title: Perceptions of barriers and facilitators to cervical cancer screening among low-income, HIV-infected women from an integrated HIV clinic.
abstract: Significantly elevated rates of cervical cancer and low rates of Papanicolaou (Pap) smear screening have been documented among HIV-infected women. However, little is known about women's perceptions of cervical cancer screening utilization. Hence, this study describes barriers and facilitators related to cervical cancer screening in a sample of HIV-infected women seeking care at an integrated HIV clinic in Houston, Texas. Using an inductive qualitative methodological approach, data were obtained from five focus group discussions with a total of 33, HIV-infected women. The majority of the study sample consisted of women who self-identified as Black (69.7%), and reported heterosexual contact as the mode of HIV acquisition (75.8%). Barriers to cervical cancer screening were described as pain and discomfort associated with receiving Pap smears and subsequent procedures; lack of awareness of cervical cancer as a preventable disease; limited transportation access; and systemic issues as it relates to scheduling gynecological appointments. Facilitators were described as awareness of HIV-infected women's increased risk of cervical cancer and strong provider-patient relationships. To address disparities in cervical cancer screening among low-income HIV-infected women, programs should capitalize on the identified facilitators and alleviate modifiable barriers using multilevel strategies.
authors.affiliation: a Division of Community Health Sciences , University of Illinois at Chicago School of Public Health , Chicago , IL , USA.
authors.forename: Faith E
authors.initials: FE
authors.lastname: Fletcher
authors.forename: Meredith
authors.initials: M
authors.lastname: Buchberg
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Schover
authors.forename: Karen
authors.initials: K
authors.lastname: Basen-Engquist
authors.forename: Mirjam-Colette
authors.initials: MC
authors.lastname: Kempf
authors.forename: Roberto C
authors.initials: RC
authors.lastname: Arduino
authors.forename: Damon J
authors.initials: DJ
authors.lastname: Vidrine
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D001071:Appointments and Schedules; D055088:Early Detection of Cancer; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000208:ethnology / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006763:Hospitals, Chronic Disease; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology; D065006:Papanicolaou Test / Q000009:adverse effects* / Q000523:psychology; D011203:Poverty; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013781:Texas; D014186:Transportation; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D014626:Vaginal Smears / Q000009:adverse effects* / Q000523:psychology; D044465:White People / Q000706:statistics & numerical data
keywords: HIV-infected women; Pap smear screening; barriers; cervical cancer screening; facilitators