Developing a tool to measure cervical cancer stigma among HIV+ women in Kenya

开发一种工具来衡量肯尼亚艾滋病毒妇女中宫颈癌的耻辱感

• 批准号: 9914142
• 负责人: Megan J. Huchko
• 金额: $ 17.78万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9914142
• 关键词: AIDS education; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adopted; Affect; Anti-Retroviral Agents; Awareness; Behavior; Biological; Cancer Burden; Caring; Cervical Cancer Screening; Clinic; Data; Development; Diagnosis; Disease; Education; Enrollment; Factor Analysis; Family; Future; Gender; HIV; HIV Seronegativity; HIV Seropositivity; Health Personnel; Health Services Accessibility; Healthcare; Human Development; Human Papillomavirus; Incidence; Individual; Infrastructure; Intervention; Interview; Joints; Kenya; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measurement; Measures; Methods; Outcome; Phase; Population; Poverty; Prevention; Property; Provider; Psychometrics; Race; Research Personnel; Risk; Services; Sex Orientation; Sexually Transmitted Diseases; Shame; Social Perception; Stigmatization; Structure; Surveys; Testing; United Nations; Validation; Validity and Reliability; Woman; Women' s Health; Work; World Health Organization; base; cervical cancer prevention; early screening; experience; follow-up; health care quality; improved; infection risk; insight; instrument; intersectionality; low and middle-income countries; method development; mortality; prevent; prevention service; programs; response; risk perception; screening; service programs; sexual HIV transmission; sexual trauma; social stigma; success; theories; therapy design; tool; treatment services; uptake; willingness

Cervical cancer is an AIDS-defining malignancy, and there is clear evidence that HIV increases the risk of infection with human papillomavirus (HPV) and development of pre-cancer and cancer. Further, there is a global disparity in HIV and cervical cancer burden, with the greatest incidence and mortality for both diseases in low- and middle-income countries. The poor outcomes related to both cervical cancer and HIV are preventable with access to and uptake of quality healthcare. As HIV care has become more widely available, researchers and program planners have recognized the importance of interventions to address stigma. Negative social perceptions and stigma about HIV have led to reluctance to test or access treatment in some populations; however, little is known about the presence and potential impact of cervical cancer-related stigma, particularly among HIV-positive women. Uptake of cervical cancer screening and prevention services depends on a convergence of service availability, personal perception of risk and willingness to seek services, all of which may be significantly affected by disease-related stigma. Further, as more programs adopt HPV testing as their method of cervical cancer screening, there may be an additional layer of stigma related to diagnosis with a sexually transmitted disease. A better understanding of whether and how HIV-related stigma intersects and possibly amplifies HPV and cervical cancer stigma and willingness to seek services would guide the development of stigma reduction interventions that could improve screening and follow-up rates. To facilitate this understanding, we propose to use intersectional theory to develop and validate measures for stigma related to HPV and cervical cancer among HIV-infected women. We will carry out in-depth interviews with HIV- positive women, HIV-negative women and providers in Kisumu, Kenya to develop a framework for understanding the individual and intersectional HPV, cervical cancer and HIV-related stigmas. Using data from these interviews, we will develop context-specific measures of HPV, cervical cancer and intersectional stigmas of HPV, cervical cancer and HIV. We will then pilot and validate the instrument using rigorous survey development methods. Finally, we will administer the finalized survey among HIV-positive women enrolled in care at the Family AIDS and Education Services Program in Kisumu, Kenya to evaluate the relationship between stigma related to HPV and cervical cancer among HIV-positive women and engagement in care. Insight into the interplay between individual and intersectional stigmas and willingness to seek services will help us inform future interventions to increase the reach and impact of cervical cancer screening among HIV- positive women.

宫颈癌是一种艾滋病定义的恶性肿瘤，有明确的证据表明艾滋病毒会增加患艾滋病的风险 人乳头瘤病毒 (HPV) 感染以及癌前期和癌症的发展。此外，还有一个 全球艾滋病毒和宫颈癌负担存在差异，这两种疾病的发病率和死亡率最高 在低收入和中等收入国家。与宫颈癌和艾滋病毒相关的不良结果是 通过获得和接受优质医疗保健可以预防。随着艾滋病毒护理变得越来越普遍， 研究人员和方案规划者已经认识到采取干预措施解决耻辱问题的重要性。 对艾滋病毒的负面社会认知和耻辱导致一些人不愿接受检测或接受治疗 人口；然而，人们对宫颈癌相关耻辱的存在和潜在影响知之甚少， 尤其是艾滋病毒呈阳性的女性。宫颈癌筛查和预防服务的接受程度取决于 基于服务可用性、个人对风险的感知以及寻求服务的意愿，所有这些 这可能会受到与疾病相关的耻辱感的显着影响。此外，随着越来越多的项目采用 HPV 检测 作为宫颈癌筛查的方法，可能还存在与诊断相关的另一层耻辱 患有性传播疾病。更好地了解与艾滋病毒相关的耻辱是否以及如何交叉 并可能加剧 HPV 和宫颈癌的耻辱感，寻求服务的意愿将引导 制定减少耻辱感的干预措施，以提高筛查和随访率。为了方便 基于这种理解，我们建议使用交叉理论来开发和验证耻辱措施 与感染艾滋病毒的女性中的 HPV 和宫颈癌有关。我们将对艾滋病病毒感染者进行深度访谈 肯尼亚基苏木的阳性妇女、艾滋病毒阴性妇女和提供者制定一个框架 了解个体和交叉 HPV、宫颈癌和 HIV 相关的耻辱。使用数据来自 在这些访谈中，我们将针对 HPV、宫颈癌和交叉耻辱制定针对具体情况的衡量标准 HPV、宫颈癌和艾滋病毒。然后，我们将通过严格的调查来试验和验证该仪器 开发方法。最后，我们将对登记在册的艾滋病毒呈阳性女性进行最终调查。 在肯尼亚基苏木的家庭艾滋病和教育服务项目中进行护理，以评估这种关系 HIV 阳性女性中与 HPV 和宫颈癌相关的耻辱与护理参与之间的关系。 深入了解个人和交叉耻辱之间的相互作用以及寻求服务的意愿将 帮助我们为未来的干预措施提供信息，以扩大艾滋病毒宫颈癌筛查的覆盖范围和影响 积极的女性。

项目成果

Developing a framework to describe stigma related to cervical cancer and HPV in western Kenya.

• DOI: 10.1186/s12905-022-01619-y
• 发表时间: 2022-02-11
• 期刊: BMC women's health
• 作者: Ginjupalli R;Mundaden R;Choi Y;Herfel E;Oketch SY;Watt MH;Makhulo B;Bukusi EA;Huchko M
• 通讯作者: Huchko M