"This is Really Something: Same Place, Same Day Result, Same Day Treatment" Women's Experiences of Testing Positive for HPV and Receiving Same-day Treatment in Papua New Guinea: an Interpretative Phenomenological Analysis

Overview

Journal BMC Womens Health

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2023 Aug 18

PMID 37596636

Authors

Hawa Camara

Somu Nosi

Gloria Munnull

Steven G Badman

John Bolgna

Joseph Kuk

Glen Dl Mola

Rebecca Guy

Andrew J Vallely

Angela Kelly-Hanku

Affiliations

Soon will be listed here.

Abstract

Introduction: Human papillomavirus (HPV) testing is transforming cervical screening globally. The World Health Organization (WHO) now recommends same-day HPV screen-and-treat for primary cervical screening in low- and middle-income countries (LMIC) but there is a lack of evidence on women's lived experience of testing positive for oncogenic HPV and receiving same-day treatment. This study aimed to address this knowledge gap among women participating in a same-day HPV screen-and-treat (HPV S&T) program in Papua New Guinea.

Methods: As part of a larger qualitative study, this paper explores the lived experiences of 26 women who tested positive for oncogenic HPV and were treated the same day. We analysed the data using the interpretative phenomenological analysis method. All data were managed using Nvivo 12.5.

Results: The interpretative phenomenological analysis led to three superordinate themes: 1) facing and alleviating initial worries, (2) transforming the disclosure process, and (3) connecting to their faith. Women's experiences of the same day HPV screen-and-treat were framed by initial emotional reactions to their positive HPV test result, and having access to treatment on the same day, which helped address their worries and fears, and transformed their experience of disclosing their test result and subsequent treatment to family and friends.

Conclusion: This study shows that, while women experience similar initial emotional reactions, undergoing same day treatment quickly resolved the women's worries, making this program highly acceptable. Overall, women's engagement in the program confirmed its high acceptability and cultural congruence, leaving women feeling empowered and hopeful about their future, and the future of all Papua New Guinea women.

References

Arbyn M, Smith S, Temin S, Sultana F, Castle P . Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018; 363:k4823. PMC: 6278587. DOI: 10.1136/bmj.k4823. View

Vallely A, Tollman P . Health service delivery models for scaling use of point-of-care HPV 'test and treat' strategies in high-burden, low-income settings. J Virus Erad. 2019; 5(Suppl 1):1-3. PMC: 6428153. View

Kelly-Hanku A, Aggleton P, Shih P . 'We call it a virus but I want to say it's the devil inside': redemption, moral reform and relationships with God among people living with HIV in Papua New Guinea. Soc Sci Med. 2014; 119:106-13. DOI: 10.1016/j.socscimed.2014.08.020. View

Roura M, Urassa M, Busza J, Mbata D, Wringe A, Zaba B . Scaling up stigma? The effects of antiretroviral roll-out on stigma and HIV testing. Early evidence from rural Tanzania. Sex Transm Infect. 2008; 85(4):308-12. PMC: 2708343. DOI: 10.1136/sti.2008.033183. View

Vallely A, Mola G, Kaldor J . Achieving control of cervical cancer in Papua New Guinea: what are the research and program priorities?. P N G Med J. 2014; 54(3-4):83-90. View

Tsai A, Bangsberg D, Bwana M, Haberer J, Frongillo E, Muzoora C . How does antiretroviral treatment attenuate the stigma of HIV? Evidence from a cohort study in rural Uganda. AIDS Behav. 2013; 17(8):2725-31. PMC: 3773278. DOI: 10.1007/s10461-013-0503-3. View

Qaderi K, Mirmolaei S, Geranmayeh M, Farnam F, Hasani S . 'Does HPV affect my fertility?' Reproductive concerns of HPV-positive women: a qualitative study. Reprod Health. 2021; 18(1):72. PMC: 8017806. DOI: 10.1186/s12978-021-01126-7. View

Patel H, Moss E, Sherman S . HPV primary cervical screening in England: Women's awareness and attitudes. Psychooncology. 2018; 27(6):1559-1564. DOI: 10.1002/pon.4694. View

Monsonego J, Cortes J, da Silva D, Jorge A, Klein P . Psychological impact, support and information needs for women with an abnormal Pap smear: comparative results of a questionnaire in three European countries. BMC Womens Health. 2011; 11:18. PMC: 3123641. DOI: 10.1186/1472-6874-11-18. View

10.

Sundstrom B, Smith E, Delay C, Luque J, Davila C, Feder B . A reproductive justice approach to understanding women's experiences with HPV and cervical cancer prevention. Soc Sci Med. 2019; 232:289-297. DOI: 10.1016/j.socscimed.2019.05.010. View

11.

Persson A, Kelly-Hanku A, Bell S, Mek A, Worth H, Nake Trumb R . "Vibrant Entanglements": HIV Biomedicine and Serodiscordant Couples in Papua New Guinea. Med Anthropol. 2018; 38(3):267-281. DOI: 10.1080/01459740.2018.1530670. View

12.

McBride E, Tatar O, Rosberger Z, Rockliffe L, Marlow L, Moss-Morris R . Emotional response to testing positive for human papillomavirus at cervical cancer screening: a mixed method systematic review with meta-analysis. Health Psychol Rev. 2020; 15(3):395-429. DOI: 10.1080/17437199.2020.1762106. View

13.

Rubin M, Tripsas C . Perceived uncertainty, coping strategies, and adaptation in women with human papillomavirus on pap smear. J Low Genit Tract Dis. 2010; 14(2):81-9. DOI: 10.1097/LGT.0b013e3181c945d6. View

14.

Woo Y, Gravitt P, Khor S, Ng C, Saville M . Accelerating action on cervical screening in lower- and middle-income countries (LMICs) post COVID-19 era. Prev Med. 2021; 144:106294. PMC: 7931730. DOI: 10.1016/j.ypmed.2020.106294. View

15.

Kelly-Hanku A, Aggleton P, Shih P . I shouldn't talk of medicine only: Biomedical and religious frameworks for understanding antiretroviral therapies, their invention and their effects. Glob Public Health. 2017; 13(10):1454-1467. DOI: 10.1080/17441692.2017.1377746. View

16.

Toliman P, Badman S, Gabuzzi J, Silim S, Forereme L, Kumbia A . Field Evaluation of Xpert HPV Point-of-Care Test for Detection of Human Papillomavirus Infection by Use of Self-Collected Vaginal and Clinician-Collected Cervical Specimens. J Clin Microbiol. 2016; 54(7):1734-1737. PMC: 4922075. DOI: 10.1128/JCM.00529-16. View

17.

Camara H, Nosi S, Munnull G, Badman S, Bolgna J, Kuk J . Women's acceptability of a self-collect HPV same-day screen-and-treat program in a high burden setting in the Pacific. BMC Health Serv Res. 2022; 22(1):1514. PMC: 9746197. DOI: 10.1186/s12913-022-08842-1. View

18.

DiStefano A, Hui B, Barrera-Ng A, Quitugua L, Peters R, Dimaculangan J . Contextualization of HIV and HPV risk and prevention among Pacific Islander young adults in Southern California. Soc Sci Med. 2012; 75(4):699-708. PMC: 3383406. DOI: 10.1016/j.socscimed.2012.04.011. View

19.

Smith R, Hernandez R, Catona D . Investigating Initial Disclosures and Reactions to Unexpected, Positive HPV Diagnosis. West J Commun. 2015; 78(4):426-440. PMC: 4309010. DOI: 10.1080/10570314.2013.786120. View

20.

Zuch M, Lurie M . 'A virus and nothing else': the effect of ART on HIV-related stigma in rural South Africa. AIDS Behav. 2011; 16(3):564-70. DOI: 10.1007/s10461-011-0089-6. View