title: Changes in knowledge of cervical cancer prevention and human papillomavirus among women with human immunodeficiency virus.
abstract: OBJECTIVE
  To estimate changes in high-risk women's knowledge of cervical cancer prevention, human papillomavirus (HPV), and HPV vaccination since introduction and marketing of HPV vaccines.
  
  
  METHODS
  At study visits in 2007 and 2008-2009, women with the human immunodeficiency virus (HIV) and at-risk comparison women in a multicenter U.S. cohort study completed 44-item self-report questionnaires exploring their knowledge of cervical cancer prevention, HPV, and HPV vaccination. Results from 2007 were compared with those obtained in 2008-2009. Knowledge scores were correlated with demographic variables, measures of education and attention, and medical factors. Significant associations were assessed in multivariable models.
  
  
  RESULTS
  HIV-seropositive women had higher knowledge scores than seronegative women at baseline (13.2 ± 5.7 compared with 11.8 ± 6.0, P < .001) and follow-up (14.1 ± 5.3 compared with 13.2 ± 5.5, P = .01), but the change in scores was similar (0.9 ± 5.3 compared with 1.5 ± 5.5, P = .13). Knowledge that cervical cancer is caused by a virus rose significantly (P = .005), but only to 24%. Belief that cervical cancer is preventable only rose from 52% to 55% (P = .04), but more than 90% of women in both periods believed regular Pap testing was important. In analysis of covariance models, higher baseline score, younger age, higher education level, higher income, and former- as opposed to never-drug users, but not HIV status, were associated with improved knowledge.
  
  
  CONCLUSIONS
  High-risk women's understanding of cervical cancer and HPV has improved, but gaps remain. Improvement has been weakest for less educated and lower-income women.
  
  
  METHODS
  II.
authors.affiliation: From the Washington University School of Medicine, St. Louis, Missouri; the Department of Veterans Affairs Hines VA Medical Center and Northwestern University Feinberg School of Medicine, Chicago, Illinois; the CORE Center at John H. Stroger Jr Hospital of Cook County, Chicago, Illinois; the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; the University of California, San Francisco, California; Montefiore Medical Center, Bronx, New York; Georgetown University School of Medicine, Washington, DC; Albert Einstein College of Medicine, Bronx, New York; the Eunice Kennedy Shriver National Institute for Child Health and Human Development, Bethesda, Maryland; and the State University of New York, Downstate Medical Center, Brooklyn, New York.
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Weber
authors.forename: Johanna L
authors.initials: JL
authors.lastname: Goderre
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hessol
authors.forename: Donna
authors.initials: D
authors.lastname: Henry
authors.forename: Christine
authors.initials: C
authors.lastname: Colie
authors.forename: Howard D
authors.initials: HD
authors.lastname: Strickler
authors.forename: D Heather
authors.initials: DH
authors.lastname: Watts
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Wilson
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D030361:Papillomavirus Infections / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control* / Q000821:virology