Cervical Cancer Prevention Knowledge and Abnormal Pap Test Experiences Among Women Living with HIV/AIDS

Abstract

Background Cervical cancer prevention knowledge deficits persist among women living with HIV/AIDS (WLHA) despite increased risk of developing cervical dysplasia/cancer. We examined associations between WLHA’s cervical cancer prevention knowledge and abnormal Pap test history. Methods We recruited 145 urban and rural WLHA from Ryan White-funded clinics and AIDS service organizations located in the southeastern United States between March 2011 and April 2012. For this analysis, women who reported a history of cervical cancer (n=3) or had a complete hysterectomy (n=14), and observations with missing data (n=22) were excluded. Stata/IC 13 was used to perform cross-tabulations and chi-squared tests. Results Our sample included 106 predominantly non-Hispanic Black (92%) WLHA. Mean age was 46.3±10.9 years. Half (50%) had ≤ high school education. One-third (37%) had low health literacy. The majority (83%) had a Pap test <1 year ago and 84% knew that WLHA should have a Pap test every year, once two tests are normal. Many (68%) have had an abnormal Pap test. Abnormal Pap test follow-up care knowledge varied. While 86% knew follow-up care could include a repeat Pap test, only 56% knew this could also include an HPV test. Significantly more women who had an abnormal Pap test knew follow-up care could include a biopsy (p=0.001). Conclusions For WLHA to make informed/shared decisions about their cervical health, they need to be knowledgeable about cervical cancer care options across the cancer control continuum. Providing WLHA with prevention knowledge beyond screening recommendations seems warranted given their increased risk of developing cervical dysplasia/neoplasia.

Levels and determinants of breast and cervical cancer screening uptake in HIV‐infected women compared with the general population in France

“…Moreover, although we found a high level of CCS within the preceding 3 years, CCS uptake among the HIV‐infected women in the preceding year was suboptimal. The proportion of HIV‐infected women who reported having undergone CCS in the preceding year was consistent with previous studies based on self‐reported data and on comparable indicators .…”

“…Previous research showed high variability in BCS (24–67% ) and CCS (25–83% ) rates among HIV‐infected women, which could have been partly attributable to over/underestimations caused by differences in the study populations (urban , low‐income , mostly African‐Americans and smokers ), in data collection (self‐reported , measured and repeated ) and in the definitions (screening during the study period and being up to date for screening measured with different cut‐offs ). Studies generally report lower or similar levels of BCS and CCS in HIV‐infected women compared with the general population.…”

Social and Structural Determinants of Cervical Health among Women Engaged in HIV Care

“…Improvements in health outcomes for WLH can only be fully realized if women access the services necessary to prolong and sustain a good quality of life. Identifying innovative communication channels and psychoeducational approaches to engage WLH who are connected to care, but not engaged in cervical cancer screening are central to impacting cervical cancer health disparities among women at highest risk for poor outcomes [30]. …”

“…Our primary outcomes of interest, all associated with cervical cancer screening engagement, were adapted from the literature and previous work of the authors [15, 29, 30]. Three items were used to assess cervical cancer screening engagement: (1) “When did you have your most recent Pap test?” (<1 year ago/≥1 year ago/Don’t Know); (2) “How many Pap tests did you have during the first year after being diagnosed HIV-positive?…”

HPV Vaccine Awareness and Knowledge Among Women Living with HIV

“…Our response rate was 86.3% (145/168). This cross-sectional study was approved by the University of South Carolina’s institutional review board and has been previously described (11–12). …”