Wigfall Lisa T, Bynum Shalanda A, Brandt Heather M, Friedman Daniela B, Bond Sharon M, Lazenby Gweneth B, Richter Donna L, Glover Saundra H, Hébert James R
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA,
J Cancer Educ. 2015 Jun;30(2):213-9. doi: 10.1007/s13187-014-0688-9.
Cervical cancer prevention knowledge deficits persist among women living with HIV/AIDS (WLHA) despite increased risk of developing cervical dysplasia/cancer. We examined associations between WLHA's cervical cancer prevention knowledge and abnormal Pap test history. We recruited 145 urban and rural WLHA from Ryan White-funded clinics and AIDS service organizations located in the southeastern USA between March 2011 and April 2012. For this analysis, women who reported a history of cervical cancer (n = 3) or had a complete hysterectomy (n = 14) and observations with missing data (n = 22) were excluded. Stata/IC 13 was used to perform cross-tabulations and chi-squared tests. Our sample included 106 predominantly non-Hispanic Black (92%) WLHA. Mean age was 46.3 ± 10.9 years. Half (50%) had ≤ high school education. One third (37%) had low health literacy. The majority (83 %) had a Pap test <1 year ago, and 84 % knew that WLHA should have a Pap test every year, once two tests are normal. Many (68%) have had an abnormal Pap test. Abnormal Pap test follow-up care knowledge varied. While 86% knew follow-up care could include a repeat Pap test, only 56% knew this could also include an HPV test. Significantly, more women who had an abnormal Pap test knew follow-up care could include a biopsy (p = 0.001). For WLHA to make informed/shared decisions about their cervical health, they need to be knowledgeable about cervical cancer care options across the cancer control continuum. Providing WLHA with prevention knowledge beyond screening recommendations seems warranted given their increased risk of developing cervical dysplasia/neoplasia.
尽管感染艾滋病毒/艾滋病的女性(WLHA)患宫颈发育异常/癌症的风险增加,但她们对宫颈癌预防知识的欠缺依然存在。我们研究了WLHA的宫颈癌预防知识与巴氏试验异常史之间的关联。2011年3月至2012年4月期间,我们从美国东南部由瑞安·怀特基金资助的诊所和艾滋病服务组织招募了145名城乡WLHA。在本次分析中,排除了报告有宫颈癌病史的女性(n = 3)、已进行全子宫切除术的女性(n = 14)以及有缺失数据的观察对象(n = 22)。使用Stata/IC 13进行交叉制表和卡方检验。我们的样本包括106名主要为非西班牙裔黑人(92%)的WLHA。平均年龄为46.3±10.9岁。一半(50%)的人受教育程度≤高中。三分之一(37%)的人健康素养较低。大多数(83%)在1年前进行过巴氏试验,84%的人知道WLHA在两次巴氏试验结果正常后应每年进行一次巴氏试验。许多人(68%)曾有巴氏试验异常。巴氏试验异常后的后续护理知识各不相同。虽然86%的人知道后续护理可能包括重复巴氏试验,但只有56%的人知道这也可能包括HPV检测。值得注意的是,更多巴氏试验异常的女性知道后续护理可能包括活检(p = 0.001)。为使WLHA能够就其宫颈健康做出明智/共同的决策,她们需要了解癌症控制连续统一体中宫颈癌的护理选择。鉴于WLHA患宫颈发育异常/肿瘤的风险增加,为她们提供超出筛查建议的预防知识似乎是必要的。