Developing a framework to describe stigma related to cervical cancer and HPV in western Kenya.
Developing a framework to describe stigma related to cervical cancer and HPV in western Kenya.
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DOI：
10.1186/s12905-022-01619-y
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发表时间：
2022-02-11
期刊：
影响因子：
--
通讯作者：
Huchko M
中科院分区：
文献类型：
--
作者：
Ginjupalli R;Mundaden R;Choi Y;Herfel E;Oketch SY;Watt MH;Makhulo B;Bukusi EA;Huchko M
尽管人乳头瘤病毒(HPV)和宫颈癌在低收入和中等收入国家高流行，但耻辱仍然是一个问题。解决HPV和宫颈癌的耻辱可以显著改善这些疾病的健康结果。本研究的目的是确定耻辱的表现及其对求医行为的潜在影响。2019年，在肯尼亚基苏木，对艾滋病毒携带者妇女、艾滋病毒阴性妇女、社区卫生志愿者和卫生保健提供者进行了26次深度访谈。访谈的目的是了解社区内与污名有关的现有态度或经历。我们对访谈进行了主题分析，以确定内化的、预期的和歧视性的态度。在内化的态度中，一个突出的观察到的主题是对死亡的恐惧与HPV阳性检测有关。这源于对HPV和宫颈癌之间的差异缺乏了解，并对决定寻求筛查或继续治疗的妇女构成了重大障碍。社区成员的歧视性态度，包括对滥交、不忠或艾滋病毒状况的假设，被认为阻碍了妇女获得筛查和治疗机会。采访还显示，该地区对HPV的认识有限，这可能是导致缺乏对HPV或宫颈癌患者的污名的原因之一。耻辱有可能通过其驱动因素导致筛查和治疗吸收减少。这包括由于缺乏知识而降低了对个人风险的感知，这导致了HPV风险行为的增加。未来的研究必须侧重于创建和整合减少耻辱的干预措施，主要是为了鼓励妇女寻找主要和次要的预防措施。网上版载有补充材料，可在10.1186/s12905-022-01619-y查阅。
Despite a high prevalence of human papillomavirus (HPV) and cervical cancer in low and middle-income countries, stigma remains an issue. Addressing HPV and cervical cancer stigma could significantly improve health outcomes for these conditions. The objective of this study was to identify the manifestations of stigma and their potential impacts on health-seeking behavior. Twenty-six in-depth interviews were conducted with women living with HIV, HIV-negative women, community health volunteers, and health care providers in Kisumu, Kenya in 2019. The interviews were designed to draw out existing attitudes or experiences related to stigma within the community. We conducted a thematic analysis of the interviews to identify internalized, anticipated, and discriminatory attitudes. Within internalized attitudes, a prominent observed theme was a fear of death associated with a positive HPV test. This stemmed from a lack of understanding of differences between HPV and cervical cancer and posed a significant barrier for women deciding to seek screening or to continue with treatment. Discriminatory attitudes of community members, including assumptions of promiscuity, infidelity, or HIV status, were perceived to prevent women from accessing screening and treatment opportunities. The interviews also exhibited a limited awareness of HPV in this region, which may have contributed to a lack of enacted stigma towards people living with HPV or cervical cancer. Stigma has the potential to lead to decreased screening and treatment uptake through its drivers. This includes a decreased perception of personal risk due to a lack of knowledge, which results in increased HPV-risk behaviors. Future research must focus on creating and integrating stigma-reducing interventions, primarily to encourage women to seek out primary and secondary preventative measures. The online version contains supplementary material available at 10.1186/s12905-022-01619-y.
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