Center for Global Reproductive Health, Duke Global Health Institute, Durham, North Carolina, USA
Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA.
BMJ Open. 2019 Jul 24;9(7):e028669. doi: 10.1136/bmjopen-2018-028669.
We sought to understand the beliefs, social norms and logistical factors that affect human papillomavirus (HPV)-positive women's uptake of cryotherapy treatment as part of a two-part cervical cancer screening strategy in rural Kenya.
In-depth interviews within a parent cluster-randomised trial.
Government-run county hospital in western Kenya.
273 of 372 (73.4%) HPV-positive women who underwent cryotherapy RESULTS: Many women feared that an HPV infection meant they would develop cancer. Almost all women reported initial fear of the treatment procedure, followed by a more positive experience than anticipated. Lacking funds for transportation to the treatment site was the most common barrier. Women felt that decentralised treatment would be the most important facilitator of greater access. Spousal encouragement and financial support were key facilitators of treatment access, however many women felt that other husbands in the community would not be supportive. Women described successfully acquiring treatment as empowering, and almost all would recommend seeking cryotherapy to other women who test HPV-positive. Most felt eager to share their own experiences with others to encourage treatment.
The main facilitators of treatment access were understanding of the health risks and sense of empowerment. A decentralised treatment model or transportation support may facilitate access, along with improved health messaging about HPV infection, cancer and the treatment process. Focusing on women's personal feelings of empowerment may further improve uptake and satisfaction. These data will be used to design a strategy to improve linkage to treatment.
NCT02124252.
我们旨在了解信念、社会规范和后勤因素，这些因素影响人乳头瘤病毒（HPV）阳性妇女接受冷冻治疗作为肯尼亚农村地区两步式宫颈癌筛查策略的一部分。
在一项父母集群随机试验中进行深入访谈。
肯尼亚西部政府经营的县医院。
372 名 HPV 阳性妇女中接受冷冻治疗的 273 名（73.4%）。
许多妇女担心 HPV 感染意味着她们会患上癌症。几乎所有妇女都报告说最初对治疗过程感到恐惧，然后体验到比预期更积极的结果。缺乏前往治疗地点的交通资金是最常见的障碍。妇女认为分散治疗将是促进更多获得治疗机会的最重要因素。配偶的鼓励和经济支持是治疗获得的关键因素，但许多妇女认为社区中的其他丈夫不会支持。妇女描述成功获得治疗是赋权的，几乎所有妇女都会向其他 HPV 阳性妇女推荐冷冻治疗。大多数妇女渴望与他人分享自己的经验，以鼓励治疗。
治疗机会的主要促进因素是对健康风险的理解和赋权感。分散治疗模式或交通支持可能会促进获得治疗的机会，同时改善有关 HPV 感染、癌症和治疗过程的健康信息传递。关注妇女个人的赋权感可能会进一步提高参与度和满意度。这些数据将用于设计一项改善治疗联系的策略。
NCT02124252。
