Evaluation of human papilloma virus communicative education strategies: A pilot screening study for cervical cancer

Abstract

Background: High-risk human papilloma virus (HR-HPV) is highly prevalent in sexually active men and women; HR-HPV has been classified as a sexually transmitted infection (STI) and as a necessary, but not sufficient, causal agent for cervical cancer. Women who test positive for HPV often experience serious psychosocial consequences such as fear, shame, fatalism and stigmatisation, as the result of popular perceptions of questionable moral and sexual conduct. To improve this situation, public health sector HPV communication and education strategies need to be improved. Objective: To evaluate the HPV communicative education strategies used in a pilot study for cervical cancer screening in Colombia using the HPV DNA test. Methodology: Analytic, qualitative research involving 10 focus groups (FGs) with women 30–65 years of age, grouped according to their test results (positive or negative) and age (younger or older than 50 years). Women participated in HPV communication and educational activities which included radio announcements, cartoon novel story books, flip charts and face-to-face communication. Content analysis of FGs discussions was conducted. Results: After participating in HPV communication and education activities, women were unable to differentiate clearly between infection and disease. HPV-negative women classified HPV as dangerous, primarily due to the vaccine communication strategies. The most remembered media were the cartoon novel story books, from which women were able to recall more details about the love story content than about the natural history of HPV. HPV-positive women felt afraid and fatalistic regarding their own HPV infection; face-to-face communication alleviated their anxiety and helped them recognise an HPV-positive report as good news. Conclusion: High-quality HPV vaccine communication strategies need to be implemented alongside screening messages. Face-to-face communication proved to be the most effective strategy for reducing the burden of stigmatisation among HPV-positive women, but timing is an essential component of communication.