ASPO Abstracts

Assessing acceptance of system-level intervention strategies to increase cervical cancer screening and follow up among women living with HIV

Authors: Rodriguez SA, Gonzalez C, Lee SC, Tiro JA

Category: Behavioral Science & Health Communication
Conference Year: 2020

Abstract Body:
Purpose: Women living with HIV (WLWH) are at increased risk of cervical cancer compared to women without HIV. Previous research revealed inadequate screening (53%) within 12 months and follow-up (42%) within six months among WLWH accessing care in our integrated safety-net healthcare system. This study aimed to obtain patient feedback on 1) the acceptability of system-level interventions (e.g., intensified appointment reminders, patient navigation) aimed at increasing cervical cancer screening and follow-up, and 2) educational messages targeting WLWH. Methods: We utilized our PROPSR cohort database to identify eligible participants. We conducted N=11 semi- structured interviews with WLWH accessing care in our safety-net healthcare system. Interviews were audio- recorded, transcribed, and double-coded using an iterative deductive-inductive approach. Results: Patient recruitment was challenging. Among the 99 eligible women, 24 interviews were scheduled with 13 no-shows. Overall, response rate was 11%. All participants were receptive to intensified appointment reminders via letters and phone calls. Some felt that a text message may be inappropriate due to privacy concerns. All participants felt that a patient navigator would be an important intervention component to improve outreach. Most participants felt educational messages that incorporated statistics and medical information were more impactful to raise perceived risk than short motivational slogans. Two themes emerged inductively. First, most patients spoke about the importance of women taking care of themselves so they may take care of family members. Participants suggested this theme be incorporated into broader messaging relayed through letters, phone calls, and educational materials. Second, women discussed the theme of community. Multiple participants suggested a group for WLWH to come together to discuss health issues including cervical cancer screening. Conclusions: Two important themes emerged from our interviews with patients that were not originally included in the proposed interventions or educational messages. Patient perspectives and feedback are critical to designing patient-centered interventions for increasing cervical cancer screening and follow up.

Keywords: Key words: women with HIV; cervical cancer screening