Pap Testing Screening Experiences of HIV-Positive Women

The Human Papillomavirus (HPV) is the most common sexually transmitted disease, and is known to cause genital warts, cervical intraepithelial neoplasia (CIN), and cervical cancer. HIV-positive women are at greater risk of contracting HPV, experiencing CIN, having more advanced-grade CIN, and developing cervical cancer due to their compromised immune status. Since becoming an essential part of womens preventive healthcare, the Papanicolaou test, commonly known as the Pap smear, has helped to reduce cervical cancer incidence and mortality; however, many HIV-positive women do not meet recommended Pap test screening guidelines. This study addressed the following research question: What psychosocial, cultural, contextual, and organizational factors influence HIV-positive womens engagement in cervical cancer screening? Using a qualitative grounded theory approach, one-on-one interviews were conducted with 19 HIV-positive, African American women of childbearing age in Shelby County, TN. Additionally, participants completed a questionnaire to assess demographic and socioeconomic characteristics, health history, and Pap test screening knowledge. Seven major themes emerged from the data: General Lack of Knowledge, Benefits Outweigh Barriers, Limited Role of Social Support, Disconnect Between Health and Religious Beliefs, HIV as a Facilitator, Reliance on Healthcare Provider, and Intersectionality. The findings presented here provide insight into what motivates HIV-positive women to engage in regular Pap test screening as well as how factors across the social ecological spectrum are related. This information will help public health practitioners to develop interventions for increasing and preserving cervical cancer screening compliance