Female perspectives on male involvement in a human-papillomavirus-based cervical cancer-screening program in western Kenya

Abstract

Background To be effective, population-based cervical cancer prevention programs must be tailored to meet the needs of the target population. One important factor in cervical cancer screening may include male involvement. To iteratively improve a screening program employing self-collected vaginal swabs for human-papillomavirus (HPV) testing in western Kenya, we examined the role of male partners and community leaders in decision-making and accessing screening services. Methods We carried out 604 semi-structured, in-depth interviews (IDIs) with women and community health volunteers who took part in a multiphase trial of implementation strategies for HPV-based cervical cancer screening. IDIs were coded and themes related to decision-making, screening and treatment barriers, and influence of male partners and community leaders were identified and analyzed. Results Women experienced both support and opposition from their male partners. Partner support took the form of financial support for transportation and emotional support and encouragement, while opposition ranged from anticipated negative reactions to lack of permission, isolation, and abandonment. Though most women described their own partners as supportive, many felt that other male partners would not be supportive. Most participants believed that increased HPV and cervical cancer knowledge would increase partner support. Women reported a general acceptance of involvement of community leaders in education and screening campaigns, in a setting where such leaders may hold influence over men in the community. Conclusion There was a clear interest in involving male partners in the cervical cancer prevention process, specifically in increasing knowledge and awareness. Future research should explore the feasibility and effectiveness of engaging male partners in cervical cancer screening and prevention programs. Electronic supplementary material The online version of this article (10.1186/s12905-019-0804-4) contains supplementary material, which is available to authorized users.

“A loving man has a very huge responsibility”: A mixed methods study of Malawian men’s knowledge and beliefs about cervical cancer

“…The literature on determinants of screening uptake in lower-resource settings has identified important factors including women's cervical cancer knowledge, perceived efficacy of screening, and beliefs about disease severity and susceptibility [13][14][15][16][17][18]. Women have also reported that their male partners influence cervical cancer screening decisions [13,[18][19][20][21][22][23][24], and the World Health Organization recommends male-targeted outreach as a way to increase cervical cancer screening uptake [25] however very little is known about men's perspectives on cervical cancer and screening approaches [26].…”

"A loving man has a very huge responsibility": A mixed methods study of Malawian men's knowledge and beliefs about cervical cancer

“…The literature on determinants of screening uptake in lower-resource settings has identi ed important factors including women's cervical cancer knowledge, perceived e cacy of screening, and beliefs about disease severity and susceptibility [13][14][15][16][17][18]. Women have also reported that their male partners in uence cervical cancer screening decisions [13,[18][19][20][21][22][23][24], and the World Health Organization recommends maletargeted outreach as a way to increase cervical cancer screening uptake [25] -however very little is known about men's perspectives on cervical cancer and screening approaches [26].…”

“…The literature on determinants of screening uptake in lower-resource settings has identi ed important factors including women's cervical cancer knowledge, perceived e cacy of screening, and beliefs about disease severity and susceptibility [13][14][15][16][17][18]. Women have also reported that their male partners in uence cervical cancer screening decisions [13,[18][19][20][21][22][23][24], and the World Health Organization recommends maletargeted outreach as a way to increase cervical cancer screening uptake [25] -however very little is known about men's perspectives on cervical cancer and screening approaches [26]. The limited literature on this topic indicates that men are not very knowledgeable about cervical cancer (including risk factors, symptoms and ways of screening or treating), and that despite general support for the concept of cancer prevention, some men have hesitations about their wives undergoing screening [27][28][29][30][31][32][33][34][35][36][37][38].…”

"A loving man has a very huge responsibility": A mixed methods study of Malawian men's knowledge and beliefs about cervical cancer

“…disease severity and susceptibility [13][14][15][16][17][18]. Women have also reported that their male partners in uence cervical cancer screening decisions [13,[18][19][20][21][22][23][24], and the World Health Organization recommends maletargeted outreach as a way to increase cervical cancer screening uptake [25] -however very little is known about men's perspectives on cervical cancer and screening approaches [26].…”

“…disease severity and susceptibility [13][14][15][16][17][18]. Women have also reported that their male partners in uence cervical cancer screening decisions [13,[18][19][20][21][22][23][24], and the World Health Organization recommends maletargeted outreach as a way to increase cervical cancer screening uptake [25] -however very little is known about men's perspectives on cervical cancer and screening approaches [26]. The limited literature on this topic indicates that men are not very knowledgeable about cervical cancer (including risk factors, symptoms and ways of screening or treating), and that despite general support for the concept of cancer prevention, some men have hesitations about their wives undergoing screening [27][28][29][30][31][32][33][34][35][36][37][38].…”