The Blurred Lines of HPV and Cervical Cancer Knowledge: Exploring the Social and Cultural Factors of Identity, Gender, and Sexuality in Caribbean Immigrant Women

This dissertation explores how the sociocultural experiences of migration and acquisition of health knowledge influence the beliefs and behaviors related to human papillomavirus (HPV) risks and cervical cancer prevention among women who have emigrated from English-speaking Caribbean nations and now live in the Tampa Bay metropolitan area. Genital human papillomavirus is very common, and cervical cancer is the most common HPV-associated cancer. Additionally, all cervical cancers are caused by the HPV infection. More women of color, including Black and Hispanic women, are diagnosed with cervical cancer and at a later stage of the disease than women of other races or ethnicities. Black women have lower levels of knowledge and awareness of HPV and related preventive measures compared to Whites. The incidence of cervical cancer is higher among African American/Black women and Latina women than among White women. Globally, Caribbean countries have some of the highest incidence and mortality rates of cervical cancer. It is unclear how knowledge, perceptions and behaviors surrounding HPV risks and cervical cancer influence prevention practices among immigrant women from English-speaking Caribbean countries residing in the United States. Existing literature highlights factors which influence cervical cancer prevention behaviors and HPV knowledge among immigrants in the United States, including educational barriers, HPV tests and vaccine costs, duration of time within the United States, in addition to the beliefs, myths and stigma surrounding cervical cancer originating in the birth country. But there is a dearth of information on immigrant women from the Caribbean. Ethnographic methods were employed in this study, including participant observation, key-informant interviewing, focus groups, and semi-structured in-depth interviewing to assess attitudes, available knowledge, culturally specific perceptions, and behavioral practices of the study participants. This dissertation develops a modified approach in the Critical Medical Anthropology (CMA) genre that links political economy with an interpretive approach. It also utilizes the theoretical approaches of transnationalism and embodiment to analyze the phenomena under consideration. Some key outcomes of this research are as follows: Many women were very aware of HPV, and most women were familiar with cervical cancer. However, the majority of women were not confident regarding how HPV and cervical cancer were connected. They did not know how a virus causes a chronic disease. Even with some of the study participants having the HPV vaccine, they were still not aware of the link between the two. This lead the researcher to inquire what HPV or a sexually transmitted disease meant to the women, resulting in a mixture of responses ranging from never thinking about HPV or acquiring an infection to placing blame on being “loose” or “promiscuous” as a woman. Their narratives provided insights into how their childhood and familial experiences as young Caribbean women contributed to how they act upon knowledge about being sick, having an infection, or living a healthy lifestyle since migrating to the United States. This research contributes to works applying anthropological perspectives and ethnographic methodology to narrow the gap in available literature relevant to migration, Black Caribbean immigrant health and cancer health disparities