Wong J P H, Vahabi M, Miholjcic J, Tan V, Owino M, Li A T W, Poon M K L
Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON.
Committee for Accessible aids Treatment, Toronto, ON.
Curr Oncol. 2018 Feb;25(1):e73-e82. doi: 10.3747/co.25.3855. Epub 2018 Feb 28.
Cervical cancer rates are disproportionately high among women living with the human immunodeficiency virus (wlhiv). Cervical cancer is preventable through hpv screening, regular Pap tests, and early cancer detection. Evidence indicates that hpv and cervical cancer screening are suboptimal among wlhiv, who face a myriad of access barriers. Considering that screening is an effective first-line defense to cervical cancer, we conducted a scoping review with the aim of gaining a better understanding about: (1) the knowledge and perceptions of hpv and cervical cancer screening among wlhiv; and (2) the acceptability of self-sampling for hpv among wlhiv. We searched five electronic databases for peer-reviewed articles that were published in English within the last ten years, reported on studies with hiv-positive women who were aged 16 or older, and satisfied the topics of the review. A total of 621 articles were found. After accounting for duplicates and unmet criteria, 17 articles and 1 abstract, reporting on studies in the United States and Africa, were included in this review. The review highlighted that most wlhiv had inadequate knowledge of hpv transmission and cervical cancer prevention, which influenced their perceptions of risk and susceptibility. Screening barriers included misconceptions about Pap tests, fear of diagnosis of serious illness, perceived pain, embarrassment, bodily modesty, and limited access to female health care providers. This review also affirms that self-sampling is an acceptable and promising screening option for wlhiv. Implications for policy, research, and practice are discussed.
在感染人类免疫缺陷病毒(HIV)的女性中,宫颈癌发病率异常高。宫颈癌可通过HPV筛查、定期巴氏试验和早期癌症检测来预防。有证据表明,在面临众多获取障碍的感染HIV的女性中,HPV和宫颈癌筛查情况并不理想。鉴于筛查是预防宫颈癌的有效一线防御措施,我们进行了一项范围综述,目的是更好地了解:(1)感染HIV的女性对HPV和宫颈癌筛查的知识与认知;(2)感染HIV的女性对HPV自我采样的接受程度。我们在五个电子数据库中搜索了过去十年内以英文发表的同行评审文章,这些文章报道了针对16岁及以上HIV阳性女性的研究,且符合综述主题。共找到621篇文章。在排除重复文章和不符合标准的文章后,本综述纳入了17篇文章和1篇摘要,这些文章报道了在美国和非洲开展的研究。该综述强调,大多数感染HIV的女性对HPV传播和宫颈癌预防的知识不足,这影响了她们对风险和易感性的认知。筛查障碍包括对巴氏试验的误解、对严重疾病诊断的恐惧、感知到的疼痛、尴尬、身体隐私观念以及获得女性医疗服务提供者的机会有限。本综述还证实,自我采样对感染HIV的女性来说是一种可接受且有前景的筛查选择。文中讨论了对政策、研究和实践的启示。