Assessment of factors impacting cervical cancer screening among low-income women living with HIV-AIDS.
Very little is currently known about factors impacting the prevalence of cervical cancer screening among women living with HIV-AIDS (WLHA). To better understand this issue, we surveyed low-income, medically underserved women receiving subsidized gynecologic care through an integrated HIV clinic. A self-administered questionnaire was completed by 209 women who self-identified as HIV positive. A total of 179 subjects (85.7%) reported having had a Pap test in the last three years. The majority of WLHA (95%) knew that the Pap test screens for cervical cancer. However, overall knowledge of cervical cancer risk factors, such as multiple sexual partners or sex with a man with multiple partners, was low (43% and 35%, respectively). Unscreened women were younger and more likely to be single with multiple current sexual partners. In multivariable analyses, the only factors associated with Pap testing were a woman's perception that her partner wants her to receive regular screening (aOR 4.64; 95% CI: 1.15-23.76; p = .04), number of clinic visits during the past year (aOR 1.36, 95% CI: 1.05-1.94; p = .04) and knowledge that the need for a Pap test does not depend on whether or not a woman is experiencing vaginal bleeding (aOR 6.52, 95% CI: 1.04-49.71; p = .05). We conclude that support from male partners in addition to effective contact with the health system and knowledge of cervical cancer risk factors influence Pap utilization among low-income WLHA. Future measures to improve the care for this population should increase knowledge of cervical cancer risk factors and encourage social support for cervical cancer screening among WLHA.
a Departments of Obstetrics & Gynecology , Baylor College of Medicine , Houston , TX 77030 , USA.
Abayomi N
AN
Ogunwale
a Departments of Obstetrics & Gynecology , Baylor College of Medicine , Houston , TX 77030 , USA.
Maame Aba
MA
Coleman
a Departments of Obstetrics & Gynecology , Baylor College of Medicine , Houston , TX 77030 , USA.
Haleh
H
Sangi-Haghpeykar
d Dan L. Duncan Cancer Center , Baylor College of Medicine , Houston , TX 77030 , USA.
Ivan
I
Valverde
b Departments of Pediatrics , Baylor College of Medicine , Houston , TX 77030 , USA.
Jane
J
Montealegre
d Dan L. Duncan Cancer Center , Baylor College of Medicine , Houston , TX 77030 , USA.
Maria
M
Jibaja-Weiss
a Departments of Obstetrics & Gynecology , Baylor College of Medicine , Houston , TX 77030 , USA.|c Departments of Pathology & Immunology , Baylor College of Medicine , Houston , TX 77030 , USA.|d Dan L. Duncan Cancer Center , Baylor College of Medicine , Houston , TX 77030 , USA.|e Center for Reproductive Medicine , Baylor College of Medicine , Houston , TX 77030 , USA.
Matthew L
ML
Anderson
D055088:Early Detection of Cancer; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D065006:Papanicolaou Test; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult
Cervical cancer screening; HIV; Pap test; barriers; beliefs; male partner