Developing a tool to measure cervical cancer stigma among HIV+ women in Kenya

开发一种工具来衡量肯尼亚艾滋病毒妇女中宫颈癌的耻辱感

• 批准号: 9914142
• 负责人: Megan J. Huchko
• 金额: $ 17.78万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9914142
• 关键词: AIDS education; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adopted; Affect; Anti-Retroviral Agents; Awareness; Behavior; Biological; Cancer Burden; Caring; Cervical Cancer Screening; Clinic; Data; Development; Diagnosis; Disease; Education; Enrollment; Factor Analysis; Family; Future; Gender; HIV; HIV Seronegativity; HIV Seropositivity; Health Personnel; Health Services Accessibility; Healthcare; Human Development; Human Papillomavirus; Incidence; Individual; Infrastructure; Intervention; Interview; Joints; Kenya; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measurement; Measures; Methods; Outcome; Phase; Population; Poverty; Prevention; Property; Provider; Psychometrics; Race; Research Personnel; Risk; Services; Sex Orientation; Sexually Transmitted Diseases; Shame; Social Perception; Stigmatization; Structure; Surveys; Testing; United Nations; Validation; Validity and Reliability; Woman; Women' s Health; Work; World Health Organization; base; cervical cancer prevention; early screening; experience; follow-up; health care quality; improved; infection risk; insight; instrument; intersectionality; low and middle-income countries; method development; mortality; prevent; prevention service; programs; response; risk perception; screening; service programs; sexual HIV transmission; sexual trauma; social stigma; success; theories; therapy design; tool; treatment services; uptake; willingness

Cervical cancer is an AIDS-defining malignancy, and there is clear evidence that HIV increases the risk of infection with human papillomavirus (HPV) and development of pre-cancer and cancer. Further, there is a global disparity in HIV and cervical cancer burden, with the greatest incidence and mortality for both diseases in low- and middle-income countries. The poor outcomes related to both cervical cancer and HIV are preventable with access to and uptake of quality healthcare. As HIV care has become more widely available, researchers and program planners have recognized the importance of interventions to address stigma. Negative social perceptions and stigma about HIV have led to reluctance to test or access treatment in some populations; however, little is known about the presence and potential impact of cervical cancer-related stigma, particularly among HIV-positive women. Uptake of cervical cancer screening and prevention services depends on a convergence of service availability, personal perception of risk and willingness to seek services, all of which may be significantly affected by disease-related stigma. Further, as more programs adopt HPV testing as their method of cervical cancer screening, there may be an additional layer of stigma related to diagnosis with a sexually transmitted disease. A better understanding of whether and how HIV-related stigma intersects and possibly amplifies HPV and cervical cancer stigma and willingness to seek services would guide the development of stigma reduction interventions that could improve screening and follow-up rates. To facilitate this understanding, we propose to use intersectional theory to develop and validate measures for stigma related to HPV and cervical cancer among HIV-infected women. We will carry out in-depth interviews with HIV- positive women, HIV-negative women and providers in Kisumu, Kenya to develop a framework for understanding the individual and intersectional HPV, cervical cancer and HIV-related stigmas. Using data from these interviews, we will develop context-specific measures of HPV, cervical cancer and intersectional stigmas of HPV, cervical cancer and HIV. We will then pilot and validate the instrument using rigorous survey development methods. Finally, we will administer the finalized survey among HIV-positive women enrolled in care at the Family AIDS and Education Services Program in Kisumu, Kenya to evaluate the relationship between stigma related to HPV and cervical cancer among HIV-positive women and engagement in care. Insight into the interplay between individual and intersectional stigmas and willingness to seek services will help us inform future interventions to increase the reach and impact of cervical cancer screening among HIV- positive women.

宫颈癌是一种定义艾滋病的恶性肿瘤，有明确的证据表明，艾滋病毒会增加患艾滋病的风险。 感染人乳头瘤病毒(HPV)与癌症前期和癌症的发展。此外，还有一个 艾滋病毒和宫颈癌负担的全球差异，这两种疾病的发病率和死亡率最高 在低收入和中等收入国家。与宫颈癌和艾滋病毒相关的不良结局是 可通过获得和采用高质量的医疗保健来预防。随着艾滋病毒护理变得越来越普遍， 研究人员和项目规划者已经认识到干预措施的重要性，以解决耻辱问题。 社会对艾滋病毒的负面看法和耻辱导致一些人不愿进行检测或获得治疗 然而，人们对宫颈癌相关污名的存在和潜在影响知之甚少。 特别是在艾滋病毒阳性妇女中。宫颈癌筛查和预防服务的接受情况取决于 关于服务可获得性、个人风险感知和寻求服务意愿的融合，所有 这可能会受到与疾病相关的耻辱的显著影响。此外，随着越来越多的项目采用HPV检测 作为他们的宫颈癌筛查方法，可能还有一层与诊断有关的耻辱 患有性传播疾病。更好地理解艾滋病毒相关的污名是否以及如何交叉 并可能放大HPV和宫颈癌的耻辱和寻求服务的意愿将指导 制定减少污名的干预措施，以提高筛查和随访率。为了方便 为了理解这一点，我们建议使用交叉理论来开发和验证针对污名的措施 与艾滋病毒感染妇女中的人乳头瘤病毒和宫颈癌有关。我们将对艾滋病毒进行深入采访-- 在肯尼亚基苏木，阳性妇女、艾滋病毒阴性妇女和提供者制定一个框架，以促进 了解个体和跨部门的HPV、宫颈癌和艾滋病毒相关的污名。使用来自 在这些访谈中，我们将制定针对具体情况的HPV、宫颈癌和横断面污名的测量方法 人乳头瘤病毒、宫颈癌和艾滋病毒。然后，我们将使用严格的调查来试用和验证该仪器 开发方法。最后，我们将对登记的艾滋病毒阳性妇女进行最终调查。 在肯尼亚基苏木的家庭艾滋病和教育服务计划中的关怀，以评估两人之间的关系 在艾滋病毒阳性妇女中，与HPV和宫颈癌有关的耻辱与参与护理之间的关系。 洞察个人和跨部门的耻辱与寻求服务的意愿之间的相互作用 帮助我们为未来的干预措施提供信息，以增加宫颈癌筛查在艾滋病毒- 积极的女人。

项目成果

Developing a framework to describe stigma related to cervical cancer and HPV in western Kenya.

• DOI: 10.1186/s12905-022-01619-y
• 发表时间: 2022-02-11
• 期刊: BMC women's health
• 作者: Ginjupalli R;Mundaden R;Choi Y;Herfel E;Oketch SY;Watt MH;Makhulo B;Bukusi EA;Huchko M
• 通讯作者: Huchko M