiro GK, Wade K, Zimet G, Gilca V, Janda M, Kahn J, Daley E, Rosberger Z. Factors associated with human papillomavirus (HPV) test acceptability in primary screening for cervical cancer: A mixed methods research synthesis. Prev Med 2018; 116:40-50. [PMID: 30172799 DOI: 10.1016/j.ypmed.2018.08.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/27/2018] [Accepted: 08/27/2018] [Indexed: 01/14/2023]
Abstract
Primary screening for cervical cancer is transitioning from the longstanding Pap smear towards implementation of an HPV-DNA test, which is more sensitive than Pap cytology in detecting high-risk lesions and offers greater protection against invasive cervical carcinomas. Based on these results, many countries are recommending and implementing HPV testing-based screening programs. Understanding what factors (e.g., knowledge, attitudes) will impact on HPV test acceptability by women is crucial for ensuring adequate public health practices to optimize cervical screening uptake. We used mixed methods research synthesis to provide a categorization of the relevant factors related to HPV primary screening for cervical cancer and describe their influence on women's acceptability of HPV testing. We searched Medline, Embase, PsycINFO, CINAHL, Global Health and Web of Science for journal articles between January 1, 1980 and October 31, 2017 and retained 22 empirical articles. Our results show that while most factors associated with HPV test acceptability are included in the Health Belief Model and/or Theory of Planned Behavior (e.g., attitudes, knowledge), other important factors are not encompassed by these theoretical frameworks (e.g., health behaviors, negative emotional reactions related to HPV testing). The direction of influence of psychosocial factors on HPV test acceptability was synthesized based on 14 quantitative studies as: facilitators (e.g., high perceived HPV test benefits), barriers (e.g., negative attitudes towards increased screening intervals), contradictory evidence (e.g., sexual history) and no impact (e.g., high perceived severity of HPV infection). Further population-based studies are needed to confirm the impact of these factors on HPV-based screening acceptability.
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Affiliation(s)
- Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Erika Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie, Blvd., EAD 709M, Fort Worth, TX 76107-2699, USA.
| | - Anila Naz
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Samara Perez
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
| | - Gilla K Shapiro
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
| | - Kristina Wade
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Gregory Zimet
- Indiana University School of Medicine, Section of Adolescent Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, USA.
| | - Vladimir Gilca
- Institut National de Santé Publique du Québec, 945 Wolfe Avenue, Québec, Quebec G1V 5B3, Canada.
| | - Monika Janda
- Queensland University of Technology, Faculty of Health, Brisbane, Australia.
| | - Jessica Kahn
- University of Cincinnati (Ohio), Division of Adolescent and Transition Medicine, MLC 4000, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
| | - Ellen Daley
- University of South Florida, Department of Community and Family Health, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL 33612, USA.
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
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12
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Effects of Human Papillomavirus Awareness and Knowledge on Psychological State of Women Referred to Cervical Cancer Screening. J Low Genit Tract Dis 2018; 22:178-183. [PMID: 29672447 DOI: 10.1097/lgt.0000000000000397] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of the study was to assess the impact of human papillomavirus (HPV) awareness and knowledge on physiological state and quality of life of women referred to colposcopy and/or HPV testing. MATERIALS AND METHODS A cross-sectional study was carried out at University Hospital, Belgrade, Serbia. The women with abnormal Pap test results obtained at the primary care centers requiring colposcopy and/or HPV testing were included. Before gynecological examination, participants filled the questionnaire on demographic characteristics, gynecological history, questionnaire for the evaluation of HPV awareness and HPV knowledge level, a set of self-report questionnaires assessing the anxiety level, quality of life, and concern about the smear and colposcopy results and perceived risk of developing cervical cancer. RESULTS Of 324 women, 196 (60.5%) were aware of HPV. They reported higher concern about test results (p < .001), perceived risk of developing cervical cancer (p < .001), and had significantly lower quality of life (p = .004) than women who did not hear anything about this virus. On contrary, better knowledge correlated with younger age (p < .001) and better quality of life (p < .0001) and was associated with lower anxiety, lower concern about smear test results, and lower perceived risk of developing cancer. CONCLUSIONS Human papillomavirus awareness and knowledge have different impact on psychological state and quality of life. Being aware of HPV is not enough for reducing the stress and anxiety and increasing the coverage of screening. Therefore, it is necessary to increase women's knowledge through more detailed information about HPV in different public health messages and education programs.
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13
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O'Connor M, O'Leary E, Waller J, Gallagher P, Martin CM, O'Leary JJ, Sharp L. Socio-economic variations in anticipated adverse reactions to testing HPV positive: Implications for the introduction of primary HPV-based cervical screening. Prev Med 2018; 115:90-96. [PMID: 30144488 DOI: 10.1016/j.ypmed.2018.08.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/07/2018] [Accepted: 08/21/2018] [Indexed: 11/18/2022]
Abstract
Some cervical cancer screening programmes are replacing cytology with human papillomavirus (HPV) DNA testing as the primary screening test. Concerns have been previously raised around the potential psychosocial impact of testing positive for HPV. We analysed socio-economic variations in anticipated adverse reactions to testing positive for HPV in women of screening age in the general population. A questionnaire was mailed to a random sample of 5553 women aged 20-64 in 2010, selected through primary care in Ireland. This included questions on: socio-economics; HPV knowledge; and women's anticipated adverse psychosocial responses to testing HPV positive (shame, anxiety, stigma and worry). Multivariable linear regression was used to identify socio-economic factors significantly associated with each anticipated adverse reaction. The response rate was 62% (n = 3470). In multivariate analyses, having only attained primary level education were significantly associated with higher mean scores for all four adverse outcomes. Religion was significantly associated with all four adverse outcomes. Age was associated with anxiety and worry; younger women (<30 years) had the highest mean scores. Being married/cohabiting was significantly associated with significantly lower shame and worry scores. Not working was significantly associated with higher mean anxiety and worry scores. Our large population-based survey found significant socio-economic variations in anticipated adverse reactions to testing HPV positive. In order to minimise possible negative impacts on screening uptake and alleviate potential adverse psychological effects of HPV-based screening on women, screening programmes may need to develop specific messages around HPV infection and HPV screening that target certain subgroups of women.
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Affiliation(s)
| | - Eamonn O'Leary
- National Cancer Registry Ireland, Kinsale Road, Cork, Ireland
| | - Jo Waller
- Department of Behavioural Science and Health, University College London, London, UK
| | - Pamela Gallagher
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Cara M Martin
- Department of Histopathology, University of Dublin, Trinity College, Ireland; Department of Pathology, Coombe Women and Infants University Hospital, Ireland, Ireland
| | - John J O'Leary
- Department of Histopathology, University of Dublin, Trinity College, Ireland; Department of Pathology, Coombe Women and Infants University Hospital, Ireland, Ireland
| | - Linda Sharp
- Institute of Health & Society, Newcastle University, UK
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14
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Allen-Leigh B, Uribe-Zúñiga P, León-Maldonado L, Brown BJ, Lörincz A, Salmeron J, Lazcano-Ponce E. Barriers to HPV self-sampling and cytology among low-income indigenous women in rural areas of a middle-income setting: a qualitative study. BMC Cancer 2017; 17:734. [PMID: 29121873 PMCID: PMC5679364 DOI: 10.1186/s12885-017-3723-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 10/30/2017] [Indexed: 11/10/2022] Open
Abstract
Background Data is needed about barriers to self-collection of Human Papillomavirus (HPV) samples and cytology among low-income, disadvantaged women living in rural areas of lower-income countries as these women are at increased risk of cervical cancer mortality. Methods Individual interviews (n = 29), focus groups (n = 7, 5–11 participants) and discussion groups (n = 2, 18–25 participants) were organized with women from three indigenous ethnic groups residing in rural areas in Mexico, after they were provided with free, self-sampled HPV tests. These groups are low-income, underserved by healthcare and have historically been on the receiving end of racism and social exclusion. Descriptive, qualitative content analysis was done, including two cycles of coding. Results Interview and focus/discussion group data indicate women had limited understanding of HPV’s role in cervical cancer etiology. They identified HPV’s existence, that cytology detects cervical cancer, the need for regular testing and that cervical cancer is sexually transmitted. Organizational barriers to clinic-based cytology included irregular supplies of disposable speculums, distance to clinics and lack of clear communication by healthcare personnel. Women considered self-collected HPV-testing easy, less embarrassing and less painful than cytology, an opportunity for self-care and most felt they understood how to take a self-sample after a 20-min explanation. Some women feared hurting themselves when taking the self-sample or that they would take the sample incorrectly, which they worried would make the test useless. Attending HPV-testing in groups facilitated use by allowing women to discuss their doubts and fears before doing self-collection of the sample or to ask other women who were the first to do the self-sampling what the experience had been like (whether it hurt and how easy it was). Lack of indoor bathrooms was a barrier to doing HPV self-sampling at home, when those homes were resource-poor (one-room dwellings). Conclusions Low-income, indigenous Mexican women residing in rural, underserved areas identified their need for cervical cancer screening but encountered multiple barriers to cytology-based screening. They found a number of advantages of HPV self-sampled tests. Employing self-collected HPV-testing instead of cytology could resolve some but not all gender-related, organizational or technical quality-of-care issues within cervical cancer detection and control programs. Electronic supplementary material The online version of this article (10.1186/s12885-017-3723-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Betania Allen-Leigh
- Public Health Methods Department, Reproductive Health Division, Center for Population Health Research, National Institute of Public Health, Mexico City, Mexico
| | - Patricia Uribe-Zúñiga
- National Center for the Prevention and Control of HIV and AIDS (CENSIDA), Mexico City, Mexico
| | - Leith León-Maldonado
- CONACYT, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Brandon J Brown
- Center for Healthy Communities, Department of Social Medicine and Population Health, UCR School of Medicine, UC Irvine, Riverside, California, USA
| | - Attila Lörincz
- Center for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Jorge Salmeron
- Center for Population Health Research, National Institute of Public Health, Av. Universidad #655, Colonia Sta. Ma. Ahuacatitlán, 62508, Cuernavaca, Morelos, Mexico.,Epidemiology and Health Services Research Unit, Mexican Social Security Institute (IMSS), Cuernavaca, Morelos, Mexico
| | - Eduardo Lazcano-Ponce
- Center for Population Health Research, National Institute of Public Health, Av. Universidad #655, Colonia Sta. Ma. Ahuacatitlán, 62508, Cuernavaca, Morelos, Mexico.
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Karanth SS, Lairson DR, Savas LS, Vernon SW, Fernández ME. The cost of developing a computerized tailored interactive multimedia intervention vs. a print based Photonovella intervention for HPV vaccine education. EVALUATION AND PROGRAM PLANNING 2017; 63:1-6. [PMID: 28279866 DOI: 10.1016/j.evalprogplan.2017.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/01/2017] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
Abstract
Mobile technology is opening new avenues for healthcare providers to create and implement tailored and personalized health education programs. We estimate and compare the cost of developing an i-Pad based tailored interactive multimedia intervention (TIMI) and a print based (Photonovella) intervention to increase human papillomavirus (HPV) immunization. The development costs of the interventions were calculated using a societal perspective. Direct cost included the cost of planning the study, conducting focus groups, and developing the intervention materials by the research staff. Costs also included the amount paid to the vendors who produced the TIMI and Photonovella. Micro cost data on the staff time and materials were recorded in logs for tracking personnel time, meeting time, supplies and software purchases. The costs were adjusted for inflation and reported in 2015 USD. The total cost of developing the Photonovella was $66,468 and the cost of developing the TIMI was $135,978. The amortized annual cost for the interventions calculated at a 3% discount rate and over a 7-year period was $10,669 per year for the Photonovella and $21,825 per year for the TIMI intervention. The results would inform decision makers when planning and investing in the development of interactive multimedia health interventions.
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Affiliation(s)
- Siddharth S Karanth
- Center for Health Services Research, School of Public Health, University of Texas Health Science Center at Houston, United States
| | - David R Lairson
- Center for Health Services Research, School of Public Health, University of Texas Health Science Center at Houston, United States.
| | - Lara S Savas
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, United States
| | - Sally W Vernon
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, United States
| | - María E Fernández
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, United States
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16
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McBride E, Marlow L, Forster AS, Moss S, Myles J, Kitchener H, Patnick J, Waller J. Psychological Impact of Primary Screening (PIPS) for HPV: a protocol for a cross-sectional evaluation within the NHS cervical screening programme. BMJ Open 2016; 6:e014356. [PMID: 28011816 PMCID: PMC5223654 DOI: 10.1136/bmjopen-2016-014356] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/17/2016] [Accepted: 11/30/2016] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The NHS Cervical Screening Programme is now using human papillomavirus (HPV) testing as the primary test in six sentinel sites in England, with the intention of rolling this out across the whole of England. Previous research evaluating HPV testing in the cervical screening context suggests that an HPV-positive result may increase anxiety beyond that associated with abnormal cytology, but this has not been explored in the context of primary HPV testing. The main aim of this study is to explore the impact of the HPV primary screening programme on anxiety and distress. METHODS AND ANALYSIS A cross-sectional between-groups design (total N ∼ 673) will be employed to assess the psychological impact of different HPV and cytology results at three time points: shortly after receiving the results, and 6 and 12 months later. Women will fall into one of six groups based on their screening results. The primary outcomes will be anxiety and general distress. Secondary outcomes will include understanding of screening results, perceived risk of cervical cancer, psychosexual functioning, intention to attend future screening and knowledge of HPV. General linear modelling will be used to test for differences between groups and changes over the three time points. ETHICS AND DISSEMINATION Health Research Authority approval was received on 26 September 2016. Ethical approval was received from London- Surrey Borders NHS Research Ethics Committee on 30 August 2016. Section 251 approval was received from the Confidentiality Advisory Group on 24 August 2016. Results will be disseminated via peer-reviewed publication and presentation at national and international conferences.
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Affiliation(s)
- Emily McBride
- Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Laura Marlow
- Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Alice S Forster
- Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Sue Moss
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Jonathan Myles
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Henry Kitchener
- Women's Cancer Centre, Institute of Cancer Sciences, University of Manchester, Manchester, UK
| | | | - Jo Waller
- Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
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17
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Abstract
Objectives The main objective of this study was to review the evidence relating to the level of awareness of human papillomavirus (HPV) in the general population and the implications for the potential introduction of HPV vaccination and HPV testing as part of screening. Methods PubMed search performed on terms: ‘HPV education’, ‘HPV awareness’ ‘Genital Warts Awareness’ Results Public awareness of HPV is generally very low, particularly with respect to its relation to abnormal smears and cervical cancer although knowledge levels vary to some extent according to sociodemographic characteristics. There is also much confusion around which types cause warts and the types that can cause cancer. The sexually transmissible nature of the infection is of major concern and confusion to women. Conclusions Due to the lack of current awareness of HPV, significant education initiatives will be necessary should HPV vaccination and/or HPV testing be introduced. Organized edification of healthcare workers and the media, who constitute the two most preferred sources of information, will be crucial.
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Affiliation(s)
- K S Cuschieri
- Specialist Virology Centre, Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
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18
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León-Maldonado L, Wentzell E, Brown B, Allen-Leigh B, Torres-Ibarra L, Salmerón J, Billings DL, Thrasher JF, Lazcano-Ponce E. Perceptions and Experiences of Human Papillomavirus (HPV) Infection and Testing among Low-Income Mexican Women. PLoS One 2016; 11:e0153367. [PMID: 27149525 PMCID: PMC4858263 DOI: 10.1371/journal.pone.0153367] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 03/29/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND HPV infection causes cervical cancer, a major contributor to morbidity and mortality among low-income Mexican women. Human papillomavirus (HPV) DNA testing is now a primary screening strategy in Mexico's early cervical cancer detection program (ECDP). Research on Mexican women's perceptions of HPV and testing is necessary for establishing culturally appropriate protocols and educational materials. Here, we explore perceptions about HPV and HPV-related risk factors among low-income Mexican ECDP participants. METHODS We conducted semi-structured interviews with 24 ECDP participants from two primary care health clinics in Michoacán state, Mexico. Interviews addressed women's understandings of and experiences with HPV and HPV testing. Analysis was inductive and guided by the Health Belief Model with a focus on gender. RESULTS Women's confusion about HPV and HPV screening caused emotional distress. They understood HPV to be a serious disease that would always cause severe symptoms, often characterizing it as analogous to HIV or inevitably carcinogenic. Women also attributed it to men's sexual behaviors, specifically infidelity and poor hygiene. Women described both sexes' desire for sex as natural but understood men's negative practices of masculinity, like infidelity, as the causes of women's HPV infection. Some women believed dirty public bathrooms or heredity could also cause HPV transmission. CONCLUSIONS These results are consistent with prior findings that geographically and economically diverse populations lack clear understandings of the nature, causes, or symptoms of HPV, even among those receiving HPV testing. Our findings also reveal that local cultural discourse relating to masculinity, along with failure to provide sufficient education to low-income and indigenous-language speaking patients, exacerbate women's negative emotions surrounding HPV testing. While negative emotions did not deter women from seeking testing, they could be ameliorated with better health education and communication.
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Affiliation(s)
- Leith León-Maldonado
- CONACYT, Instituto Nacional de Cancerología, Ciudad de México, México
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Emily Wentzell
- Department of Anthropology, The University of Iowa, Iowa City, IA, United States of America
| | - Brandon Brown
- Department of Social Medicine and Population Health, School of Medicine, University of California, Riverside, CA, United States of America
| | - Betania Allen-Leigh
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Leticia Torres-Ibarra
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Jorge Salmerón
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México
| | - Deborah L. Billings
- Department of Health, Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - James F. Thrasher
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- Department of Health, Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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Yildirim JG, Arabaci Z. Innovations in HPV vaccination and roles of nurses in cervical cancer prevention. Asian Pac J Cancer Prev 2015; 15:10053-6. [PMID: 25556424 DOI: 10.7314/apjcp.2014.15.23.10053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The human papilloma virus (HPV) is the main aetiological agent for cervical cancer, one of the most frequent cancers observed in women throughout the world. There are effective programs for reducing the incidence of cervical cancer with HPV vaccination. The objective of this study was to discuss the applicability of the HPV vaccination and the role of nurses in prevention of cervical cancer. Use of bivalent and quadrivalent vaccines has been initiated against the types of HPV which are the primary cause of cancer. The quadrivalent HPV vaccination has entered into the routine vaccination schedule in many European countries for use in children and adolescents between 9-15 years of age and for women between 16-26 years of age, whereas it has been proposed that the bivalent vaccination should be given to girls between 9-18 years of age. While cervical cancer is among the cancers that can be prevented, it is essential to continue screening tests while introducing vaccination in a systematic manner for protection. On this subject, among the most important roles of nurses is to implement the screening programs by fulfilling the caregiving, training and consultancy roles for the society and especially, for high risk groups and to increase the awareness of the people.
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Affiliation(s)
- Julide Gulizar Yildirim
- Department of Community Health Nursing, Faculty of Nursing, Ege University, Izmir, Turkey E-mail :
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20
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O'Connor M, Costello L, Murphy J, Prendiville W, Martin CM, O'Leary JJ, Sharp L. Influences on human papillomavirus (HPV)-related information needs among women having HPV tests for follow-up of abnormal cervical cytology. ACTA ACUST UNITED AC 2014; 41:134-41. [PMID: 25248873 DOI: 10.1136/jfprhc-2013-100750] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Testing for human papillomavirus (HPV) infection has recently been introduced into cervical screening programmes. We investigated (1) barriers to accessing and absorbing information and (2) factors that influence information needs among women undergoing HPV tests. METHODS In-depth interviews were conducted with 27 women who had HPV tests performed in a colposcopy clinic as part of follow-up of low-grade abnormal cytology or post-treatment for cervical intraepithelial neoplasia (CIN). Interviews were transcribed verbatim, coded and analysed using Framework Analysis, to identify main themes and sub-themes. RESULTS Among these women, barriers to accessing and absorbing HPV information were: being overwhelmed with information; context of the HPV test; colposcopy clinic experience(s); women's perceptions of medical professionals' behaviours and attitudes, and information available on the Internet. Factors influencing women's HPV information needs were: concerns surrounding abnormal cytology or diagnosis of CIN; amount of information provided about HPV; awareness HPV is sexually transmitted; previous negative health care experience(s); and the HPV test in relation to other life events. The timing of delivery of HPV information was key to women absorbing or remembering the information given; it was important that information was given in stages rather than altogether. CONCLUSIONS In women undergoing HPV testing during follow-up, the amount and timing of delivery of HPV information requires careful consideration. Significant barriers exist to accessing and absorbing HPV information which, unless addressed, could have serious implications in terms of women's comprehension of HPV tests. Given the expanding use of HPV testing within cervical screening, further research on HPV-related information issues is needed.
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Affiliation(s)
- Mairead O'Connor
- Study Coordinator, National Cancer Registry Ireland, Cork, Ireland
| | - Liza Costello
- Study Researcher, National Cancer Registry Ireland, Cork, Ireland
| | - Judith Murphy
- Study Coordinator, National Cancer Registry Ireland, Cork, Ireland
| | - Walter Prendiville
- Associate Professor and Consultant in Obstetrics and Gynaecology, The Adelaide and Meath Hospital, Dublin, Ireland
| | - Cara M Martin
- Assistant Professor in Molecular Pathology and Tumour Biology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - John J O'Leary
- Professor of Pathology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Linda Sharp
- Epidemiology and Adjunct Professor, National Cancer Registry Ireland, Cork, Ireland
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Marlow LAV, Waller J. Communicating the changes to cervical cancer screening in England: the choice to have an HPV test. WOMENS HEALTH 2014; 10:221-3. [PMID: 24956287 DOI: 10.2217/whe.14.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Laura A V Marlow
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, UCL, Gower Street, London WC1E 6BT, UK
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McRae J, Martin C, O'Leary J, Sharp L. "If you can't treat HPV, why test for it?" Women's attitudes to the changing face of cervical cancer prevention: a focus group study. BMC WOMENS HEALTH 2014; 14:64. [PMID: 24885650 PMCID: PMC4135323 DOI: 10.1186/1472-6874-14-64] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 04/25/2014] [Indexed: 11/28/2022]
Abstract
Background The relationship between infection with high-risk strains of human papillomavirus (HPV) and cervical cancer is transforming prevention through HPV vaccination and HPV oncogenic testing. In Ireland, a national cervical cancer screening programme and HPV vaccination were recently launched; HPV testing is currently being integrated into the screening programme. Women’s views on the transformation of cervical cancer prevention have been relatively little investigated. Methods Using qualitative focus groups, we determined women’s knowledge, attitudes towards, and acceptability of cervical cancer screening, HPV oncogenic testing and vaccination of HPV. Fifty nine women, recruited through primary care in Ireland, participated in ten focus groups. A dynamic topic guide was developed from literature reviewed. Women were provided with standardised information about HPV infection, HPV testing. Discussion transcripts were analysed thematically. Results The primary themes that emerged regarding HPV infection were: knowledge, emotional response and societal influences; especially those of healthcare practitioners. Knowledge, logistics, and psychological impact were the primary themes relating to HPV testing. Women’s attitudes towards HPV testing changed during discussion as issues were explored, thus demonstrating the complexity of this issue; lack of existing treatment for HPV infection influenced women’s attitudes, attachment to existing cervical cancer screening also was a significant factor. Conclusions Women currently have a strong attachment to cytology and any changes towards HPV primary testing will need to be managed carefully. To ensure that future cervical cancer prevention strategies will be acceptable to women, sufficient thought will have to be given to information provision and education. We identified the importance to women of healthcare practitioners’ opinions regarding HPV. Appropriate and timely information on HPV will be crucial in order to minimise possible psychological effects women may have.
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Affiliation(s)
- Judith McRae
- National Cancer Registry, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland.
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Giorgi Rossi P, Baldacchini F, Ronco G. The Possible Effects on Socio-Economic Inequalities of Introducing HPV Testing as Primary Test in Cervical Cancer Screening Programs. Front Oncol 2014; 4:20. [PMID: 24575388 PMCID: PMC3919018 DOI: 10.3389/fonc.2014.00020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 01/24/2014] [Indexed: 11/13/2022] Open
Abstract
Background: Screening with HPV is more effective than Pap test in preventing cervical cancer. HPV as primary test will imply longer intervals and a triage test for HPV positive women. It will also permit the development of self-sampling devices. These innovations may affect population coverage, participation, and compliance to protocols, and likely in a different way for less educated, poorer, and disadvantaged women. Aim: To describe the impact on inequalities, actual or presumed, of the introduction of HPV-based screening. Methods: The putative HPV-based screening algorithm has been analyzed to identify critical points for inequalities. A systematic review of the literature has been conducted searching PubMed on HPV screening coverage, participation, and compliance. Results were summarized in a narrative synthesis. Results: Knowledge about HPV and cervical cancer was lower in women with low socio-economic status and in disadvantaged groups. A correct communication can reduce differences. Longer intervals will make it easier to achieve high-population coverage, but higher cost of the test in private providers could reduce the use of opportunistic screening by disadvantaged women. There are some evidences that inviting for HPV test instead of Pap increases participation, but there are no data on social differences. Self-sampling devices are effective in increasing participation and coverage. Some studies showed that the acceptability of self-sampling is higher in more educated women, but there is also an effect on hard-to-reach women. Communication of HPV positivity may increase anxiety and impact on sexual behaviors, the effect is stronger in low educated and disadvantaged women. Finally, many studies found indirect evidence that unvaccinated women are or will be more probably under-screened. Conclusion: The introduction of HPV test may increase population coverage, but non-compliance to protocols and interaction with opportunistic screening can increase the existing inequalities.
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Affiliation(s)
- Paolo Giorgi Rossi
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale di Reggio Emilia , Reggio Emilia , Italy
| | - Flavia Baldacchini
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale di Reggio Emilia , Reggio Emilia , Italy
| | - Guglielmo Ronco
- Unit of Cancer Epidemiology II, Center for Cancer Epidemiology and Prevention (CPO) , Turin , Italy
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Dodd RH, McCaffery KJ, Marlow LAV, Ostini R, Zimet GD, Waller J. Knowledge of human papillomavirus (HPV) testing in the USA, the UK and Australia: an international survey. Sex Transm Infect 2014; 90:201-7. [PMID: 24412997 PMCID: PMC3995259 DOI: 10.1136/sextrans-2013-051402] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective To measure knowledge and awareness of human papillomavirus (HPV) testing in the USA, the UK and Australia. Methods Participants in the USA, UK and Australia completed an anonymous web-based survey measuring awareness and knowledge of HPV (n=2409). We report analyses on a subsample of 1473 men and women in the USA (n=617), UK (n=404) and Australia (n=452) who had heard of HPV and completed questions about HPV testing. Results Overall, 50% of the sample (742/1473) had heard of HPV testing. Awareness of HPV testing was higher in the USA (62%) than in the UK (44%) and Australia (40%) (p<0.001). Among those who had heard of HPV testing, the mean knowledge score (out of 6) was 2.78 (SD: 1.49). No significant differences in knowledge score were found between the countries but, overall, women scored significantly higher than men (2.96 vs 2.52, p<0.001). Conclusions Awareness of HPV testing among people who have heard of HPV is higher in the USA than in the UK and Australia, but overall knowledge is low. This has important implications in those countries where HPV testing is being used in cervical screening. Increasing knowledge about the implications of HPV test results may help minimise any negative psychological consequences associated with HPV testing. Raising awareness in men could become increasingly important if HPV testing is introduced into the management of other cancers where HPV plays an aetiological role.
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Affiliation(s)
- Rachael H Dodd
- Department of Epidemiology & Public Health, Cancer Research UK Health Behaviour Research Centre, UCL, , London, UK
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Baxi SS, Shuman AG, Corner GW, Shuk E, Sherman EJ, Elkin EB, Hay JL, Pfister DG. Sharing a diagnosis of HPV-related head and neck cancer: the emotions, the confusion, and what patients want to know. Head Neck 2013; 35:1534-41. [PMID: 23169350 PMCID: PMC3689851 DOI: 10.1002/hed.23182] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2012] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Oropharyngeal cancers are increasingly associated with human papillomavirus (HPV). Little is known about the experience of patients receiving this diagnosis. METHODS Semistructured interviews were conducted with ten survivors of HPV-related oropharyngeal cancer. The interviews were transcribed, and recurring themes were identified. RESULTS Physicians were a trusted source of information regarding HPV. Framing the diagnosis in terms of prognosis resonated with patients. The uncertainty about transmission, latency, and communicability colored the dialogue about HPV. Despite some understanding of prevalence and transmission, patients worried about their partner's risk. Patients sought information about HPV on the Internet, but it was not easily navigable. Emotional reactions to the diagnosis remained mostly cancer-centric rather than HPV-centric. A patient-education handout was developed in response to patient questions. CONCLUSIONS Additional educational resources explaining the facts about HPV in HNSCC in a consistent way including content of highest priority to patients may improve understanding of HPV.
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Affiliation(s)
- Shrujal S. Baxi
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
| | - Andrew G. Shuman
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Public Health, Weil Medical College of Cornell University, New York, NY 10021
| | - Geoffrey W. Corner
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
| | - Elyse Shuk
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
| | - Eric J. Sherman
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Medicine, Weil Medical College of Cornell University, New York, NY 10021
| | - Elena B. Elkin
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Public Health, Weil Medical College of Cornell University, New York, NY 10021
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Psychiatry, Weil Medical College of Cornell University, New York, NY 10021
| | - David G. Pfister
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Medicine, Weil Medical College of Cornell University, New York, NY 10021
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Sharpe PA, Brandt HM, McCree DH, Owl-Myers E, Taylor B, Mullins G. Development of culturally tailored educational brochures on HPV and pap tests for American Indian women. J Transcult Nurs 2013; 24:282-90. [PMID: 23632451 DOI: 10.1177/1043659613481676] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Participatory formative research guided the creation of a culturally tailored educational brochure about human papillomavirus (HPV) at an American Indian women's clinic. METHOD A review of existing educational materials and in-depth interviews were conducted. Nine steps for creating health communications messages that were patterned after National Cancer Institute guidelines guided the brochure development process. RESULTS Of 95 women tested for HPV, 41% were positive, 32 (34%) agreed to the in-depth interview, and 9 agreed to the pretesting interview. Mean age was 41 years. Interviews revealed key themes concerning emotional reactions to abnormal Pap test results and HPV; need for basic information about HPV, Pap tests, and results; concerns about HPV stigma, sexual transmission, and communication with sexual partner; and the preferred source and format for HPV educational materials. A literature review revealed 12 areas of basic HPV content. CONCLUSIONS A participatory process successfully engaged nursing staff and patients in creating culturally appropriate brochures for clinic use. IMPLICATIONS This article provides specific steps for creating culturally tailored patient education materials.
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Affiliation(s)
- Cathy C. Bertram
- a University of Hawaii, Queen’s Medical Center , Honolulu , Hawaii
| | - Victoria P. Niederhauser
- b University of Hawaii, School of Nursing and Dental Hygiene , 2538 McCarhy Mall, Honolulu , Hawaii , 96822
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McCree DH, Daley EM, Gorbach P, Hamm RM, Sharpe PA, Brandt HM, McFarlane M, Kerndt P, McDermott RJ, Perrin KMK, Lawrence JSS. Awareness of Diagnosis and Knowledge of HPV in Women Patients. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2010.10599146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Ellen M. Daley
- b University of South Florida, College of Public Health , Tampa , FL , 33612
| | - Pamina Gorbach
- c University of California, Los Angeles School of Public Health , Los Angeles , CA , 90089
| | - Robert M. Hamm
- d University of Oklahoma, Health Sciences Center , Oklahoma City , OK , 73104
| | - Patricia A. Sharpe
- e University of South Carolina, Arnold School of Public Health , Columbia , SC , 29208
| | - Heather M. Brandt
- f University of South Carolina, Arnold School of Public Health , Columbia , SC , 29208
| | - Mary McFarlane
- g Centers for Disease Control and Prevention (CDC) , Atlanta , GA , 30333
| | - Peter Kerndt
- h Los Angeles County Health Department , Los Angeles , CA , 90012
| | - Robert J. McDermott
- i University of South Florida, College of Public Health , Tampa , FL , 33612
| | - Karen M. Kay Perrin
- j University of South Florida, College of Public Health , Tampa , FL , 33612
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Dunne EF, Friedman A, Datta SD, Markowitz LE, Workowski KA. Updates on human papillomavirus and genital warts and counseling messages from the 2010 Sexually Transmitted Diseases Treatment Guidelines. Clin Infect Dis 2012; 53 Suppl 3:S143-52. [PMID: 22080267 DOI: 10.1093/cid/cir703] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In April 2009, experts on sexually transmitted diseases (STDs) were convened to review updates on STD prevention and treatment in preparation for the revision of the Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines. At this meeting, there was a discussion of important updates on human papillomavirus (HPV), genital warts, and cervical cancer screening. METHODS Key questions were identified with assistance from an expert panel, and systematic reviews of the literature were conducted searching the English-language literature of the PubMed computerized database (US National Library of Medicine). The available evidence was reviewed, and new information was incorporated in the 2010 CDC STD Treatment Guidelines. RESULTS Two HPV vaccines are now available, the quadrivalent HPV vaccine and the bivalent HPV vaccine; either vaccine is recommended routinely for girls aged 11 or 12 years. The quadrivalent HPV vaccine may be given to boys and men aged 9-26 years. A new patient-applied treatment option for genital warts, sinecatechins 15% ointment, is available and recommended for treatment of external genital warts. This product is a mixture of active ingredients (catechins) from green tea. Finally, updated counseling guidelines and messages about HPV, genital warts, and cervical cancer are included. CONCLUSIONS This manuscript highlights updates to the 2010 CDC STD Treatment Guidelines for HPV and genital warts. Important additions to the 2010 STD Treatment Guidelines include information on prophylactic HPV vaccine recommendations, new patient-applied treatment options for genital warts, and counseling messages for patients on HPV, genital warts, cervical cancer screening, and HPV tests.
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Affiliation(s)
- Eileen F Dunne
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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White HL, Mulambia C, Sinkala M, Mwanahamuntu MH, Parham GP, Moneyham L, Grimley DM, Chamot E. 'Worse than HIV' or 'not as serious as other diseases'? Conceptualization of cervical cancer among newly screened women in Zambia. Soc Sci Med 2012; 74:1486-93. [PMID: 22459188 DOI: 10.1016/j.socscimed.2012.01.028] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 01/17/2012] [Accepted: 01/19/2012] [Indexed: 01/13/2023]
Abstract
Invasive cervical cancer is the second most common cancer among women worldwide, with approximately 85% of the disease burden occurring in developing countries. To date, there have been few systematic efforts to document African women's conceptualization of cervical cancer after participation in a visual inspection with acetic acid (VIA)-based "see and treat" cervical cancer prevention program. In this study, conducted between September, 2009-July, 2010, focus groups and in-depth interviews were conducted with 60 women who had recently undergone cervical cancer screening at a government-operated primary health care clinic in Lusaka, Zambia. Interviewers elicited participants' causal representations of cervical cancer, associated physical signs and symptoms, perceived physical and psychological effects, and social norms regarding the disease. The lay model of illness causation portrayed by participants after recent exposure to program promotion messages departed in several ways from causal models described in other parts of the world. However, causal conceptualizations included both lay and biomedical elements, suggesting a possible shift from a purely traditional causal model to one that incorporates both traditional concepts and recently promoted biomedical concepts. Most, but not all, women still equated cervical cancer with death, and perceived it to be a highly stigmatized disease in Zambia because of its anatomic location, dire natural course, connections to socially-condemned behaviors, and association with HIV/AIDS. No substantive differences of disease conceptualization existed according to HIV serostatus, though HIV positive women acknowledged that their immune status makes them more aware of their health and more likely to seek medical attention. Further attention should be dedicated to the processes by which women incorporate new knowledge into their representations of cervical cancer.
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Affiliation(s)
- Heather L White
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA
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Abstract
BACKGROUND Because high-risk HPV is highly prevalent in the general population, usually transient, and rarely causes clinical symptoms, and because diagnostic and treatment options for HPV in men are lacking, partner notification is not useful for preventing transmission or protecting the health of male partners. METHODS We conducted a nationally representative survey of clinicians in 7 specialties that perform cervical cancer screening. Providers were asked whether they recommend that women with an abnormal Pap or positive HPV test inform sex partners of the infection or refer partners to a clinician. RESULTS A large proportion of providers in all 7 specialties encourage women with either an abnormal Pap or a positive HPV test to tell their sex partners to see a clinician, ranging from 48% to 73% across specialties. Providers who perform reflex HPV testing were more likely to recommend that patients with an ASCUS Pap inform their partners of test results if an HPV test was positive than if it was negative (66%-83% vs. 29%-50%); providers who perform adjunct HPV testing were more likely to recommend that patients with a normal Pap inform their partners if an HPV test was positive than if it was negative (72%-92% vs. 30%-52%). CONCLUSIONS Most providers advise patients with cervical cancer screening tests suggestive of HPV infection to notify their sex partners and to refer them to a clinician. Guidelines are needed for providers to clarify any rationale for clinical evaluation of male partners, including that informing partners has a limited role in the control of HPV transmission or in preventing adverse health outcomes in the male partner.
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Bhatla N, Singla S, Awasthi D. Human papillomavirus deoxyribonucleic acid testing in developed countries. Best Pract Res Clin Obstet Gynaecol 2011; 26:209-20. [PMID: 22154228 DOI: 10.1016/j.bpobgyn.2011.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 11/15/2011] [Indexed: 02/07/2023]
Abstract
Cervical cancer has been largely eliminated in developed countries with the implementation of cytology-based screening programmes that depend on a call-recall system, followed by colposcopy and biopsy, treatment of precancerous lesions and follow up. With the discovery that persistent infection with high-risk human papillomavirus types is necessary for the development of cervical cancer, several tests for human papillomavirus deoxyribonucleic acid have been developed that can identify women at risk. Human papillomavirus deoxyribonucleic acid testing is more sensitive and only slightly less specific than cytology for detecting cervical intraepithelial neoplasia. It is also more reproducible, with the potential for self-sampling. Human papillomavirus genotyping, messenger RNA analysis and other biomarkers can help to further stratify this group and diminish referrals to colposcopy. Initially, human papillomavirus testing was used as an adjunct to cytology for triage of borderline cases, but evidence has shown its superiority as a screening method and in the follow up of women treated for cervical intraepithelial neoplasia.
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Affiliation(s)
- Neerja Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi 110029, India.
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Juraskova I, O'Brien M, Mullan B, Bari R, Laidsaar-Powell R, McCaffery K. HPV vaccination and the effect of information framing on intentions and behaviour: an application of the theory of planned behaviour and moral norm. Int J Behav Med 2011. [PMID: 21879340 DOI: 10.1007/s12529‐011‐9182‐5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is a common sexually transmitted infection (STI) known to cause cervical cancer and genital warts. However, making the genital warts aspect explicit may reduce HPV vaccination intention and behaviour due to perceived stigma associated with STIs. PURPOSE This study investigated the effect of differential information framing on intention to receive the HPV vaccine using the Theory of Planned Behaviour (TPB) and moral norm construct. METHOD Female university students were randomised to receive a fact sheet describing the HPV vaccine as: (1) preventing cervical cancer only (n = 81); or (2) preventing both cervical cancer and genital warts (n = 78). A 2-month follow-up investigated relationships between vaccination intention and actual behaviour. RESULTS No effect of information framing was detected on intention to receive the HPV vaccine, or vaccine uptake behaviour at 2-month follow-up. The traditional TPB components predicted 54% of the variance in vaccination intention (F (3,155) = 61.580, p < 0.001), and moral norm explained an additional 6.2%. Intention predicted a significant but relatively small proportion of variation (9.6%) in behaviour. CONCLUSION The HPV vaccine does not seem to be associated with perceptions of stigma related to genital warts, and has broad acceptance among a female university population. This study demonstrates that TPB is suited to investigate HPV vaccination, and has helped clarify the role of moral norm within the TPB.
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Affiliation(s)
- Ilona Juraskova
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED); School of Psychology, The University of Sydney, Sydney, NSW, Australia.
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Juraskova I, O’Brien M, Mullan B, Bari R, Laidsaar-Powell R, McCaffery K. HPV Vaccination and the Effect of Information Framing on Intentions and Behaviour: An Application of the Theory of Planned Behaviour and Moral Norm. Int J Behav Med 2011; 19:518-25. [DOI: 10.1007/s12529-011-9182-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Blomberg K, Tishelman C, Ternestedt BM, Törnberg S, Levál A, Widmark C. How can young women be encouraged to attend cervical cancer screening? Suggestions from face-to-face and internet focus group discussions with 30-year-old women in Stockholm, Sweden. Acta Oncol 2011; 50:112-20. [PMID: 21091087 DOI: 10.3109/0284186x.2010.528790] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND cervical cancer screening (CCS) using Pap-smears has been carried out for decades and is still an essential tool for secondary cancer prevention. Focus has traditionally been on what hinders women's attendance, instead of researching this issue from a positive standpoint, i.e. what factors encourage women to take a Pap-smear? In this article, we therefore explore issues that 30-year-old women have addressed as encouraging CCS attendance, with particular focus on aspects susceptible to intervention. MATERIAL AND METHODS through the population-based cervical cancer screening (PCCSP) registry in Stockholm, Sweden, a stratified random sampling technique was used to recruit women from the same birth cohort with varied CCS histories and results. Nine face-to-face focus groups discussions (FGDs) and 30 internet-based FGDs were conducted with a total of 138 women aged 30. Qualitative analysis was inspired by interpretative description, to generate clinically relevant and useful data. RESULTS in general, these women expressed positive views about the PCCSP as an existing service, regardless of screening history. They described a wide range of factors encompassing the entire screening trajectory from invitation through follow-up which could motivate young women to CCS participation, including social marketing. Many of the suggestions related to individualization of the PCCSP, as well as a need to understand the relationship between human papilloma virus (HPV) and cervical cancer. DISCUSSION [corrected these results are discussed in terms of the inherent tension between population-based public health initiatives and individually-oriented health care provision. Many suggestions given are already incorporated into the existing Stockholm-Gotland screening program, although this information may not reach women who need it. New research should test whether systematic information on HPV may provide a missing link in motivating young women to attend CCS, and which of their suggestions can serve to increase CCS participation.
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Affiliation(s)
- Karin Blomberg
- Department NVS, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
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Lee Mortensen G, Adeler AL. Qualitative study of women's anxiety and information needs after a diagnosis of cervical dysplasia. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2010; 18:473-482. [PMID: 21151479 PMCID: PMC2967227 DOI: 10.1007/s10389-010-0330-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Accepted: 03/18/2010] [Indexed: 10/28/2022]
Abstract
AIM: Each year almost 15,000 Danish women are diagnosed with cervical dysplasia, a precursor to cervical cancer. The period of medical follow-up, or 'watchful waiting', to monitor for regression or progression of the lesion before deciding if treatment by conisation is necessary can be long. The aim of this study was to examine the experiences of women with different stages of cervical dysplasia and to examine whether their knowledge of human papillomavirus (HPV) as the cause of cervical dysplasia influenced their perception of their disease. SUBJECT AND METHODS: We used focus group and individual interviews with 12 women diagnosed with different stages of cervical dysplasia-women who had and had not been conised. Interview guides were prepared on the basis of a literature review that identified important issues and questions for the participants. RESULTS: The participants considered cervical dysplasia to be a highly distressing condition and experienced monitoring as a worrying delay before regression of the lesions or treatment could be initiated. Women expressed a fear of cancer that was not proportional to the stage of their dysplasia, but was determined by their degree of knowledge about their condition. Unlike other sexually transmitted diseases, information about HPV did not result in stigmatisation as the perception of this disease was dominated by cancer. CONCLUSION: This study showed that it is extremely important to address women's fears, their need for information and to ensure better communication with medical practitioners about cervical dysplasia immediately after diagnosis, irrespective of the disease stage.
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Leung SS, Leung I. Cervical cancer screening: knowledge, health perception and attendance rate among Hong Kong Chinese women. Int J Womens Health 2010; 2:221-8. [PMID: 21072314 PMCID: PMC2971734 DOI: 10.2147/ijwh.s10724] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Indexed: 11/23/2022] Open
Abstract
Purpose: Cervical cancer screening has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. However, cervical screening attendance rates are still far from satisfactory in many countries. Strategies, health promotion and education programs need to be developed with clear evidence of the causes and factors relating to the low attendance rate. The study aims to assess the prediction of cervical screening attendance rate by Chinese women’s knowledge about cervical cancer and cervical screening as well as their perception of health. Patients and methods: A survey with self-reported questionnaires was conducted on 385 Chinese women recruited from a community clinic in Hong Kong. Participants were Chinese women, Hong Kong residents, aged 18–65 years, able to read Chinese or English, and were not pregnant. Results: Women aged 37 years or less, with at least tertiary education, who perceived having control over their own health and had better knowledge on risk factors, were more likely to attend cervical cancer screening. Many participants had adequate general knowledge but were unable to identify correct answers on the risk factors. Conclusion: Health promotion efforts need to focus on increasing women’s knowledge on risk factors and enhancing their perceived health control by providing more information on the link between screening and early detection with lower incidence rates and mortality from cervical cancer.
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Affiliation(s)
- Sharron Sk Leung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong
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Mortensen GL, Larsen HK. The quality of life of patients with genital warts: a qualitative study. BMC Public Health 2010; 10:113. [PMID: 20205944 PMCID: PMC2848198 DOI: 10.1186/1471-2458-10-113] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Accepted: 03/07/2010] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Genital warts, which are caused by infection with human papillomavirus (HPV), are one of the most common sexually transmitted diseases in Europe. Although genital warts are commonly perceived as a non-serious condition, treatment is often long, of varying effectiveness and the recurrence rate is high. Very few studies have been performed on the personal consequences of genital warts. The aim of this qualitative study, set in Denmark, was to examine the ways in which genital warts may affect patients' quality of life. METHODS To obtain an in-depth understanding of patients' perceptions of genital warts, we used qualitative focus-group interviews with five men and five women aged between 18 and 30 years who had genital warts. The interview guide was based on a literature review that identified important issues and questions. The data were analysed using a medical anthropological approach. RESULTS Patients' experiences were related to cultural conceptions of venereal diseases and the respective identities and sexuality of the sexes. The disease had negative psychological and social effects both for men and for women and it affected their sex and love lives, in particular. The psychological burden of the disease was increased by the uncertain timeline and the varying effectiveness of treatment. We identified a need for more patient information about the disease and its psycho-sexual aspects. CONCLUSIONS The men and women participating in this study considered their quality of life to be significantly lowered because of genital warts. The experiences described by the participants give insights that may be valuable in treatment and counselling.The quadrivalent HPV vaccine that has now been added to the childhood vaccination programme for girls in Denmark for the prevention of cervical cancer can also prevent 90% of cases of genital warts. Our results suggest that HPV vaccination could considerably reduce the largely unacknowledged psychological and social burden associated with genital warts, in men as well as women.
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Affiliation(s)
| | - Helle K Larsen
- Venereal Diseases Clinic, Bispebjerg Hospital, Bispebjerg Bakke 23, 4 Tvaervej, 1 sal, 2400 Copenhagen NV, Denmark
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McCaffery KJ, Irwig L, Turner R, Chan SF, Macaskill P, Lewicka M, Clarke J, Weisberg E, Barratt A. Psychosocial outcomes of three triage methods for the management of borderline abnormal cervical smears: an open randomised trial. BMJ 2010; 340:b4491. [PMID: 20179125 PMCID: PMC2827716 DOI: 10.1136/bmj.b4491] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess which of three triage strategies for women with borderline abnormal cervical smear results in the best psychosocial outcomes. DESIGN Pragmatic, non-blinded, multicentre, randomised controlled trial. SETTING 18 family planning clinics across Australia, covering both urban and rural areas, between January 2004 and October 2006. PARTICIPANTS Women aged 16-70 years (n=314) who attended routine cervical screening and received a borderline cervical smear. INTERVENTIONS Patients were randomly assigned to human papillomavirus (HPV) DNA testing (n=104), a repeat smear test at six months (n=106), or the patient's informed choice of either test supported by a decision aid (n=104). Psychosocial outcomes were assessed at multiple time points over 12 months by postal questionnaire. MAIN OUTCOME MEASURES We assessed health related quality of life (SF36 mental health subscale), cognitive effects (such as perceived risk of cervical cancer, intrusive thoughts), affective outcomes (general anxiety [state-trait anxiety inventory]), specific anxiety about an abnormal smear (cervical screening questionnaire), and behavioural outcomes (sexual health behaviour and visits to the doctor) over 12 months of follow-up. RESULTS At two weeks, some psychosocial outcomes were worse for women allocated to HPV testing compared with those in the smear testing group (SF36 vitality subscale: t=-1.63, df=131, P=0.10; intrusive thoughts chi(2)=8.14, df=1, P<0.01). Over 12 months, distress about the abnormal smear was lowest in women allocated to HPV testing and highest in the repeat smear testing group (t=-2.89, df=135, P<0.01). Intrusive thoughts were highest in patients allocated to HPV testing (25%, compared with 13% in the informed choice group; difference=12%, 95% CI -1.1% to 25.1%). Women in the HPV DNA group and the informed choice group were more satisfied with their care than women allocated to repeat smear testing. CONCLUSIONS Although the psychosocial effect was initially worse for women allocated to HPV triage, over the full year of follow-up this intervention was better for women's psychosocial health than repeat smear testing. Offering informed choice could have a small advantage for cognitive outcomes, but in view of the additional effort and logistical complexity that this intervention requires, HPV testing alone can be justified for most women. TRIAL REGISTRATION actr.org.au Identifier: 12605000111673.
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Affiliation(s)
- Kirsten J McCaffery
- Screening and Test Evaluation Program, School of Public Health, University of Sydney, NSW 2006, Australia.
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Rosen NO, Knäuper B, Pagé G, Di Dio P, Morrison E, Mayrand MH, Franco EL, Rosberger Z. Brief research report: uncertainty-inducing and reassuring facts about HPV: a descriptive study of French Canadian women. Health Care Women Int 2009; 30:892-902. [PMID: 19742363 DOI: 10.1080/07399330903066434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We sought to describe information that makes women feel (1) uncertain and (2) reassured about their human papillomavirus (HPV) status and the potential health implications of an HPV DNA test result and (3) to examine information seeking after receiving their result. Thirty women (previously tested HPV negative) read factual information on HPV and cervical cancer and were asked which facts were uncertainty inducing and which were reassuring. Twenty-four facts reassured women of their HPV negative status, 11 facts made women feel uncertain, and 10 facts made them feel both. The most common reason for seeking information in the future was receiving a positive test result. The authors outline what specific facts about HPV health providers can emphasize to alleviate anxiety and encourage women to feel reassured of their low cancer risk following a negative test result.
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Affiliation(s)
- Natalie O Rosen
- Department of Psychology, McGill University, Montréal, Quebec, B3A 1B1, Canada.
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Fernandez ME, McCurdy SA, Arvey SR, Tyson SK, Morales-Campos D, Flores B, Useche B, Mitchell-Bennett L, Sanderson M. HPV knowledge, attitudes, and cultural beliefs among Hispanic men and women living on the Texas-Mexico border. ETHNICITY & HEALTH 2009; 14:607-24. [PMID: 19953392 PMCID: PMC2874420 DOI: 10.1080/13557850903248621] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND US Hispanic women have higher cervical cancer incidence rates than non-Hispanic White and African-American women and lower rates of cervical cancer screening. Knowledge, attitudes, and cultural beliefs may play a role in higher rates of infection of human papillomavirus (HPV) and decisions about subsequent diagnosis and treatment of cervical cancer. STUDY AIM To explore the level of HPV knowledge, attitudes, and cultural beliefs among Hispanic men and women on the Texas-Mexico border. METHODOLOGICAL APPROACH Informed by feminist ethnography, the authors used an interpretive approach to understand local respondents' concerns and interests. Focus group sessions were analyzed using thematic content analysis. RECRUITMENT AND SAMPLE: Promotoras (lay health workers) recruited participants using convenience sampling methods. Group sessions were held in public service centers in Brownsville. Participants' ages ranged from 19 to 76 years. METHODS ANALYSIS: Focus group discussions were audio-recorded and transcribed in Spanish. Researchers read and discussed all the transcripts and generated a coding list. Transcripts were coded using ATLAS.ti 5.0. KEY FINDINGS Participants had little understanding about HPV and its role in the etiology of cervical cancer. Attitudes and concerns differed by gender. Women interpreted a diagnosis of HPV as a diagnosis of cancer and expressed fatalistic beliefs about its treatment. Men initially interpreted a diagnosis of HPV as an indication of their partners' infidelity, but after reflecting upon the ambiguity of HPV transmission, attributed their initial reaction to cultural ideals of machismo. Men ultimately were interested in helping their partners seek care in the event of a positive diagnosis. IMPLICATIONS FOR PRACTICE Results suggest that understanding Hispanics' cultural norms and values concerning disease, sexuality, and gender is essential to the design and implementation of interventions to prevent and treat HPV and cervical cancer.
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Affiliation(s)
- Maria E Fernandez
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
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Lloyd GP, Marlow LAV, Waller J, Miles A, Wardle J. An experimental investigation of the emotional and motivational impact of HPV information in adolescents. J Adolesc Health 2009; 45:532-4. [PMID: 19837362 DOI: 10.1016/j.jadohealth.2009.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 06/03/2009] [Accepted: 06/09/2009] [Indexed: 10/20/2022]
Abstract
We examined psychologic responses to information about human papillomavirus (HPV) in young women within the age range of the UK's HPV vaccination "catch-up" program (13-16 years). Respondents absorbed HPV information without becoming worried, were receptive to cervical screening and vaccination, and these attitudes were enhanced by presentation of relevant information.
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Affiliation(s)
- Gareth P Lloyd
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Bossuyt PMM, McCaffery K. Additional patient outcomes and pathways in evaluations of testing. Med Decis Making 2009; 29:E30-8. [PMID: 19726782 DOI: 10.1177/0272989x09347013] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Before medical tests are introduced into practice, they should be properly evaluated. Randomized trials and other comprehensive evaluations of tests and test strategies can best be designed based on an understanding of how tests can benefit or harm patients. Tests primarily affect patients' health by guiding clinical decision making and downstream management, such as the decision to order more tests or to start, stop, or modify treatment. In this article, the authors demonstrate that tests can have additional effects on patient outcome, which may be cognitive, emotional, social, or behavioral. They present a framework to help researchers and policy makers consider the cognitive, emotional, social, and behavioral effects of testing. These additional effects may be important themselves and may also influence the clinical outcomes of testing through different pathways. The authors provide examples from test evaluations in the literature to illustrate how these additional effects can be important in the evaluation of testing or indeed any health intervention.
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Affiliation(s)
- Patrick M M Bossuyt
- Department of Clinical Epidemiology & Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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Waller J, Marlow LAV, Wardle J. Anticipated shame and worry following an abnormal Pap test result: the impact of information about HPV. Prev Med 2009; 48:415-9. [PMID: 19059280 DOI: 10.1016/j.ypmed.2008.11.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 11/07/2008] [Accepted: 11/09/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the impact of HPV and cervical cancer information on women's anticipated feelings of worry and shame if they received an abnormal cervical screening result. MEASURES Data were obtained from a British population-based survey of 1081 women aged 25-64 years, carried out in 2006-7. Women were given 'phased' information about HPV and asked whether it would make them feel more or less worried and ashamed if they had an abnormal Pap result. RESULTS At baseline, 5.5% women anticipated shame if they had an abnormal Pap test but 88.8% anticipated worry. General and prevalence information about HPV led 4.6% and 5.8% of women to say they would feel more ashamed, while 14.2% said they would feel more ashamed following sexual transmission information. About a third of women also said they would feel more worried having read the information. These responses were more common in women with little education and from non-white ethnic groups. CONCLUSIONS HPV information could make women feel more worried about getting an abnormal Pap result, and may make some women feel more ashamed. Worryingly, this may particularly be true for women in groups with low screening uptake rates. Care needs to be taken to ensure HPV information is clear and does not raise unnecessary anxiety.
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Affiliation(s)
- Jo Waller
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London, UK.
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Bertram CC, Magnussen L. Informational needs and the experiences of women with abnormal Papanicolaou smears. ACTA ACUST UNITED AC 2008; 20:455-62. [DOI: 10.1111/j.1745-7599.2008.00341.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Giordano L, Webster P, Anthony C, Szarewski A, Davies P, Arbyn M, Segnan N, Austoker J. Improving the quality of communication in organised cervical cancer screening programmes. PATIENT EDUCATION AND COUNSELING 2008; 72:130-136. [PMID: 18538725 DOI: 10.1016/j.pec.2008.02.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Revised: 02/18/2008] [Accepted: 02/19/2008] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To provide health professionals involved in cervical cancer screening with an insight into the complex issues relating to communication about screening and to provide a framework for a more effective communication strategy. METHODS This paper has been compiled by a multidisciplinary pan-European group of health professionals and cancer advocates from several European screening programmes. European surveys on screening communication, literature reviews and group discussion were used for this purpose. RESULTS Information on cervical screening must be accessible, relevant, comprehensible, comprehensive, client-centred, phase-specific and multilevel. An effective communication strategy should consider health professionals' screening knowledge and their communication skills, consumers' health literacy skills and the communication needs of specific sub-groups in the target population. Co-operation between screening professionals, advocacy groups and journalists should be promoted. CONCLUSION To communicate effectively and appropriately is a complex task which can be influenced by a number of factors. Screening workers need better information themselves and must take into account the needs and characteristics of the target population. PRACTICE IMPLICATIONS This document should provide a useful tool to help screening professionals in designing and developing good quality and effective communication strategies.
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KITCHENER H, FLETCHER I, ROBERTS C, WHEELER P, ALMONTE M, MAGUIRE P. The psychosocial impact of human papillomavirus testing in primary cervical screeninga study within a randomized trial. Int J Gynecol Cancer 2008; 18:743-8. [DOI: 10.1111/j.1525-1438.2007.01113.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Garcia FA, Saslow D. Prophylactic Human Papillomavirus Vaccination: A Breakthrough in Primary Cervical Cancer Prevention. Obstet Gynecol Clin North Am 2007; 34:761-81, ix. [DOI: 10.1016/j.ogc.2007.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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