"My husband says this: If you are alive, you can be someone…": Facilitators and barriers to cervical cancer screening among women living with HIV in India

Cancer Causes Control. 2019 Apr;30(4):365-374. doi: 10.1007/s10552-019-01145-7. Epub 2019 Feb 26.


Purpose: Women living with human immunodeficiency virus (WLWH) have a higher risk of cervical cancer than women without HIV. In addition, women in India experience a high burden of death from cervical cancer. This qualitative study evaluated individual and interpersonal factors influencing cervical cancer screening among WLWH in Surat, India.

Methods: In-depth interviews were conducted with 25 WLWH and 15 stakeholders in Surat, India. Data were analyzed using directed content analysis to identify individual and intrapersonal barriers and facilitators.

Results: WLWH lacked knowledge and reported being afraid of cervical cancer and cervical cancer screening but were interested in learning more about it. Interpersonal factors influencing cervical cancer screening included receipt or lack of instrumental and emotional family support, interactions with healthcare providers, and receipt or lack of information about cervical cancer and the Pap test from healthcare providers.

Conclusion: Widespread public education is necessary to increase awareness of cervical cancer and cervical cancer screening and to encourage family members to support women who wish to obtain screening. Patient- and provider-focused interventions may facilitate the process of providing cervical cancer care to WLWH who are obtaining care in busy public healthcare systems in India.

Keywords: Early detection of cancer; HIV; Papanicolaou test; Papillomavirus infections; Qualitative research; Uterine cervical neoplasms.

MeSH terms

  • Adult
  • Early Detection of Cancer / psychology
  • Female
  • HIV Infections / complications*
  • Humans
  • India
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Papanicolaou Test / psychology
  • Spouses
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears / psychology