Very little is currently known about factors impacting the prevalence of cervical cancer screening among women living with HIV-AIDS (WLHA). To better understand this issue, we surveyed low-income, medically underserved women receiving subsidized gynecologic care through an integrated HIV clinic. A self-administered questionnaire was completed by 209 women who self-identified as HIV positive. A total of 179 subjects (85.7%) reported having had a Pap test in the last three years. The majority of WLHA (95%) knew that the Pap test screens for cervical cancer. However, overall knowledge of cervical cancer risk factors, such as multiple sexual partners or sex with a man with multiple partners, was low (43% and 35%, respectively). Unscreened women were younger and more likely to be single with multiple current sexual partners. In multivariable analyses, the only factors associated with Pap testing were a woman's perception that her partner wants her to receive regular screening (aOR 4.64; 95% CI: 1.15-23.76; p = .04), number of clinic visits during the past year (aOR 1.36, 95% CI: 1.05-1.94; p = .04) and knowledge that the need for a Pap test does not depend on whether or not a woman is experiencing vaginal bleeding (aOR 6.52, 95% CI: 1.04-49.71; p = .05). We conclude that support from male partners in addition to effective contact with the health system and knowledge of cervical cancer risk factors influence Pap utilization among low-income WLHA. Future measures to improve the care for this population should increase knowledge of cervical cancer risk factors and encourage social support for cervical cancer screening among WLHA.

Medically underserved populations continue to be disproportionately burdened by cancer. The exact reason for this disparity has not been fully elucidated, but likely involves multiple factors. We explored the potential utility of a novel community-based cancer education program called Forum Theater (FT), aimed at raising awareness about colorectal (CRC) and cervical cancer (CxC) screening among African-American, Hispanic, and Vietnamese populations. We also determined audience likelihood of obtaining CRC and CxC screening in the 6 months following performances. Thirty FT performances were held between September 2011 and July 2012. A brief survey was administered at each performance, eliciting responses on key CRC and CxC screening questions. A total of 662 community residents (316 Hispanic, 165 African-American, and 181 Vietnamese; overall mean age 50.3 ± 16.4) participated in performances. The survey response rate was 71.1 %. After seeing FT performances, the majority responded correctly (>70 %) on CRC and CxC screening questions. In comparison to Hispanic and Vietnamese participants, African-Americans were less likely to report that CRC and CxC are preventable (p < 0.05), that timely and regular screening saves lives (p = 0.05), and that CxC screening should begin at age 21 for most women (p < 0.05). Our findings suggest that FT may be an effective strategy to disseminate cancer screening information. Lack of awareness that CRC/CxC screening saves lives and that CRC/CxC is preventable, as reported by African-Americans, may not stem from lack of knowledge or misconceptions alone, but may be influenced by a sense of fatalism regarding cancer outcomes in this population.

Background: Male spouses and partners play an important role in determining a woman's willingness to participate in cervical cancer screening. However, the attitudes and behaviors by which they influence a woman's decision to undergo Pap testing remain poorly understood. Methods: A series of semi-structured, qualitative interviews were conducted in Spanish with 19 recent Latino immigrants in Houston, Texas. The interview format was designed to establish each individual's pattern of engagement with the United States healthcare system, assess baseline knowledge of cervical cancer screening and evaluate attitudes and patterns of communication with their female partners regarding health care. Interview questions were constructed using principles of the Theory of Reasoned Action. All interviews were conducted in Spanish. After translation, responses were coded and scored with the goal of identifying themes and key observations. Results: Most subjects reported few, if any, interactions with the healthcare system since their arrival in the United States. Although most participants reported being aware that women should be seen by their doctors regularly, fewer than half could clearly indicate the purpose of a Pap test or could state with certainty the last time their female partner had undergone screening. Multiple subjects expressed a general distrust of the health care system and concern for its costs. Approximately half of subjects reported that they accompanied their female partner to the health care provider's office and none of the participants reported that they were present in examination rooms at the time their partner underwent screening. Multiple participants endorsed that there may be some concerns within their community regarding women receiving frequent gynecologic care and distrust of the healthcare system. Almost all interviewed subjects stated that while they would allow their female partners to see male physicians, they also expressed the opinion that other men might be uncomfortable with this and that women would likely be more comfortable with female physicians.

Introduction: The burden of cancers that can be prevented through early detection, specifically breast, cervical, and colorectal cancer, remains higher among medically underserved minority populations. Disparities in knowledge and awareness of screening contribute to the increased burden. We developed an innovative community theater program to educate and promote breast, cervical, and colorectal cancer screening among medically underserved Hispanic, African American, and Vietnamese communities of Harris County, TX. Methods: The program consists of two original plays and nine monologues that promote breast, cervical, or colorectal cancer screening and are culturally tailored to each racial/ethnic and linguistic group. They are all based on a health communications framework, specifically the Extended Parallel Process Model, built on the constructs of perceived susceptibility, perceived severity, self-efficacy, and response efficacy. Each play and monologue was written by an independent professional playwright with input on health messaging from health care professionals. The scripts were then worked through an iterative process between them and clinical and community advisory boards. Live performances by professional actors were held in community venues located in medically underserved zip codes. The monologues were developed in three different languages, English, Spanish, and Vietnamese. Anonymous surveys were self-conducted after each performance. Events included a performance of the monologue or play, a question-and-answer session with a health care professional, and distribution of educational materials. Typically, a representative from a partner institution was also available to connect audience members to health care services. Anonymous self-administered surveys are conducted after each performance. Results: Between January 2014 and present, 128 monologues were performed, including 32 for cervical cancer, 28 for colorectal cancer, and 68 for breast cancer. A total of 3,332 individuals attended the performances (average audience size = 26). Among the 2,745 participants who completed post-performance surveys (response rate = 82.4%), 82.1% indicated that they were very likely to obtain a screening test after watching the performance, compared to 68.5% prior to the performance (p &lt; 0.05). Increase in the proportion of individuals with high intentions to screen was highest for cervical cancer (28.4% increase), followed by colorectal cancer (23.9%) and breast cancer (15.5%), and these differences were statistically significant (p &lt; 0.05). The increase in the proportion of individuals with high intentions to screen was highest specifically for Hispanic audiences of the cervical cancer monologue. Discussion: Community theater performances are an effective method of improving knowledge and awareness of screening and cancer prevention among medically underserved minority populations in Harris County, TX. Performances were especially effective in Hispanic communities. This may be due to their success in breaking barriers associated with culturally taboo topics associated with these cancers. Citation Format: Veronica Landa, Jane Montealegre, Roshanda Chenier, Glori Chauca, Ivan Valverde, Maria Jibaja-Weiss. Using community theater to improve knowledge and awareness of cancer preventive health behaviors in Harris County, TX [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C16.