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

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.