title: Motivations and experiences of women who accessed "see and treat" cervical cancer prevention services in Zambia.
abstract: BACKGROUND
  In Zambia, a country with a generalized HIV epidemic, age-adjusted cervical cancer incidence is among the highest worldwide. In 2006, the University of Alabama at Birmingham-Center for Infectious Disease Research in Zambia and the Zambian Ministry of Health launched a visual inspection with acetic acid (VIA) -based "see and treat" cervical cancer prevention program in Lusaka. All services were integrated within existing government-operated primary health care facilities.
  
  
  OBJECTIVE
  Study aims were to (i) identify women's motivations for cervical screening, (ii) document women's experiences with screening and (iii) describe the potentially reciprocal influences between women undergoing cervical screening and their social networks.
  
  
  METHODS
  Focus group discussions (FGD) and in-depth interviews (IDI) were conducted with women who accepted screening and with care providers. Low-level content analysis was performed to identify themes evoked by participants. Between September 2009 and July 2010, 60 women and 21 care providers participated in 8 FGD and 10 IDI.
  
  
  RESULTS
  Women presented for screening with varying needs and expectations. A majority discussed their screening decisions and experiences with members of their social networks. Key reinforcing factors and obstacles to VIA screening were identified.
  
  
  CONCLUSIONS
  Interventions are needed to gain support for the screening process from influential family members and peers.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Heather L
authors.initials: HL
authors.lastname: White
authors.forename: Chishimba
authors.initials: C
authors.lastname: Mulambia
authors.forename: Moses
authors.initials: M
authors.lastname: Sinkala
authors.forename: Mulindi H
authors.initials: MH
authors.lastname: Mwanahamuntu
authors.forename: Groesbeck P
authors.initials: GP
authors.lastname: Parham
authors.forename: Sharon
authors.initials: S
authors.lastname: Kapambwe
authors.forename: Linda
authors.initials: L
authors.lastname: Moneyham
authors.forename: Mirjam C
authors.initials: MC
authors.lastname: Kempf
authors.forename: Eric
authors.initials: E
authors.lastname: Chamot
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D005260:Female; D006078:Government Programs / Q000379:methods / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration; D012944:Social Support; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology; D016387:Women's Health; D015024:Zambia