津巴布韦农村地区参与人乳头瘤病毒筛查的 HIV 阳性和 HIV 阴性妇女的宫颈癌筛查知识、态度和实践。
Knowledge, attitudes, and practices of cervical Cancer screening among HIV-positive and HIV-negative women participating in human papillomavirus screening in rural Zimbabwe.
机构信息
Department of Pathology, University of Wisconsin, 600 Highlands Ave, Madison, WI, USA.
Department of Internal Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
出版信息
BMC Womens Health. 2020 Jul 25;20(1):153. doi: 10.1186/s12905-020-01017-2.
BACKGROUND
Women in low- and middle-income countries are at the highest risk of cervical cancer yet have limited access to and participation in cervical cancer screening programs. Integrating self-collected, community-based screening offers a potential primary screening method in areas of limited resources. In this paper, we present a study evaluating knowledge, attitudes, and practices of cervical cancer and Human Papilloma Virus (HPV) in rural Zimbabwe.
METHODS
We performed a community-based cross-sectional knowledge, attitudes and practices of HPV and cervical cancer study in rural Zimbabwe from January 2017-May 2017. Women were selected for the study via random number generation from complete lists of inhabitants in the study area if they satisfied the inclusion criteria (≥30-years-old, ≤65-years-old, not pregnant, intact uterus). If selected, they participated in a 19-question structured knowledge, attitudes and practices survey. The questionnaire included questions on demographics, education, knowledge of HPV, cervical cancer, and risk factors. Chi-squared tests were evaluated comparing knowledge, attitudes and practices relating to HPV and cervical cancer screening with actual infection with HPV. Women were also offered a voluntary HIV and self-collected HPV screening.
RESULTS
Six hundred seventy-nine women were included in the knowledge, attitudes and practices survey. Most women (81%) had heard of cervical cancer while the majority had not heard of HPV (12%). The number of women that had been screened previously for cervical cancer was low (5%). There were no significant differences between and within groups regarding knowledge of cervical cancer and actual overall infection with HR-HPV, HPV 16, and HPV 18/45 test results.
CONCLUSIONS
Most women in rural Zimbabwe have heard of cervical cancer, but the number that had been screened was low. Extending existing outreach services to include cervical cancer screening, potentially including HPV screening, should include cervical cancer/HPV education and screening triage. This approach would serve to bridge the gap between knowledge and screening availability to address some of the barriers to cervical cancer care still affecting women in many regions of the world.
背景
中低收入国家的女性面临着最高的宫颈癌风险，但获得和参与宫颈癌筛查计划的机会有限。在资源有限的地区，采用自我采集、社区为基础的筛查方法可能是一种初步筛查方法。本文介绍了一项在津巴布韦农村地区评估宫颈癌和人乳头瘤病毒（HPV）的知识、态度和实践的研究。
方法
我们于 2017 年 1 月至 5 月在津巴布韦农村地区进行了一项基于社区的 HPV 和宫颈癌知识、态度和实践的横断面研究。如果符合纳入标准（≥30 岁，≤65 岁，未怀孕，子宫完整），通过在研究区域居民的完整名单中随机生成数字选择妇女参加研究。如果被选中，她们会参与一个包含 19 个问题的结构化知识、态度和实践调查。问卷包括人口统计学、教育、HPV、宫颈癌和危险因素方面的问题。用卡方检验比较了与 HPV 和宫颈癌筛查相关的知识、态度和实践与 HPV 实际感染之间的关系。还为女性提供了自愿的 HIV 和自我采集的 HPV 筛查。
结果
共有 679 名妇女参加了知识、态度和实践调查。大多数妇女（81%）听说过宫颈癌，而大多数妇女（12%）没有听说过 HPV。以前接受过宫颈癌筛查的妇女人数较少（5%）。在宫颈癌和 HR-HPV、HPV 16 和 HPV 18/45 检测结果的总体感染方面，组内和组间没有显著差异。
结论
津巴布韦农村地区的大多数妇女听说过宫颈癌，但接受过筛查的人数较少。扩大现有外展服务，包括宫颈癌筛查，可能包括 HPV 筛查，应包括宫颈癌/HPV 教育和筛查分诊。这种方法将有助于弥合知识和筛查之间的差距，为解决许多地区的宫颈癌护理仍然影响到的一些妇女面临的障碍提供服务。
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