Online Program

286709
Cervical cancer prevention knowledge and screening behaviors among medically underserved women living with HIV


Monday, November 4, 2013

Lisa T. Wigfall, PhD, Health Services Policy and Management, University of South Carolina - Arnold School of Public Health, Columbia, SC
Heather M. Brandt, PhD, CHES, Department of Health Promotion, Education, and Behavior & Cancer Prevention and Control Program, University of South Carolina-Arnold School of Public Health, Columbia, SC
Shalanda Bynum, PhD, MPH, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD
Daniela B. Friedman, PhD, Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC
Donna L. Richter, EdD, FAAHB, Dean, Arnold School of Public Health, University of South Carolina, Columbia, SC
Saundra H. Glover, PhD, MBA, Arnold School of Public Health, University of South Carolina, Columbia, SC
James R. Hebert, ScD, Arnold School of Public Health, University of South Carolina, Columbia, SC
Background: Cervical cancer mortality rates are highest among Black females, a vulnerable group also disproportionately affected by HIV/AIDS. HIV infection exacerbates cancer-related health disparities because a weakened immune system increases cervical cancer risk. This study examined cervical cancer prevention knowledge and screening behaviors. Preferences for a future cervical cancer prevention program were also assessed.

Methods: We recruited 145 HIV-positive women (90% Black) from urban and rural Ryan White-funded clinics and community-based AIDS-service organizations located in the southeastern United States. This two-phased, explanatory design, mixed-methods study examined cervical cancer prevention knowledge and screening behaviors using an interviewer-administered online survey. Follow-up interviews and focus group discussions were conducted to clarify and expand needs assessment data from the survey.

Results: Only about half (48%) knew that HIV infection increased cervical cancer risk. Knowledge about HPV infection acquisition (28%), prevention (46%), and link to cervical cancer (48%) were also low. Only 58% reported having a Pap test within the past year. Traditional (individual/group sessions) and mHealth (text message, email, social media) delivery formats were recommended for a future cervical cancer prevention education program.

Conclusions: Cervical cancer is preventable when precancerous lesions are detected and treated early in the disease process. Health system failures along the cancer care/control continuum exacerbate cervical cancer health disparities. Cancer prevention and control efforts are needed to improve cervical health outcomes among HIV-positive women. Peer networks may be the best approach to using cost-effective mHealth tools to disseminate cancer prevention health information.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe cervical cancer knowledge and screening behaviors of HIV-positive women. Describe HIV-positive women’s needs and preferences for a cervical cancer prevention education program.

Keyword(s): Cancer Prevention, Cancer Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the co-principal investigator and project leader of two pilot studies focused on cervical cancer prevention and control among women living with HIV.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.