Helena Painter (United Kingdom)
Botswana Harvard AIDS Institute Partnership .Presenter of 2 Presentations
IMPACT OF CERVICITIS ON PERFORMANCE OF PRIMARY HIGH RISK HPV TESTING FOLLOWED BY VISUAL EVALUATION IN WOMEN LIVING WITH HIV (ID 573)
Webcast
KNOWLEDGE AND BELIEFS ABOUT CERVICAL CANCER PREVENTION AMONG WOMEN LIVING WITH HIV IN BOTSWANA (ID 803)
Abstract
Introduction
The cervical cancer burden is significant in low- and middle-income countries (LMIC), with HIV co-infection a significant risk factor. Despite scaling up of screening programmes, uptake varies across LMIC and is sub-optimal in Botswana. We explored cervical cancer and screening knowledge and beliefs of women living with HIV (WLWH) to identify strategies to improve screening participation.
Methods
A mixed-methods approach was used, including a cross-sectional survey of womem aged 25-55 years from an HIV clinic and in-depth interviews among a sub-group of participants. Survey data were analysed descriptively. Qualitative data were analysed thematically using the Health Beliefs Model (HBM) as a theoretical framework.
Results
312 WLWH completed the survey. 84 (27%) reported knowing the cause of cervical cancer; however, only 20 (6%) identified HPV as a cause. 100 women correctly identified a sexual behaviour as a risk factor for cervical cancer. Common reasons for previous screening included attending on the advice of a healthcare worker (HCW) (n=108) and participants’ desire to know their health status (n=108). 15 women had never been screened, mainly due to time limitations (n=7) and fear of the results (n=3). Qualitative analysis of 8 interviews revealed a high essential awareness of cervical cancer; however, misconceptions regarding causes and prevention, such as good hygiene or sexual behaviours, affected women’s perceived susceptibility. Cervical cancer was sometimes viewed as a ‘death sentence’, which influenced perceived severity and benefits of screening. Accordingly, fear of abnormal screening results was a common barrier. Women trusted information from HCW and were interested in education delivered by HCW through the media, workshops and clinic-based programmes.
Conclusions
Misconceptions about cervical cancer and screening persist in Botswana. Interventions targeting local knowledge gaps and barriers are needed to change beliefs and screening behaviours. HCW are trusted information sources, highlighting opportunities to improve knowledge and promote screening through multiple channels.