Changes in knowledge of cervical cancer prevention and human papillomavirus among women with human immunodeficiency virus.

Massad LS, Evans CT, Weber KM, Goderre JL, Hessol NA, Henry D, Colie C, Strickler HD, Watts DH, Wilson TE. Changes in knowledge of cervical cancer prevention and human papillomavirus among women with human immunodeficiency virus. Obstetrics and gynecology. 2010 Oct 1; 116(4):941-7.

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Abstract:

OBJECTIVE: To estimate changes in high-risk women''s knowledge of cervical cancer prevention, human papillomavirus (HPV), and HPV vaccination since introduction and marketing of HPV vaccines. METHODS: At study visits in 2007 and 2008-2009, women with the human immunodeficiency virus (HIV) and at-risk comparison women in a multicenter U.S. cohort study completed 44-item self-report questionnaires exploring their knowledge of cervical cancer prevention, HPV, and HPV vaccination. Results from 2007 were compared with those obtained in 2008-2009. Knowledge scores were correlated with demographic variables, measures of education and attention, and medical factors. Significant associations were assessed in multivariable models. RESULTS: HIV-seropositive women had higher knowledge scores than seronegative women at baseline (13.2 ± 5.7 compared with 11.8 ± 6.0, P < .001) and follow-up (14.1 ± 5.3 compared with 13.2 ± 5.5, P = .01), but the change in scores was similar (0.9 ± 5.3 compared with 1.5 ± 5.5, P = .13). Knowledge that cervical cancer is caused by a virus rose significantly (P = .005), but only to 24%. Belief that cervical cancer is preventable only rose from 52% to 55% (P = .04), but more than 90% of women in both periods believed regular Pap testing was important. In analysis of covariance models, higher baseline score, younger age, higher education level, higher income, and former- as opposed to never-drug users, but not HIV status, were associated with improved knowledge. CONCLUSION: High-risk women''s understanding of cervical cancer and HPV has improved, but gaps remain. Improvement has been weakest for less educated and lower-income women. LEVEL OF EVIDENCE: II.