Knowledge and experience of a cohort of HIV-positive and HIV-negative Ghanaian women after undergoing human papillomavirus and cervical cancer screening

Abstract

BackgroundCervical 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.MethodsThis 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.ResultsA 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.ConclusionsKnowledge 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.

Correlates of cervical cancer screening participation, intention and self-efficacy among Muslim women in southern Ghana

“…For instance, more than two-thirds of the participants incorrectly indicated that cervical cancer affects the face and specified that it cannot be prevented. Studies conducted in Africa and the United Arab Emirates have reported similar findings [ 17 – 19 ]. Our study further found knowledge about cervical cancer to be associated with increased odds of engaging in CCS.…”

“…The authors found spousal approval, religious and cultural commitment and the gender of the healthcare provider to be important barriers to seeking CCS [ 36 ]. Given the peculiar issues confronting Muslim women regarding CCS, self-collection of samples for HPV screening can play an important role to improve the acceptability of screening and uptake [ 19 ]. For instance, in Liberia, Muslim women showed their preference for self-sampling over the conventional provider collection [ 17 ].…”

<p>A Novel Strategy for Cervical Cancer Prevention Using Cervical-Vaginal Self-Collected Samples Shows High Acceptability in Women Living in Low-Income Conditions from Bucaramanga, Colombia</p>

“…In this study, 76.3% of women said that the collection was easy, and 77.9% reported that the procedure was very comfortable. 23 Similarly, in New York a survey was conducted among 172 Hispanic women after they underwent gynecological examination and self-collection sampling at the same time; 69% reported ease of use, 62% felt less pain, 56% agreed they could do it alone, and 52% liked the privacy. These showed that self-collected sampling can remove many barriers in different cultures and populations.…”

Women’s experiences in a community-based screen-and-treat cervical cancer prevention program in rural Malawi: a qualitative study

“…We used 7 domains of inquiry to guide semi-structured interviews: 1) baseline knowledge of cervical cancer; 2) perception of cervical cancer screening; 3) screen-andtreat experience; 4) acceptability of the pilot screening program; 5) follow-up challenges; 6) community and partner support; 7) attitudes towards self-sampling for HPV testing as alternative screening method. Domains of inquiry were developed based on existing literature exploring barriers to cervical cancer screening in SSA [13,14,[20][21][22][23] and assessment of screening programs in in LMIC [24][25][26][27][28]. The interviews were conducted in the local language, Chichewa, by study staff experienced in qualitative data collection methods (MT).…”