Factors Associated with HPV Screening and Acquisition in Young Women in Botswana

博茨瓦纳年轻女性 HPV 筛查和感染的相关因素

• 批准号: 8936660
• 负责人: JOHN BARTON JEMMOTT
• 金额: $ 14.76万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8936660
• 关键词: Address; Adult; Affect; Africa South of the Sahara; African; Age; Age-Years; Attitude; Behavior; Behavior Therapy; Belief; Botswana; Cancer Etiology; Cervical; Cervical Cancer Screening; Cessation of life; Characteristics; Clinic; Comorbidity; Country; Data; Developing Countries; Diagnosis; Disease Progression; Early treatment; Epidemic; Expectancy; Family; General Population; Grant; HIV; HIV Infections; Health; Heterosexuals; High Prevalence; Human Papillomavirus; Human papilloma virus infection; Infection; Intervention; Knowledge; Life; Literature; Malignant neoplasm of cervix uteri; Multiple Partners; Online Systems; Outcome; Participant; Patients; Population; Pregnant Women; Prevalence; Prevention strategy; Qualitative Research; Recording of previous events; Reporting; Research; Risk; Satellite Viruses; Second Primary Cancers; Self Efficacy; Sexual Partners; Students; Subgroup; Surveys; Target Populations; Time; Universities; Woman; behavior change; cohort; condoms; consistent condom use; design; interest; prospective; public health relevance; screening; sex risk; social cognitive theory; socioeconomics; transmission process; undergraduate student; young woman

The broad, long-term objective of this project is to reduce the rates of cervical cancer in Botswana and other sub-Saharan African countries. In Botswana, the HIV prevalence rate among adults 15 to 49 years of age in 2011 was 23.4%, which was the second highest prevalence rate in the world. The primary mode of HIV transmission in Botswana is heterosexual exposure. Of particular concern is the high prevalence in antenatal clinics, where the age-adjusted HIV prevalence among pregnant women ages 15 to 49 years was 30.4% in 2011. The high HIV prevalence in Botswana contributes to an increased prevalence of HIV-associated comorbidities, including cervical cancer. Among women in Botswana, cervical cancer is the most common cancer and the second most common cause of cancer deaths. About 21% of women in the general population of Botswana harbor cervical HPV infection, and considerable evidence suggests increased risk of HPV in people living with HIV. This project addresses the urgent need for research on factors affecting screening for HPV, risk of HPV and HIV acquisition, treatment seeking, and retention in treatment among women in Botswana. The project will utilize data from participants in the 3 cohorts of the grant: Cohort 1 ^ first-year undergraduate women at the University of Botswana, Cohort 2—women captured at the time of their cervical-cancer screening, and Cohort 3—women diagnosed with cervical cancer who are undergoing treatment. An important first step in increasing any health-related behavior is the identification of factors that affect that behavior. Some of these factors will be immutable, stable characteristics that are not amenable to intervention such as demographic variables (e.g., age, family history, and socioeconomic background). Identifying stable immutable predictors helps to identify subgroups of women with differential needs for intervention. Other factors will be modifiable, amenable to change, variables that behavioral interventions can target to increase healthful behavior (e.g., knowledge, beliefs, and attitudes). Behavior-change interventions are likely to be most efficacious if they draw upon a theoretical framework and are tailored to the population. The proposed research will draw upon social cognitive theory and the reasoned action approach, which are theoretical frameworks that have been used in a wide variety of behavior-change interventions, including interventions in sub-Saharan Africa. Qualitative research will be used to identify salient beliefs about the behaviors of interest in the target populations. The prospective cohort designs will allow us to identify the predictors of the target behaviors and to examine whether theoretical variables explain them. Participants will complete confidential web-based surveys at 6-month intervals for 3 years in Cohorts 1 and 2 and for 2 years in Cohort 3. The Specific Aims are to identify prospective predictors of cervical-cancer screening, acquisition of HIV and HPV infection, treatment seeking in women screened for cervical cancer, and remaining in treatment among women diagnosed with cervical cancer.

该项目的广泛长期目标是降低博茨瓦纳和其他撒哈拉以南非洲国家的宫颈癌率。在博茨瓦纳，2011年15至49岁的成年人的艾滋病毒患病率为23.4％，这是世界第二高的患病率。博茨瓦纳艾滋病毒传播的主要模式是异性恋暴露。特别令人关注的是，在天触角诊所的高患病率，在2011年，在15至49岁的孕妇中，年龄调整后的艾滋病毒患病率为30.4％。博茨瓦纳的HIV较高的HIV患病率导致包括艾滋病毒相关的共同体（包括宫颈癌）的患病率增加。在博茨瓦纳的女性中，宫颈癌是最常见的癌症，也是癌症死亡的第二大原因。博茨瓦纳港口宫颈HPV感染中约有21％的妇女中有21％的妇女，并且有大量证据表明，艾滋病毒患者的HPV风险增加。该项目旨在研究影响HPV筛查的因素，HPV和HIV获取风险，寻求治疗的风险，并在博茨瓦纳女性中的治疗中保留。该项目将利用赠款三个队列中的参与者的数据：1 ^博茨瓦纳大学的第一年本科妇女，同伙2-在宫颈癌筛查时被捕获的妇女和宫颈3-妇女妇女正在接受治疗的宫颈癌。增加任何与健康相关行为的重要第一步是识别影响该行为的因素。其中一些因素将是不可变的，稳定的特征，这些特征不适合干预，例如人口统计学变量（例如，年龄，家族史和社会经济背景）。识别稳定的不变预测因素有助于识别有不同需求的妇女的亚组。其他因素将是可修改的，可以改变，行为干预措施可以针对增加健康行为的变量（例如，知识，信念和参加）。如果行为改变干预措施依靠理论框架并针对人群量身定制，则可能是最有效的。拟议的研究将借鉴社会认知理论和合理的行动方法，这些方法是在各种改变行为改变干预措施中使用的理论框架，包括撒哈拉以南非洲的干预措施。定性研究将用于确定有关目标人群感兴趣的行为的显着信念。前瞻性队列设计将使我们能够识别目标行为的预测指标，并检查理论变量是否解释了它们。参与者将在1和2中以3年的时间间隔以6个月的间隔完成基于网络的机密调查，并在3年​​中进行2年。具体目的是确定宫颈癌筛查的前瞻性预测指标，获得HIV和HPV感染的获得，对宫颈癌的女性进行治疗，以及在患有囊肿的女性治疗的女性治疗中寻找治疗的治疗方法。