“Me sentí enfermar”: percepciones y comprensión de las mujeres del resultado positivo de un test de virus del papiloma humano en Jujuy, Argentina

Abstract

Con el objetivo de analizar las percepciones y clasificar las modalidades de comprensión sobre un resultado positivo del test de virus del papiloma humano (VPH+), en 2016 realizamos 38 entrevistas en profundidad a mujeres con diagnóstico de VPH+ (prueba de Papanicolaou normal y anormal), realizado en el sistema público de salud de Jujuy. Se elaboró una tipología que delimita perfiles de mujeres en función del tipo de comprensión del resultado: 1) comprensión; 2) no-comprensión, a) subestimación, b) sobreestimación, y c) confusión. Entre aquellas que no comprendían, las entrevistadas que confundían el resultado relataron percepciones contradictorias con relación al VPH y su gravedad; quienes lo subestimaban tendían a mencionar ausencia de síntomas y a expresar escasa preocupación; mientras que aquellas que lo sobreestimaban se consideraban enfermas y expresaban preocupación, relato de una ruptura biográfica y dolores físicos. Los hallazgos confirman la necesidad de mejorar los mecanismos de entrega e información sobre los resultados para disminuir el impacto psicosocial en las mujeres y aumentar la adherencia al seguimiento sugerido.

Ten Steps to Design a Counseling App to Reduce the Psychosocial Impact of Human Papillomavirus Testing on the Basis of a User-Centered Design Approach in a Low- and Middle-Income Setting

“…For that, we reanalyzed qualitative data obtained in previous studies by our research team, which allowed us to make reinterpretations considering new research questions. 32 We examined three different corpora of data: first, from interviews carried out in 2012 among women age 18-55 years in the province of Buenos Aires who had abnormal Pap smear results (n = 30) 33,34 ; second, from interviews (n = 38) conducted among HPV-tested women in 2013 in the province of Jujuy 7,14 ; and finally, data from six FGs carried out in Jujuy with women age 30 years or older (n = 48) who had performed HPV self-collection in 2016-2017. 35 On the basis of Health Belief Model and Integrative Behavioral Model, we classified data into the following themes: knowledge, attitudes, beliefs, perceived barriers, perceived self-efficacy, and cues to adhere to follow-up.…”

“…This turned out to be the organizing axis of the design, and it became a prominent element in the different screens. 29 Studies carried out in several rural and urban settings from Argentina 7,14,33 and Latin America and among Hispanic women from the United States [39][40][41] found similar information needs. Therefore, our IA on the basis of the information needs and psychosocial concerns of urban women from Argentina might be also usable in other regional contexts, whether rural or urban.…”

“…HPV positivity can also produce anxiety, fear of cancer or death, and disease denial. [5][6][7] The HPV psychosocial impact might not only diminish women's quality of life but also reduce their ability to complete diagnosis and treatment. 8 Providing information that meets women's needs and counseling are key in alleviating HPV-related distress and its possible impact on adherence to follow-up.…”

“…HPV positivity can also produce anxiety, fear of cancer or death, and disease denial. 5 - 7 The HPV psychosocial impact might not only diminish women's quality of life but also reduce their ability to complete diagnosis and treatment. 8 …”

“…"There are women who for example forget to do medical checkups…The CHW is for that… they are sometimes for that, they are mostly …If you forget to do it, they knock on your door …"35 Abbreviations: CC, cervical cancer; HPV, human papillomavirus; KABs, knowledge, attitudes, and beliefs.a Reanalysis made from published data 7,14,[33][34][35]. …”