142nd APHA Annual Meeting and Exposition

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311380
Cervical cancer prevention knowledge and abnormal Pap test experiences among HIV-positive women

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Lisa T. Wigfall, PhD , Arnold School of Public Health, University of South Carolina, Columbia, SC
Shalanda Bynum, PhD, MPH , Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD
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
Daniela B. Friedman, MSc, PhD , Arnold School of Public Health, University of South Carolina, Columbia, SC
Sharon Bond, PhD , College of Nursing, Medical University of South Carolina, Charleston, 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
Gweneth B. Lazenby, MD, MSCR , Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston
Donna L. Richter, EdD, FAAHB , Arnold School of Public Health, University of South Carolina, Columbia
Background:  Cervical cancer prevention knowledge deficits persist among women living with HIV/AIDS (WLHA) despite increased risk for cervical dysplasia/cancer. We examined associations between WLHA’s cervical cancer prevention knowledge and abnormal Pap test history.

Methods: We recruited 145 urban and rural dwelling WLHA from Ryan-White funded clinics and AIDS service organizations located in the southeastern United States between March 2011 and April 2012. For this analysis, we excluded women who reported a history of cervical cancer (n=3) or had a complete hysterectomy (n=14). Observations with missing data (n=22) were also excluded. Stata/IC 13 was used to perform cross-tabulations and chi-squared tests.

Results: Our sample included 106 predominantly non-Hispanic African-American (92%) WLHA. Mean age was 46.3±10.9. Half (50%) had ≤ high school education. One-third (37%) had low health literacy. The majority (83%) had a Pap test <1 year ago and 84% knew that HIV-positive women should have a Pap test every year, once two tests are normal. Many (68%) have had an abnormal Pap test. Abnormal follow-up care knowledge varied. While 86% knew this could include a repeat Pap test, only 56% knew this could also include an HPV test. Significantly more women with an abnormal Pap test knew that this could include a biopsy (p=0.001) and not a blood test (p=0.048). 

Conclusions: For WLHA to make informed health decisions, they need to be knowledgeable of their treatment options across the cervical cancer care continuum. Given WLHA’s high risk for developing cervical dysplasia/cancer, providing them with prevention knowledge beyond screening recommendations seems warranted.

Learning Areas:

Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs

Learning Objectives:
Explain cervical cancer screening recommendations for HIV-positive women Describe the cancer care continuum. Identify common failures that occur along the cervical cancer care continuum. Describe cervical cancer prevention knowledge among HIV-positive women. Describe the prevalence of cervical dysplasia among HIV-positive women. Examine the relationship between cervical cancer prevention knowledge and abnormal Pap test history among HIV-positive women.

Keyword(s): Cancer and Women’s Health, Cancer Prevention and Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of research projects focused on cervical cancer prevention and control efforts aimed at vulnerable populations. My research program is focused on reducing cervical and other HPV-related cancer disparities among vulnerable populations via the development of effective health education and communication strategies. I am also interested in gaining a better understanding of the social context of interpersonal and patient-provider communication among vulnerable populations.
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.