157122 Lack of awareness of HPV test results among high-risk (HR) HPV positive and negative women may be due to age and knowledge deficits: A multi-site study in Oklahoma, Florida, and California

Sunday, November 4, 2007

Robert M. Hamm, PhD , Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Ellen Daley, PhD , Community and Family Health, University of South Florida College of Public Health, Tampa, FL
Pamina M. Gorbach, MHS, DrPH , Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA
Katy Duncan Smith, MS , Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Robert J. McDermott, PhD , Community and Family Health, University of South Florida College of Public Health, Tampa, FL
Kay Perrin , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Bita Amani, MHS , Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA
Peter R. Kerndt, MD, MPH , Sexually Transmitted Disease Program, Los Angeles County Department of Health Services, Los Angeles, CA
Objective: To examine knowledge of own HR-HPV status in women tested for HR-HPV.

Methods: Women tested for HR-HPV (270 in Oklahoma, 137 in California, and 154 in Florida) completed interviews addressing demographics, HPV knowledge, and own HR-HPV status. Multiple logistic regression predicted the accuracy of women's knowledge of own HR-HPV status.

Results: 33% of participants were white, 21% African American, 21% Native American, 12% Asian, and 11% Hispanic. 63% of participants tested positive for HR-HPV (OK: 58.5%; CA: 41.6%; FL: 89.0%; variation due to different clinics and recruitment protocols). Among HR-HPV negative participants, false positive beliefs were rare (OK: 5.4%; CA: 2.5%; FL: 11.8%). In multiple logistic regression, younger women were more likely to wrongly state they had HR-HPV (OR=0.926, p=0.045). Among HR-HPV positive participants, false negative beliefs were common (OK: 57.0%; CA: 35.1%; FL: 24.1%). Younger women (OR=0.954, p=0.007) and those with lower HPV knowledge (OR=0.863, p<0.001) were more likely not to recognize that they had HR-HPV.

Discussion: In this 2003-2006 sample from 3 states and 5 racial/ethnic groups, inaccurate understanding of actual results of HR-HPV DNA tests was seen. That the false negative beliefs were far more common than the false positive beliefs, at each site, indicates a general bias toward not recognizing one has HR-HPV. The magnitude of the bias far exceeded the differences due to age and HPV knowledge. Possible explanations include patient's denial and physician's insufficient communication with patient.

Learning Objectives:
Recognize women’s tendency not to comprehend they have a positive HR HPV test result. List the states in which this has been demonstrated.

Keywords: Cervical Cancer, STD

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

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.

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