Patient-provider communication with HIV-positive women about abnormal Pap test results

Abstract

In this article, the authors examine communication between women living with human immunodeficiency virus (WLH) and health care providers (HCPs) regarding abnormal Pap tests. During the period of March 2011 through April 2012, 145 WLH were recruited from Ryan White funded clinics and community-based AIDS service organizations located in the southeastern United States. WLH who had an abnormal Pap test (69%, n = 100/145) were asked if their HCP shared and explained information about abnormal Pap tests. The authors performed chi-square tests and multivariable logistic regression analyses using Stata I/C 13. HCPs shared information about abnormal Pap tests with 60% of participants, and explained the information they shared to 78% of those. Health literate participants were more than three times as likely to have read the information received about abnormal Pap tests (adjusted odds ratio [aOR] = 3.49, 95% confidence interval [CI] 1.19–10.23), and almost five times as likely to have understood the cancer information they read (aOR = 4.70, 95% CI 1.55–14.24). Knowing other women who had had an abnormal Pap test was not significantly associated with cancer information seeking or processing after controlling for confounding factors. The present findings underscore the need to increase WLH’s health literacy as an intermediate step to improving patient–provider communication among WLH. Lay sources of cancer information for WLH warrant further study.

HPV knowledge, screening barriers and facilitators, and sources of health information among women living with HIV: perspectives from the DC community during the COVID-19 pandemic

“…Though they had been screened, they attributed this mainly to their provider’s recommendation. These findings are congruent with other studies that have found that WLH complied with their providers’ screening recommendations even when they did not understand the procedures [ 16 ]. The women’s lack of understanding of the tests (i.e., purpose, methodology, and screening guidelines) [ 11 , 16 ], however, has been cited as a barrier that would most likely impede them from maintaining the health behavior over time [ 10 ].…”

“…Knowledge of screening can positively affect screening intention and behavior [ 9 ]; yet few U.S.-based studies have explored WLH’s HPV and cervical cancer knowledge [ 10 ]. Of the four U.S.-based knowledge-focused studies (five articles) that were included in Wong and colleague’s recent scoping review, two (South Florida and Alabama-based) used qualitative methods of focus groups or individual interviews to explore knowledge and perceptions of HPV and cervical cancer screening [ 11 , 12 ], and two (Florida and Southeastern-based) used questionnaires to examine knowledge, attitudes, perceptions, and screening behaviors [ 13 – 16 ]. These studies highlight the significance of and need for increasing knowledge and awareness related to HPV [ 11 , 13 , 17 ], cervical cancer screening recommendations [ 12 , 18 ], and cervical cancer prevention [ 12 , 19 ] among WLH.…”

“…However, the generalizability of findings from these studies are limited in several respects. First, all four of the U.S.-based studies were conducted among WLH population in the South region of the U.S. [ 11 , 12 , 14 – 16 ]. In addition, the populations of interest in both of the qualitative studies were restricted to specific racial/ethnic groups and reflected WLH who were already receiving care [ 11 , 12 ].…”

HPV-Related Cancer Prevention and Control Programs at Community-Based HIV/AIDS Service Organizations: Implications for Future Engagement

“…Because ASO play an important role in improving health outcomes for their clients ( 23 ), it seems logical that engaging their staff in HPV-related cancer prevention efforts may be a viable approach to increasing HPV vaccination rates and cervical cancer screening adherence among PLWH, MSM, and other high-risk vulnerable populations. Many HIV-positive women [including those with low health literacy; ( 24 )] have abnormal Pap test histories ( 25 ) and thus ASO staff's willingness to help HIV-positive women understand their Pap test results and encourage them to follow-up with their healthcare providers could play a vital role in reducing cervical cancer disparities among HIV-positive women.…”