Using the Health Belief Model to understand women's perception regarding HPV, CC, and Pap triage in Argentina

SANCHEZ ANTELO VICTORIA; KOHLER, RACQUEL E.; PAOLINO MELISA; VISWANATH, KASISOMAYAJULA; ARROSSI SILVINA

Congreso; 33 Conference of the International Papillomavirus Society; 2020

IntroductionCompletion of triage by women with HPV self-collected tests (HPV-SC) is challenging. We analised how women´s knowledge, perception and attitudes related to HPV/cervical cancer (CC) may influence the screening/diagnosis process. This analysis is part of a mix-method study to evaluate the effectiveness/implementation of an mHealth intervention to increase triage adherence among HPV+ women with self-collected tests (ATICA Project). MethodsDuring January 2017, six focus groups (FG) were carried out in the province of Jujuy (n=48 women, both with HPV positive and negative results), stratified by rural/urban residence. Inclusion criteria: being aged ≥30 and having performed HPV-SC. Thematic analysis was carried out using constructs from the Health Belief Model: Perception about HPV risk (susceptibility/severity), benefits/costs of triage, self-efficacy (confidence in ability to perform triage), and cues to action (mobile phone text messages –SMS- as reminders to increase adherence to triage). Results Misinformation regarding HPV and cervical cancer prevention was common. Participants considered that their HPV risk was low and an inevitable part of being a woman; many of them were not aware of the importance of continuing follow-up if HPV+. Comfort and privacy offered by HPV-SC was highlighted as a main benefit. Women had negative views about clinician-collected screening/triage: they rejected the gynecological consultation (“like a torture”), which was also perceived as producing an economic impact (transport/time to attend health centers). Lack of help from family/friends was considered an important obstacle to perform triage. Women highly accepted and valued receiving SMS to be notified about HPV result availability and to remind them about the need to attend the health center for triage if HPV+. No differences were found among rural/urban FG participants. ConclusionsMisinformation about HPV/CC, lack of awareness about the importance of triage, and rejection of the gynecological consultation are obstacles to complete triage. SMS reminders can be useful to increase triage.