Involving men in cervical cancer prevention; a qualitative enquiry into male perspectives on screening and HPV vaccination in Mid-Western Uganda

Abstract

Introduction Evidence-based preventive strategies for cervical cancer in low-resource setting have been developed, but implementation is challenged, and uptake remains low. Women and girls experience social and economic barriers to attend screening and human papillomavirus (HPV) vaccination programs. Male support has been proven successful in uptake of other reproductive healthcare services. This qualitative study with focus groups aimed to understand the perspectives of males on cervical cancer screening and HPV vaccination in Western-Uganda This knowledge could be integrated into awareness activities to increase the attendance of cervical cancer screening and HPV vaccination programs. Materials and methods Focus group discussions were conducted with men aged 25 to 60 years, who were married and/or had daughters, in Kagadi district, Mid-Western Uganda. All interviews were transcribed verbatim and thematically analyzed using an inductive approach. Results Eleven focus group discussions were conducted with 67 men. Men were willing to support their wives for screening and their daughters for HPV vaccination. Misperceptions such as family planning and poor personal hygiene leading to cervical cancer, and misperception of the preventative aspect of screening and vaccination were common. Women with cervical cancer suffer from stigmatization and family problems due to loss of fertility, less marital sexual activity, domestic violence and decreased economic productivity. Conclusions Ugandan men were willing to support cervical cancer prevention for their wives and daughters after being informed about cervical cancer. Limited knowledge among men about the risk factors and causes of cervical cancer, and about the preventative aspect of HPV vaccination and screening and their respective target groups, can limit uptake of both services. Screening and vaccination programs should actively involve men in creating awareness to increase uptake and acceptance of prevention.

Baseline knowledge on risk factors, symptoms and intended behaviour of women and men towards screening and treatment of cervical cancer in rural Uganda: A cross-sectional study

“…This makes men a critical target for impactful communication and other interventions aimed at increasing screening uptake. Men and their involvement in the control of cervical cancer are key players in the elimination of cervical cancer [9,10,11]. In this study men had signi cant better health seeking behaviour compared to the women.…”

“…Good knowledge among men would enable them to embrace the prevention programmes and also to support and encourage the women to go for screening and to seek medical help on acquisition of symptoms of cervical cancer. [10] Poor recognition of cancer symptoms by both patients and primary healthcare professionals may contribute to the advanced stage at diagnosis and poor survival of cervical cancer patients in Uganda [11,12]. Ugandan women with vaginal symptoms often rst attribute their symptoms to gynaecological infections such as candidiasis and sexually transmitted infections.…”

Men’s perceptions and perceived acceptability of their female partner’s use of self-administered intravaginal therapies for treatment of cervical precancer in Kenya

“…In contrast, a lack of male partner support is a well-documented barrier to the uptake of cervical cancer prevention-related interventions in sub-Saharan Africa. [19][20][21][22][23][24] Specific to the potential use of intravaginal therapies for cervical precancer treatment, male partner support is crucial, as these therapies often require periods of abstinence during their use. Though there is limited literature on intravaginal topical therapies for the prevention of cervical cancer in LMICs, studies on the use of intravaginal microbicides for HIV prevention among women in Sub-Saharan Africa have shown that male partner support is essential to uptake and adherence.…”

Baseline knowledge on risk factors, symptoms and intended behavior of women and men towards screening and treatment of cervical cancer in rural Uganda: a cross-sectional study

“…Limited knowledge among men about the risk factors and causes of cervical cancer can limit uptake of screening. Increased knowledge among men would enable them to embrace the prevention programs and also to support and encourage the women to go for screening and to seek medical help on acquisition of symptoms of cervical cancer [ 12 ].…”