Factors Predicting Pap Smear Adherence in HIV-infected Women: Using the Health Belief Model

Women infected with the human immunodeficiency virus are at increased risk for developing cervical cancer. Current guidelines reflect that Pap smears should be performed twice during the first year after diagnosis with HIV and annually thereafter. However, women with HIV are not obtaining Pap smears per the current guidelines. The purpose of this study was to evaluate HIV-infected women\u27s attitudes toward cervical cancer and cervical cancer screening. The research design is an exploratory, cross-sectional, quantitative design. The sample of convenience consisted of participants recruited from two ambulatory HIV clinics in Florida. Attitudes were assessed using Champion\u27s Health Belief Model and Self-efficacy scales. Knowledge was evaluated with an updated HPV/Cervical Cancer Knowledge scale. Sociodemographic variables were assessed using a Demographic Data form. The results indicate that HIV-infected women in the study were not knowledgeable about HPV or cervical cancer. They did not perceive that cervical cancer was serious, nor did they feel that they were susceptible to cervical cancer. Overall, HIV-infected women were confident in their ability to request a Pap smear, and they perceived fewer barriers and more benefits to Pap smears. Despite, perceptions of fewer barriers and more benefits a chart review revealed that approximately 43% of the study participants received a Pap smear during the past year. Perceived barriers was a significant predictor of Pap smear adherence (OR = 0.93, CI: 0.90 to 0.96, p \u3c .01). Findings from the exploratory study provide important information to clinicians and researchers that will assist in the development of effective interventions to increase Pap test adherence. Additional research is needed to further understand factors that influence cervical cancer screening in this at-risk population