Barriers to Follow-Up for Abnormal Papanicolaou Smears among Female Sex Workers in Lima, Peru

Aharon, Devora; Calderón, Martha; Solari, Vicky; Alarcon, Patricia Pereira; Zunt, Joseph R.

doi:10.1371/journal.pone.0169327

Cited by 10 publications

(12 citation statements)

References 11 publications

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“…A study among FSWs in Peru reported follow-up of only 30% of women with abnormal Pap results; not being informed of abnormal test results was a barrier. 27 Likewise in our analysis, some FSWs (7/61; 10.3%) who qualified for referral were never informed. Of those informed, poor follow-up may have been related to difficulties in communication resulting from the transient nature of FSWs who may frequently migrate between cities in search of anonymity that may reduce sex work-related stigma 28 or for more desirable employment opportunities.…”

Section: Discussionmentioning

confidence: 54%

Cervical cancer screening among transactional female sex workers in the Dominican Republic

Richards

Stonbraker

Halpern³

et al. 2018

Int J STD AIDS

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Cervical cancer is the third leading cause of cancer-related death and the second most diagnosed cancer among women in developing countries. We determined the prevalence of abnormal Papanicolaou (Pap), high-risk HPV (hrHPV), and colposcopy among transactional female sex workers (FSWs) in La Romana, Dominican Republic. The results of 144 FSWs of ages 18–54 years who completed a demographic interview and Pap testing with hrHPV detection between June 2015 and April 2016 were analyzed. Women with abnormal results were referred for colposcopy. Risk factors for abnormal Pap were assessed through bivariate and multivariate analyses. Overall, 36.1% (52/144) of Paps were abnormal and 43.4% (62/143) had hrHPV. Of all women with hrHPV and/or abnormal Pap (68/144; 47.2%), 61 (89.7%) were referred and 16 (26.2) underwent colposcopy. HPV16 and/or 18/45 was detected in 33.3% (15/45) of low-grade Paps. Binge drinking, weekly (AOR 5.1, 95% CI: 1.8–14.5) or daily (AOR 4.9, 95% CI: 1.5–16.6), and age at first sexual relation (AOR 1.2, 95% CI: 1.0–1.5) were significantly associated (p < 0.05) with abnormal Pap. Although almost half of participants had abnormal Pap or hrHPV, few underwent colposcopy. Improving access to cervical cancer screening and follow-up for FSWs is imperative.

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Section: Discussionmentioning

confidence: 54%

Cervical cancer screening among transactional female sex workers in the Dominican Republic

Richards

Stonbraker

Halpern³

et al. 2018

Int J STD AIDS

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“…[ 12 ] Inadequate knowledge of HPV and cervical cancer was also identified as a barrier among FSWs. [ 15 ]…”

Section: Introductionmentioning

confidence: 99%

Pattern of Utilization of Cervical Cancer Screening Services among Female Sex Workers in Some Selected Brothels in Abuja, Nigeria

Ilesanmi

Kehinde

2018

Asia-Pacific Journal of Oncology Nursing

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Objective:The utilization of cervical cancer screening services remains low among Female Sex Workers (FSWs) in Sub-Saharan Africa, with few or no studies conducted in Nigeria. However, the prevalence of human papillomavirus in this population is reportedly high because of associated risk factors. This study examined the pattern of cervical cancer screening service utilizations among FSWs in the Abuja metropolis.Methods:This descriptive cross-sectional survey used a purposive sampling technique to select 406 respondents via a structured questionnaire including questions regarding whether they had been screened for cervical cancer, the frequency of screening and type of screening method. Data were analyzed using SPSS version 22 and presented using frequency tables and percentages.Results:The response rate among the participants was 97.6%. The mean age of the FSWs was 32 ± 5.1 years. Regarding the pattern of screening age, the mean age at the first screening was 28 ± 4.3 years. Only 81 (20%) participants had been screened annually, and visual inspection with acetic acid was most frequently used (20.9%). Respondents preferred to undergo screening in their brothels. The awareness of screening services was high (n = 290, 71.4%); however, the utilization of cervical cancer screening services remained low, as 246 (60.6%) FSWs had never been screened. The nonutilization of screening services was related to poor accessibility and a lack of awareness and interest.Conclusions:Although a high level of awareness that would be expected to influence uptake, cervical cancer screening services were rather underutilized by the study respondents. Therefore, a concerted effort is needed to ensure that FSWs understand cervical cancer and its consequences. Hopefully, this effort will improve the uptake.

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“…Other similarities in observed barriers between treated and LTFU women included lack of partner support, stigma within the community, and feelings of stress and fear; similar findings have been reported previously in other studies. [12,13,14,17]. These may be addressed by what women suggested as a potential facilitator: increased counseling on both the disease and treatment process.…”

Section: Discussionmentioning

confidence: 99%

Stigma and Lack of Social Support Contribute to Loss-To-Follow-Up in a Cervical Cancer Prevention Program in Western Kenya

Novak¹,

Kaiser²,

Park³

et al. 2020

Preprint

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Background While highly preventable, cervical cancer remains a leading contributor to the global burden of cancer among women globally, with disproportionate impacts in Sub-Saharan Africa. Human papillomavirus (HPV) testing is a cost-effective screening strategy with the potential to increase screening uptake; however, the two-visit requirement often leads to substantial loss-to-follow-up (LTFU) for treatment. Understanding modifiable factors that contribute to LTFU is essential to ensuring maximal program impact. Methods We carried out a mixed-methods study to understand factors related to LTFU following an HPV-based cervical cancer screening campaign in rural Western Kenya. We randomly selected participants among women testing HPV positive as part of an existing intervention study to complete quantitative surveys, seeking equal numbers of treated and LTFU women. A subset of women from both groups was selected for in-depth interviews (IDIs). Results Sixty-one treated and 39 LTFU women completed the quantitative survey, and 10 women from each group completed IDIs. Cost of transportation and distance to the hospital were barriers among all women, who often depended on their partners to facilitate this. Among treated women 67% (n = 41) reported that their peers knew their HPV test result, compared to 38% (n = 15) among LTFU women (p = .007). Stigma and lack of partner and peer support emerged as strong barriers among LTFU women. Women proposed peer encouragement, including men in educational sessions, bringing facilities closer, and providing transportation as facilitators to treatment access. Conclusion Lack of partner and social support emerged as key barriers to treatment uptake among LTFU women. Future interventions should explore stigma reduction, male involvement, peer support, and alternative transportation options as potential facilitators to treatment seeking.

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Barriers to Follow-Up for Abnormal Papanicolaou Smears among Female Sex Workers in Lima, Peru

Cited by 10 publications

References 11 publications

Cervical cancer screening among transactional female sex workers in the Dominican Republic

Cervical cancer screening among transactional female sex workers in the Dominican Republic

Pattern of Utilization of Cervical Cancer Screening Services among Female Sex Workers in Some Selected Brothels in Abuja, Nigeria

Stigma and Lack of Social Support Contribute to Loss-To-Follow-Up in a Cervical Cancer Prevention Program in Western Kenya

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