title: Testing positive for human papillomavirus in routine cervical screening: examination of psychosocial impact.
abstract: OBJECTIVE
  To examine the psychosocial impact of testing positive for high risk human papillomavirus (HPV) among women attending primary cervical screening.
  
  
  METHODS
  Cross sectional survey. Measures were taken at baseline and one week after the receipt of HPV and cytology screening results.
  
  
  METHODS
  Well women's clinic in London, UK. Population or Sample Four hundred and twenty-eight women aged 20-64 years.
  
  
  METHODS
  Postal questionnaire survey.
  
  
  METHODS
  Psychosocial and psychosexual outcomes were anxiety, distress and feelings about current, past and future sexual relationships.
  
  
  RESULTS
  Women with normal cytology who tested positive for HPV (HPV+) were significantly more anxious and distressed than women who were negative (HPV-) using both a state anxiety measure [F(1,267) = 29, P < 0.0001] and a screening specific measure of psychological distress [F(1,267) = 69, P < 0.0001]. Women with an abnormal or unsatisfactory smear result, who tested HPV+, were significantly more distressed than HPV- women with the same smear result [F(1,267) = 8.8, P = 0.002], but there was no significant difference in state anxiety. Irrespective of cytology result, HPV+ women reported feeling significantly worse about their sexual relationships. Approximately one-third of women who tested positive reported feeling worse about past and future sexual relationships compared with less than 2% of HPV- women.
  
  
  CONCLUSIONS
  The findings suggest that testing positive for HPV may have an adverse psychosocial impact, with increased anxiety, distress and concern about sexual relationships. Psychosocial outcomes of HPV testing need further investigation and must be considered alongside clinical and economic decisions to include HPV testing in routine cervical screening.
authors.affiliation: Screening and Test Evaluation Program, School of Public Health, University of Sydney, NSW 2006, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: McCaffery
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
authors.forename: Sue
authors.initials: S
authors.lastname: Forrest
authors.forename: Louise
authors.initials: L
authors.lastname: Cadman
authors.forename: Anne
authors.initials: A
authors.lastname: Szarewski
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000517:prevention & control / Q000523:psychology*; D012725:Sexual Behavior / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control / Q000523:psychology*