Understanding HPV-positive women’s needs and experiences in relation to patient-provider communication issues: a qualitative study

Abstract

Background HPV testing has been integrated in cervical cancer screening program. Patient-providers relationship is extremely important to improve cervical cancer screening outcomes. This qualitative study aims to understand HPV-positive women’s needs and preferences about HCPs and patient-provider communication based on their experiences of accessing primary and specialized care. Methods We conducted 40 semi-structured interviews with HPV-positive women. Recorded interviews transcribed and analyzed using conventional content analysis approach. Results The analysis of the data led to the extraction of three main categories, including: provider’s communication and counseling skills, commitment to professional principles, and knowledgeable and competent provider. Women needed understandable discussion about HPV, emotional support and acceptance, receiving HPV-related guidance and advice, and some considerations during clinical appointments. Women needed HCPs to treat them respectfully, gently and with non-judgmental attitude. “Precancerous” and “high-risk” words and watching colposcopy monitor during procedure had made women anxious. Weak referral system and limited interactions among gynecologists and other HCPs highlighted by participants. Conclusion The results of this study, based on the experiences and perceptions of HPV women receiving health care, contain messages and practical tips to healthcare providers at the primary and specialized levels of care to facilitate patient-provider communication around HPV. Providers need to approach the discussion of HPV with sensitivity and take individual needs and preferences into account to improve the HPV-positive women’s healthcare experience.

Factors Influencing the Experience of Breast and Cervical Cancer Screening Among Women in Low- and Middle-Income Countries: A Systematic Review

“… 29 A further reason that steered participants to engage with screening were predisposing factors such as genital warts and other health conditions (eg, infertility). 30 , 34 …”

“… 29 , 36 , 40 Counseling was usually delivered verbally, although, in one study, women were shown videos and images and were disturbed by the description of the colposcopy procedure. 34 There was no difference in counseling whether it was conducted by qualified health personnel (eg, nurses, doctors) or trained laywomen (ie, breast health workers). 36 …”

“…Some women felt that they were not allowed to discuss personal concerns about their sexual health because of cultural sensitivities and a lack of privacy when information was being provided to them. 25 , 34 …”

“…Conversely, women in Nepal and Iran described multiple women being examined in the same room with no privacy and being exposed during the testing. 26 , 34 Some Zambian women objected to exposing themselves to the procedure because they deemed it was not culturally acceptable. 40 …”

Primary care Providers’ approaches to cervical cancer screening in Muslim females

“…Suboptimal counseling may be attributed to deficits in clinical knowledge of modes of transmission ( Trucchi et al, 2020 ), the ability to balance time between clinical services and counseling, and providers’ bias toward women’s sexuality overall ( Leung et al, 2019 ). Literature shows that female patients appreciate knowledgeable physicians that tactfully approach HPV counseling and testing ( Qaderi et al, 2021 ), especially females with intersecting marginalized identities such as Muslim women. Educating patients about the modes of transmission and the importance of prevention through safe sex and HPV vaccines can mend some of the medical mistrust marginalized communities feel ( Ho et al, 2021 ).…”