Knowledge and Acceptability of Pap Smears, Self-Sampling and HPV Vaccination among Adult Women in Kenya
Identifieur interne : 003326 ( Main/Merge ); précédent : 003325; suivant : 003327Knowledge and Acceptability of Pap Smears, Self-Sampling and HPV Vaccination among Adult Women in Kenya
Auteurs : Anne F. Rositch [États-Unis] ; Ann Gatuguta [Kenya] ; Robert Y. Choi [États-Unis] ; Brandon L. Guthrie [États-Unis] ; Romel D. Mackelprang [États-Unis] ; Rose Bosire [Kenya] ; Lucy Manyara [Kenya] ; James N. Kiarie [Kenya] ; Jennifer S. Smith [États-Unis] ; Carey Farquhar [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2012.
Abstract
Our study aimed to assess adult women’s knowledge of human papillomavirus (HPV) and cervical cancer, and characterize their attitudes towards potential screening and prevention strategies.
Women were participants of an HIV-discordant couples cohort in Nairobi, Kenya. An interviewer-administered questionnaire was used to obtain information on sociodemographic status, and sexual and medical history at baseline and on knowledge and attitudes towards Pap smears, self-sampling, and HPV vaccination at study exit.
Only 14% of the 409 women (67% HIV-positive; median age 29 years) had ever had a Pap smear prior to study enrollment and very few women had ever heard of HPV (18%). Although most women knew that Pap smears detect cervical cancer (69%), very few knew that routine Pap screening is the main way to prevent ICC (18%). Most women reported a high level of cultural acceptability for Pap smear screening and a low level of physical discomfort during Pap smear collection. In addition, over 80% of women reported that they would feel comfortable using a self-sampling device (82%) and would prefer at-home sample collection (84%). Nearly all women (94%) reported willingness to be vaccinated to prevent cervical cancer if offered at no or low cost.
These findings highlight the need to educate women on routine use of Pap smears in the prevention of cervical cancer and demonstrate that vaccination and self-sampling would be acceptable modalities for cervical cancer prevention and screening.
Url:
DOI: 10.1371/journal.pone.0040766
PubMed: 22808257
PubMed Central: 3393696
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Rositch</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Gatuguta, Ann" sort="Gatuguta, Ann" uniqKey="Gatuguta A" first="Ann" last="Gatuguta">Ann Gatuguta</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Department of Community Health, Kenyatta University, Nairobi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Community Health, Kenyatta University, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Choi, Robert Y" sort="Choi, Robert Y" uniqKey="Choi R" first="Robert Y." last="Choi">Robert Y. Choi</name><affiliation wicri:level="4"><nlm:aff id="aff3"><addr-line>Department of Medicine, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Guthrie, Brandon L" sort="Guthrie, Brandon L" uniqKey="Guthrie B" first="Brandon L." last="Guthrie">Brandon L. Guthrie</name><affiliation wicri:level="4"><nlm:aff id="aff4"><addr-line>Department of Epidemiology, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Mackelprang, Romel D" sort="Mackelprang, Romel D" uniqKey="Mackelprang R" first="Romel D." last="Mackelprang">Romel D. Mackelprang</name><affiliation wicri:level="4"><nlm:aff id="aff4"><addr-line>Department of Epidemiology, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff5"><addr-line>Department of Global Health, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Global Health, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Bosire, Rose" sort="Bosire, Rose" uniqKey="Bosire R" first="Rose" last="Bosire">Rose Bosire</name><affiliation wicri:level="1"><nlm:aff id="aff6"><addr-line>Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Centre for Public Health Research, Kenya Medical Research Institute, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Manyara, Lucy" sort="Manyara, Lucy" uniqKey="Manyara L" first="Lucy" last="Manyara">Lucy Manyara</name><affiliation wicri:level="1"><nlm:aff id="aff7"><addr-line>Kenya Medical Training College, Nairobi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kenya Medical Training College, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Kiarie, James N" sort="Kiarie, James N" uniqKey="Kiarie J" first="James N." last="Kiarie">James N. Kiarie</name><affiliation wicri:level="1"><nlm:aff id="aff8"><addr-line>Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Obstetrics and Gynecology, University of Nairobi, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Smith, Jennifer S" sort="Smith, Jennifer S" uniqKey="Smith J" first="Jennifer S." last="Smith">Jennifer S. Smith</name><affiliation wicri:level="2"><nlm:aff id="aff9"><addr-line>Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Farquhar, Carey" sort="Farquhar, Carey" uniqKey="Farquhar C" first="Carey" last="Farquhar">Carey Farquhar</name><affiliation wicri:level="4"><nlm:aff id="aff3"><addr-line>Department of Medicine, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff4"><addr-line>Department of Epidemiology, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff5"><addr-line>Department of Global Health, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Global Health, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>Our study aimed to assess adult women’s knowledge of human papillomavirus (HPV) and cervical cancer, and characterize their attitudes towards potential screening and prevention strategies.</p></sec><sec><title>Methods</title><p>Women were participants of an HIV-discordant couples cohort in Nairobi, Kenya. An interviewer-administered questionnaire was used to obtain information on sociodemographic status, and sexual and medical history at baseline and on knowledge and attitudes towards Pap smears, self-sampling, and HPV vaccination at study exit.</p></sec><sec><title>Results</title><p>Only 14% of the 409 women (67% HIV-positive; median age 29 years) had ever had a Pap smear prior to study enrollment and very few women had ever heard of HPV (18%). Although most women knew that Pap smears detect cervical cancer (69%), very few knew that routine Pap screening is the main way to prevent ICC (18%). Most women reported a high level of cultural acceptability for Pap smear screening and a low level of physical discomfort during Pap smear collection. In addition, over 80% of women reported that they would feel comfortable using a self-sampling device (82%) and would prefer at-home sample collection (84%). Nearly all women (94%) reported willingness to be vaccinated to prevent cervical cancer if offered at no or low cost.</p></sec><sec><title>Conclusions</title><p>These findings highlight the need to educate women on routine use of Pap smears in the prevention of cervical cancer and demonstrate that vaccination and self-sampling would be acceptable modalities for cervical cancer prevention and screening.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Walboomers, Jm" uniqKey="Walboomers J">JM Walboomers</name></author><author><name sortKey="Jacobs, Mv" uniqKey="Jacobs M">MV Jacobs</name></author><author><name sortKey="Manos, Mm" uniqKey="Manos M">MM Manos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Smith, Js" uniqKey="Smith J">JS Smith</name></author><author><name sortKey="Lindsay, L" uniqKey="Lindsay L">L Lindsay</name></author><author><name sortKey="Hoots, B" 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