Barriers to Recommended Gynecologic Care in an Urban United States HIV Clinic

Tello, Monique; Jenckes, Mollie W.; Gaver, J; Anderson, Jean; Moore, Richard D.; Chander, Geetanjali

doi:10.1089/jwh.2009.1670

Cited by 30 publications

(31 citation statements)

References 39 publications

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“…If both tests are normal, screening can be reduced to an annual schedule (Kaplan et al, 2009). Despite guidelines aimed to decrease the heavy burden of cervical cancer among HIV-infected women, Papanicolaou (Pap) screening is still underutilized by this population of women (Baranoski, Horsburgh, Cupples, Aschengrau, & Stier, 2011; Fletcher et al, 2013; Keiser et al, 2006; Logan, Khambaty, D'Souza, & Menezes, 2010; Oster, Sullivan, & Blair, 2009; Tello et al, 2010). However, a consensus is lacking on the most important barriers to cervical cancer screening utilization among HIV-infected women.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of barriers and facilitators to cervical cancer screening among low-income, HIV-infected women from an integrated HIV clinic

Fletcher

Buchberg

Schover³

et al. 2014

AIDS Care

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Significantly elevated rates of cervical cancer and low rates of Papanicolaou (Pap) smear screening have been documented among HIV-infected women. However, little is known about women’s perceptions of cervical cancer screening utilization. Hence, this study describes barriers and facilitators related to cervical cancer screening in a sample of HIV-infected women seeking care at an integrated HIV clinic in Houston, Texas. Using an inductive qualitative methodological approach, data were obtained from five focus group discussions with a total of 33, HIV-infected women. The majority of the study sample consisted of women who self-identified as Black (69.7%), and reported heterosexual contact as the mode of HIV acquisition (75.8%). Barriers to cervical cancer screening were described as pain and discomfort associated with receiving Pap smears and subsequent procedures; lack of awareness of cervical cancer as a preventable disease; limited transportation access; and systemic issues as it relates to scheduling gynecological appointments. Facilitators were described as awareness of HIV-infected women’s increased risk of cervical cancer and strong provider-patient relationships. To address disparities in cervical cancer screening among low-income HIV-infected women, programs should capitalize on the identified facilitators and alleviate modifiable barriers using multi-level strategies.

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Section: Introductionmentioning

confidence: 99%

Perceptions of barriers and facilitators to cervical cancer screening among low-income, HIV-infected women from an integrated HIV clinic

Fletcher

Buchberg

Schover³

et al. 2014

AIDS Care

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“…However, the biggest barrier to appointment attendance in this study was forgetting about the appointment; 61% of those who missed appointments reported ''forgetting'' as the reason. 1 Because forgetting plays such a large role in adherence to medical care, novel strategies are needed to address this issue. Americans are increasingly using cellular phones in their daily life, and many use these phones to send text messages.…”

mentioning

confidence: 99%

Text Messaging for Enhancement of Testing and Treatment for Tuberculosis, Human Immunodeficiency Virus, and Syphilis: A Survey of Attitudes Toward Cellular Phones and Healthcare

Person

Blain

Jiang

et al. 2011

Telemedicine and e-Health

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Objectives: The objective of this study was to assess knowledge, attitudes, and behaviors surrounding healthcare-related mobile phone use and text messaging among persons at risk for or infected with tuberculosis (TB) or the human immunodeficiency virus (HIV). Methods: An anonymous survey was conducted in three groups of subjects: (1) HIV-infected persons attending an HIV clinic; (2) persons with latent TB infection at a public health clinic; and (3) persons presenting for TB, HIV, and syphilis screening at a community screening site. Results: Three hundred fifteen (n = 315) persons responded to the survey, of whom 241 (76.5%) owned a cell phone. Cell phone owners were younger and more educated than nonowners. Transportation difficulty and forgetting appointments were cited as significant barriers by 34.2% and 39.5% of respondents, respectively. Fifty-six percent of subjects felt it would be acceptable to receive text message appointment reminders, and 33% felt that text message reminders to take medications would be acceptable. Younger age and cell phone ownership were significantly associated with acceptance of text message reminders. Black and Hispanic subjects were more likely to feel that text message reminders for appointments or medications were helpful than White subjects. Further, Black and Hispanic subjects, as well as subjects with lower educational attainment, were more receptive to healthcare-related educational text messages. Conclusions: Cell phones and text messaging were prevalent among our subjects attending HIV and TB clinics, and subjects were generally receptive to text messaging for healthcare-related communication. Interventions that explore the potential for text messaging to improve clinic attendance, medication adherence, and health knowledge should be explored.

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“…Other major HPVassociated cancers in HIV-infected individuals, including cervical cancer, suffer from poor follow-up screening rates as well. 48,49 One study of barriers to recommended cervical cancer screening in HIV-infected women found that depressive symptoms, substance use, fear of gynecologic examination and simply forgetting the appointment may be barriers to cervical cancer screening in HIV-infected women. 51 Some of those barriers may be applicable to barriers associated with poor anoscopy follow-up.…”

mentioning

confidence: 99%

Description of a Pilot Anal Pap Smear Screening Program Among Individuals Attending a Veteran's Affairs HIV Clinic

Rosa-Cunha

DeGennaro²,

Hartmann³

et al. 2011

AIDS Patient Care and STDs

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Despite the higher risk of anal cancer among HIV-infected individuals currently there are no national or international guidelines for anal dysplasia screening. We assessed acceptance and feasibility of screening for anal intraepithelial neoplasia (AIN), the rate of abnormalities, and relationship between the presence of AIN and a history of receptive anal intercourse. Eighty-two percent of HIV-patients approached during routine clinic visit agreed to participate in the study with anal Pap smear collection; 53% had abnormal cytology results and among those undergoing high-resolution anoscopy with biopsy, 55% had high-grade AIN, including 2 cases of carcinoma in situ. Anal cytology was well accepted and it was feasible to be incorporated into HIV primary care practice. Abnormal cytology was not significantly associated with history of anal intercourse ( p ¼ 0.767). The high rate of abnormal results reinforces the need for further evaluation of the role of systematic anal Pap smear screening for HIV patients.

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Barriers to Recommended Gynecologic Care in an Urban United States HIV Clinic

Cited by 30 publications

References 39 publications

Perceptions of barriers and facilitators to cervical cancer screening among low-income, HIV-infected women from an integrated HIV clinic

Perceptions of barriers and facilitators to cervical cancer screening among low-income, HIV-infected women from an integrated HIV clinic

Text Messaging for Enhancement of Testing and Treatment for Tuberculosis, Human Immunodeficiency Virus, and Syphilis: A Survey of Attitudes Toward Cellular Phones and Healthcare

Description of a Pilot Anal Pap Smear Screening Program Among Individuals Attending a Veteran's Affairs HIV Clinic

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