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“My husband says this: If you are alive, you can be someone…”: Facilitators and barriers to cervical cancer screening among women living with HIV in India

  • Kung, Timothy-Paul H.1
  • Gordon, Janna R.2
  • Abdullahi, Asha1
  • Barve, Apurva3
  • Chaudhari, Vipul4
  • Kosambiya, Jayendrakumar K.4
  • Kumar, Ambuj5
  • Gamit, Sukesha4
  • Wells, Kristen J.1, 2, 6
  • 1 San Diego State University, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA , San Diego (United States)
  • 2 San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA , San Diego (United States)
  • 3 University of California, Los Angeles, Fielding School of Public Health, 650 Charles E. Young Dr. South, 16-035 Center for Health Sciences, Los Angeles, CA, 90095-1772, USA , Los Angeles (United States)
  • 4 Government Medical College, Surat, Majuragate, Surat, Gujarat, 395001, India , Surat (India)
  • 5 University of South Florida Morsani College of Medicine, 3515 East Fletcher Avenue, MDC 27, Tampa, FL, 33612, USA , Tampa (United States)
  • 6 University of California, San Diego, Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA, 92037, USA , La Jolla (United States)
Published Article
Cancer Causes & Control
Publication Date
Feb 26, 2019
DOI: 10.1007/s10552-019-01145-7
Springer Nature


PurposeWomen living with human immunodeficiency virus (WLWH) have a higher risk of cervical cancer than women without HIV. In addition, women in India experience a high burden of death from cervical cancer. This qualitative study evaluated individual and interpersonal factors influencing cervical cancer screening among WLWH in Surat, India.MethodsIn-depth interviews were conducted with 25 WLWH and 15 stakeholders in Surat, India. Data were analyzed using directed content analysis to identify individual and intrapersonal barriers and facilitators.ResultsWLWH lacked knowledge and reported being afraid of cervical cancer and cervical cancer screening but were interested in learning more about it. Interpersonal factors influencing cervical cancer screening included receipt or lack of instrumental and emotional family support, interactions with healthcare providers, and receipt or lack of information about cervical cancer and the Pap test from healthcare providers.ConclusionWidespread public education is necessary to increase awareness of cervical cancer and cervical cancer screening and to encourage family members to support women who wish to obtain screening. Patient- and provider-focused interventions may facilitate the process of providing cervical cancer care to WLWH who are obtaining care in busy public healthcare systems in India.

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