title: Beliefs, perceptions and health-seeking behaviours in relation to cervical cancer: a qualitative study among women in Uganda following completion of an HPV vaccination campaign.
abstract: BACKGROUND
  Cervical cancer remains a leading cause of morbidity and mortality in Uganda. Despite earlier information campaigns to introduce human papilloma virus (HPV) vaccination, which also targeted cervical cancer, misinterpretation and misunderstanding of the subject remain high. Women in Uganda present with cervical cancer at an advanced stage due to poor health-seeking behaviours, with an associated high mortality rate. This project explored beliefs, attitudes, perceptions, and health-seeking behaviours in relation to cervical cancer among women in Uganda after an HPV vaccination project had been rolled out.
  
  
  METHODS
  A qualitative study design was used, with six focus group discussions (FGDs) that included 36 women, aged 25-49 years, with no previous history of cervical cancer symptoms or diagnosis. The women were interviewed in February and March 2013. The transcribed data was analysed using content analysis.
  
  
  RESULTS
  Three themes emerged: feeling unprotected and unsafe, misbelief and wondering about cervical cancer, and fear of the testing procedure. Participating women had heard of cervical cancer but preferred to wait to access cervical cancer screening until symptom debut.
  
  
  CONCLUSIONS
  There are still barriers to cervical cancer screening among women in Uganda, where there is a need for culture-specific, sensitive information and interventions to address the issues of improving the cervical cancer screening uptake among these women. Societal context needs to be taken into account when implementing community-based health education.
authors.affiliation: Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.|Gynecological, Breast and Sarcoma Cancer, Department of Oncology, Karolinska University Hospital, Solna, Sweden; hasahya@yahoo.com.
authors.forename: Olivia Topister
authors.initials: OT
authors.lastname: Hasahya
authors.affiliation: Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.|Faculty of Health Sciences, Lund University, Lund, Sweden.
authors.forename: Vanja
authors.initials: V
authors.lastname: Berggren
authors.affiliation: Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.|Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Douglas
authors.initials: D
authors.lastname: Sematimba
authors.affiliation: Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Rose Chalo
authors.initials: RC
authors.lastname: Nabirye
authors.affiliation: Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Edward
authors.initials: E
authors.lastname: Kumakech
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D014454:Uganda; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000523:psychology; D014611:Vaccination
chemical_list: D053918:Papillomavirus Vaccines
keywords: beliefs; cervical cancer screening; health belief model; health-seeking behaviours; perceptions