An intervention to increase cervical cancer screening among women living with HIV: A mixed methods study

We examined the effectiveness of a behavioral intervention in promoting cervical cancer screening among women living with HIV (WLWH) in Ghana. A Mixed-methods study was conducted involving 83 WLWH, who were randomly assigned to an intervention group (n = 42) to receive voice-recorded messages based...

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Bibliographic Details
Published in:Patient education and counseling 2024-01, Vol.118, p.107993-107993, Article 107993
Main Authors: Asare, Matthew, Obiri-Yeboah, Dorcas, Enyan, Nancy Innocentia Ebu, Nuer-Allornuvor, Gloria, Fosu, Emmanuel Sarfo, Ken-Amoah, Sebastian, Akakpo, Patrick Kafui
Format: Article
Language:English
Subjects:
3 R communication model
Cervical cancer screening
Early Detection of Cancer - methods
Female
HIV Infections - diagnosis
HPV self-sampling
Human papillomavirus 16
Human papillomavirus 18
Humans
Mass Screening - methods
Papillomaviridae - genetics
Papillomavirus Infections - diagnosis
Papillomavirus Infections - prevention & control
Uterine Cervical Neoplasms - diagnosis
Uterine Cervical Neoplasms - prevention & control
Women living with HIV
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Summary:We examined the effectiveness of a behavioral intervention in promoting cervical cancer screening among women living with HIV (WLWH) in Ghana. A Mixed-methods study was conducted involving 83 WLWH, who were randomly assigned to an intervention group (n = 42) to receive voice-recorded messages based on the 3 R model (Reframing, Reprioritizing, and Reforming) or a control group (n = 41) to receive standard care. The primary outcomes were screening uptake and HPV prevalence. Other outcomes were the acceptability, appropriateness, and feasibility of the intervention. The intervention group had a 100% screening rate, and the control group had a 14.63% screening rate. The prevalent rate of high-risk (hr)-HPV genotypes among the women was 67.5% (95%C.I: 0.56–0.77). Over 48% of the participants had multiple hr-HPV genotypes, 64.29% had HPV16/18/45%, and 73.21% had HPV 31/33/45/52/58. Of the women (89.30%) who screened positive, 60% of them were diagnosed and treated for pre-cancer lesions. The intervention messages were acceptable (encourage proactive behavior), feasible (simple, easy to understand), and appropriate (helpful, informative). Facilitators and barriers to self-sampling were identified. Combining the 3 R model with self-sampling increases cervical cancer screening among WLWH. Healthcare professionals and policymakers can use this model to increase cervical cancer screening. •Behavioral intervention that uses simplified health communication (3 R model) can increase cervical cancer screening.•HPV self-sampling coupled with the 3 R model can address cervical cancer screening access barriers in low-resource settings.•High-risk HPV genotypes are prevalent among women living with HIV.•WLWH are resilient and willing to take care of themselves if equipped with the right information and resources.
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2023.107993