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

基本信息

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
项目类别：
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

项目摘要

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发病率。2011 年，博茨瓦纳 15 至 49 岁成年人的艾滋病毒感染率为 23.4%。博茨瓦纳艾滋病毒传播的主要方式是异性接触，其中产前诊所的感染率很高。 2011 年，15 至 49 岁孕妇中年龄调整后的艾滋病毒感染率为 30.4%。博茨瓦纳的高艾滋病毒感染率导致艾滋病毒相关合并症（包括宫颈癌）的患病率增加。在博茨瓦纳妇女中，宫颈癌是最常见的。博茨瓦纳普通人群中约 21% 的女性患有宫颈 HPV 感染，并且大量证据表明风险增加。该项目解决了对影响博茨瓦纳妇女 HPV 筛查、HPV 和 HIV 感染风险、治疗寻求和保留治疗的因素进行研究的迫切需要。补助金的 3 个队列：队列 1 ^ 博茨瓦纳大学一年级本科女性，队列 2——在宫颈癌筛查时被捕获的女性，队列 3——被诊断出的女性正在接受治疗的宫颈癌患者，增加任何与健康相关的行为的重要第一步是确定影响该行为的因素，其中一些因素是不可变的、稳定的特征，不适合人口统计学变量等干预。例如，年龄、家族史和内战背景）识别稳定的、不可改变的预测因素有助于识别具有不同干预需求的女性亚群，其他因素将是可修改的、易于改变的变量，行为干预可以针对这些变量来增加健康行为。（例如，知识、信仰和态度）如果能够利用理论框架并针对人群进行调整，那么行为改变干预措施可能会最有效。拟议的研究将利用社会认知理论和合理的行动方法。这些理论框架已用于各种行为改变干预措施，包括撒哈拉以南非洲的干预措施，将用于确定目标人群感兴趣的行为的显着信念。让我们能够识别目标行为的预测因素，并检查理论变量是否可以解释它们。参与者将在队列 1 和队列 2 中每隔 6 个月完成一次保密的网络调查，在队列 3 中持续 2 年。具体目标是确定预期行为。宫颈癌筛查、HIV 和 HPV 感染、接受宫颈癌筛查的女性寻求治疗以及诊断出宫颈癌的女性继续接受治疗的预测因素。