Perceptions of barriers and facilitators to cervical cancer screening among low-income, HIV-infected women from an integrated HIV clinic

Abstract

Significantly elevated rates of cervical cancer and low rates of Papanicolaou (Pap) smear screening have been documented among HIV-infected women. However, little is known about women's perceptions of cervical cancer screening utilization. Hence, this study describes barriers and facilitators related to cervical cancer screening in a sample of HIV-infected women seeking care at an integrated HIV clinic in Houston, Texas. Using an inductive qualitative methodological approach, data were obtained from five focus group discussions with a total of 33, HIV-infected women. The majority of the study sample consisted of women who self-identified as Black (69.7%), and reported heterosexual contact as the mode of HIV acquisition (75.8%). Barriers to cervical cancer screening were described as pain and discomfort associated with receiving Pap smears and subsequent procedures; lack of awareness of cervical cancer as a preventable disease; limited transportation access; and systemic issues as it relates to scheduling gynecological appointments. Facilitators were described as awareness of HIV-infected women's increased risk of cervical cancer and strong provider–patient relationships. To address disparities in cervical cancer screening among low-income HIV-infected women, programs should capitalize on the identified facilitators and alleviate modifiable barriers using multilevel strategies.

Keywords:

• HIV-infected women
• cervical cancer screening
• barriers
• facilitators
• Pap smear screening

Acknowledgments

The authors would also like to acknowledge Yvette Peters, CNP, and Tanvir Bell, MD for their valuable feedback in the project planning phase.

Funding

This work was supported by the National Cancer Institute Grant [grant number R25TCA5770] awarded to Shine Chang and National Cancer Institute Grant [grant number P30CA16672] awarded to Ronald DePinho.

Additional information

Funding

Funding: This work was supported by the National Cancer Institute Grant [grant number R25TCA5770] awarded to Shine Chang and National Cancer Institute Grant [grant number P30CA16672] awarded to Ronald DePinho.