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What it means to receive an HPV diagnosis: Do the new screening recommendations exacerbate misunderstanding?

Jennifer L. Packing-Ebuen, MA1, Trisha E. Mueller, BS2, Holly Rayko, MA3, Ellen M. Daley, PhD, MPH2, Karen M. Perrin, PhD, MPH, RN4, Mary McFarlane, PhD5, Robert J. McDermott, PhD2, Sandra F. Naoom, MSPH(c)6, Jeffery E. Jensen, DO MS MPH MBA7, and Patricia Trow-Finney, PA3. (1) Planned Parenthood of Southwest and Central Florida, 8068 N. 56th St., Tampa, FL 33617, 813-980-3555, Jennifer.Packing-Ebuen@ppfa.org, (2) College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, (3) USF Student Health Services, 4202 East Fowler Ave., SHS 100, Tampa, FL 33620, (4) Dept. of Community and Family Health, University of South Florida, College of Public Health, 13201 Bruce B. Downs Blvd. MDC-56, Tampa, FL 33612, (5) Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-44, Atlanta, GA 30333, (6) Child and Family Studies, Louis de la Parte Florida Mental Health Institute, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 2423, Tampa, FL 33612, (7) Bay Area Women's Care, 1055 South Fort Harrison, Clearwater, FL 33756

Background: The Pap smear provides effective screening for cervical cancer, but is still underutilized by women. The use of HPV DNA testing as a supplemental screening tool has increased our ability to differentiate strains of HPV that cause genital warts and cervical cancer. This development leads to debate over use of DNA testing alone for screening, versus as an adjunctive reflex test following abnormal Pap results. Purpose: The purpose of the study was to assess the emotional impact of an HPV-related diagnosis and its possible disease sequelae, as well as patients’ HPV knowledge. Methods: Interview and written survey data were collected from women with an abnormal Pap smear and the presence of either high-risk or low-risk strains of HPV. Items examined women’s understanding of the screening role of the Pap smear, as well as their emotional reactions to an HPV diagnosis. Results: Emotional responses included fear, stigma, confusion, uncertainty about future risk of cervical cancer, and other negative reactions. Less than 5% correctly identified the Pap smear as a screening procedure for cervical cancer. Women erroneously associated the Pap smear with HIV, gonorrhea, or herpes screening, pregnancy confirmation, and birth control prescriptions. Conclusions: Whereas most women accept the Pap smear as part of normal gynecological examination procedures, regardless of how they attribute its role and purpose, its replacement by a more complex, and less familiar procedure increases the possibility of exacerbating confusion already present in many women, and thereby, negatively affecting the likelihood of their adherence to recommended screening schedules.

Learning Objectives:

Keywords: Cervical Cancer, STD

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

HPV: Clinician Practices and Women's Experiences

The 132nd Annual Meeting (November 6-10, 2004) of APHA