Pap Test Adherence, Cervical Cancer Perceptions, and HPV Knowledge Among HIV-Infected Women in a Community Health Setting

Abstract

The Health Belief Model (HBM) has been widely used as a framework to explain health behaviors in diverse populations, but little HBM research has focused on HIV-infected women and their increased risks for cervical cancer. We used Champion's Health Belief Model and Self-Efficacy scales to assess relationships between Pap test adherence and constructs of the HBM among 300 HIV-infected women. In addition, we assessed the relationship between HPV and cervical cancer knowledge and key HBM concepts. Participants reported low levels of knowledge regarding risk for cervical cancer and HPV. They perceived lower personal risk for cervical cancer. Women with higher perceived self-efficacy and lower perceived barrier scores reported better Pap test adherence. Findings indicate that HIV-infected women are not aware of the risk for cervical cancer and may not take preventive actions. Further research is needed to identify the full range of factors that impact adherence to cervical cancer screening.

Cancer disparities in people with HIV: A systematic review of screening for non‐AIDS–defining malignancies

“…10,11 These challenges are identical to those identified in the review by Lambert et al, who studied barriers to cervical cancer screening among women with HIV. 22 Thus, social determinants of health play a major role in the receipt of cancer screening among HIV-infected women and may contribute to disparities in cancer care.…”

“…Although many studies have analyzed screening for AIDS-defining malignancies (eg, cervical cancer) and historically common NADMs (eg, anal cancer), data were scarce on screening for other NADMs. [19][20][21][22][23] One significant gap in the literature was the absence of studies focused on lung cancer screening in the HIV/ AIDS population. This is concerning, because lung cancer is among the most common cancers in PWHIV, who are more likely to smoke, less likely to receive lung cancer treatment, and have higher lung cancer-specific mortality compared with the general population.…”

Cervical cancer screening among women living with HIV: a cross-sectional study using the baseline questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS)

“…32,[47][48][49] Being in a relationship and sexually inactive increased the likelihood of cervical cancer screening delays, as previously reported by others. 50,51 Explanations about HPV-related cancers need to specify that the risk remains even if a woman is no longer sexually active, because decades can pass between an initial HPV infection and the development of cervical cancer. The effect direction of ethnicity differs widely in the literature, but the impact of lower CD4 counts on cervical cancer screening adherence was previously reported by others.…”

Percepção De Mulheres Sobre O Teste De Papanicolaou

“…Apesar do desconforto relatado, ficou evi- Desta forma, evidencia que grande parcela da população desconhece a verdadeira finalidade do exame e que muitas mulheres o percebem com a finalidade de apenas diagnosticar doenças sexualmente transmissíveis (9,15) . Estudos (23)(24) mostram que a boa percepção de risco para o câncer de colo de útero está diretamente relacionada com a percepção dos benefícios do teste Papanicolaou em relação à prevenção. Independente desta questão, o momento do exame pode ser primordial para a avaliação de risco e prevenção, particularmente em mulheres com baixa condição econômica, em início de vida sexual precoce e dificuldade para acesso ao serviço de saúde (25) .…”