title: De-stigmatising human papillomavirus in the context of cervical cancer: a randomised controlled trial.
abstract: OBJECTIVE
  To identify the components of a human papillomavirus (HPV) message contributing to reducing the stigma of HPV in cervical cancer.
  
  
  METHODS
  294 ethnic Chinese women attending a community-based clinic in Hong Kong were randomly allocated to read one of three written HPV messages: Group 'lr+hrHPV': low-risk and high-risk HPVs facts, Group 'hrHPV': high-risk HPV facts only and Group 'ds+hrHPV': high-risk HPV facts and de-stigmatising components, namely being anti-stereotypical, motivational and low in complexity. Main outcome measures were high-risk HPV-related sexual stigma, knowledge, attitude towards message, and intention to be HPV-tested measured by self-administered questionnaires immediately before and after reading.
  
  
  RESULTS
  Message allocation had a significant effect on sexual stigma (F = 5.219, p = 0.006). Participants who read message ds+hrHPV showed the least stigma, and were significantly less likely to believe that high-risk HPV infection implicated promiscuity, non-monogamy or that monogamy offered complete protection against high-risk HPV. The genital HPV-focused message was more stigmatising than cervical cancer-focused messages. Of all participants, 93% (237/254) and 97% (260/269) indicated a positive intention to be HPV-tested before and after reading, respectively. There were no between-group differences noted in terms of knowledge and intention to be HPV-tested before or after reading.
  
  
  CONCLUSIONS
  Our findings show that an HPV message containing specific de-stigmatising components may reduce public stigma towards high-risk HPV. Also, focusing solely on high-risk HPV in the context of cervical cancer helps to avoid the stigmatising effect of genital warts from tainting perceptions about high-risk HPV infection.
authors.affiliation: Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China.
authors.forename: Tracy T C
authors.initials: TT
authors.lastname: Kwan
authors.forename: Kar-Fai
authors.initials: KF
authors.lastname: Tam
authors.forename: Peter W H
authors.initials: PW
authors.lastname: Lee
authors.forename: Sue S T
authors.initials: SS
authors.lastname: Lo
authors.forename: Karen K L
authors.initials: KK
authors.lastname: Chan
authors.forename: Hextan Y S
authors.initials: HY
authors.lastname: Ngan
mesh_terms: D000328:Adult; D044466:Asian People; D054626:Consumer Health Information / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006723:Hong Kong; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010353:Patient Education as Topic; D012307:Risk Factors; D013240:Stereotyping; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control* / Q000821:virology