Knowledge of HPV/Cervical Cancer and Acceptability of HPV Self-Sampling among Women Living with HIV: A Scoping Review

Abstract

Cervical cancer rates are disproportionately high among women living with the human immunodeficiency virus (wlhiv). Cervical cancer is preventable through hpv screening, regular Pap tests, and early cancer detection. Evidence indicates that hpv and cervical cancer screening are suboptimal among wlhiv, who face a myriad of access barriers. Considering that screening is an effective first-line defense to cervical cancer, we conducted a scoping review with the aim of gaining a better understanding about: (1) the knowledge and perceptions of hpv and cervical cancer screening among wlhiv; and (2) the acceptability of self-sampling for hpv among wlhiv. We searched five electronic databases for peer-reviewed articles that were published in English within the last ten years, reported on studies with hiv-positive women who were aged 16 or older, and satisfied the topics of the review. A total of 621 articles were found. After accounting for duplicates and unmet criteria, 17 articles and 1 abstract, reporting on studies in the United States and Africa, were included in this review. The review highlighted that most wlhiv had inadequate knowledge of hpv transmission and cervical cancer prevention, which influenced their perceptions of risk and susceptibility. Screening barriers included misconceptions about Pap tests, fear of diagnosis of serious illness, perceived pain, embarrassment, bodily modesty, and limited access to female health care providers. This review also affirms that self-sampling is an acceptable and promising screening option for wlhiv. Implications for policy, research, and practice are discussed.

Acceptability of HPV screening among HIV-infected women attending an HIV-dedicated clinic in Abidjan, Côte d’Ivoire

“…In our case, women expressed conflicting feelings due to their interest in the self-sampling method and their lack of confidence in performing it themselves and preferred to rely on healthcare workers. Similar results were found among women living with HIV in Kenya and Rwanda, with a discrepancy between the expressed acceptability of self-sampling and lack of self-confidence in performing it [ 28 , 29 ]. In addition, the woman-healthcare worker relationship could reduce women’s free choice in health decisions, as some felt forced to undergo the screening, which is the opposite of empowerment.…”

Knowledge, perception of HIV symptom severity and cervical cancer screening behaviour among women living with HIV in China

“…The two important barriers for unscreened women living with HIV were 'I do not know this test' and 'Not necessary to take the test', which also indicated the importance of knowledge. These findings were also consistent with previous literature, which reported that knowledge has a positive effect on intention and adherence behaviour of women living with HIV towards cervical cancer screening (Wong et al, 2018). Gu et al's (2012) study highlighted the important role of organised health-examination programmes in facilitating screening among the Chinese women population, with 90% of women reporting that their screening was part of a free programme.…”

Assessing the Acceptability of Home-Based HPV Self-Sampling: A Qualitative Study on Cervical Cancer Screening Conducted in Reunion Island Prior to the RESISTE Trial

“…A discrepancy between the acceptability of self-sampling and a lack of confidence to perform it has been described in prior studies on the acceptability of CC self-sampling among women living with HIV in Côte d'Ivoire, Kenya and Rwanda [39][40][41].…”