Abstract
BackgroundTo be effective, population-based cervical cancer prevention programs must be tailored to meet the needs of the target population. One important factor in cervical cancer screening may include male involvement. To iteratively improve a screening program employing self-collected vaginal swabs for human-papillomavirus (HPV) testing in western Kenya, we examined the role of male partners and community leaders in decision-making and accessing screening services.MethodsWe carried out 604 semi-structured, in-depth interviews (IDIs) with women and community health volunteers who took part in a multiphase trial of implementation strategies for HPV-based cervical cancer screening. IDIs were coded and themes related to decision-making, screening and treatment barriers, and influence of male partners and community leaders were identified and analyzed.ResultsWomen experienced both support and opposition from their male partners. Partner support took the form of financial support for transportation and emotional support and encouragement, while opposition ranged from anticipated negative reactions to lack of permission, isolation, and abandonment. Though most women described their own partners as supportive, many felt that other male partners would not be supportive. Most participants believed that increased HPV and cervical cancer knowledge would increase partner support. Women reported a general acceptance of involvement of community leaders in education and screening campaigns, in a setting where such leaders may hold influence over men in the community.ConclusionThere was a clear interest in involving male partners in the cervical cancer prevention process, specifically in increasing knowledge and awareness. Future research should explore the feasibility and effectiveness of engaging male partners in cervical cancer screening and prevention programs.
Highlights
To be effective, population-based cervical cancer prevention programs must be tailored to meet the needs of the target population
Given the gap in research and the known benefits of male involvement in other sexual and reproductive health (SRH) issues, we explored the perceptions of women who participated in a cervical cancer prevention study in order to (1) identify key themes to inform the development of a cervical cancer prevention specific framework for male involvement and (2) identify key characteristics that may inform a more standard definition of “male involvement” with respect to HPV/cervical cancer prevention, including where men should be included in the process
The in-depth interviews (IDIs) were composed of four categories; (1) women that participated in the outreach and education campaign (n = 120), (2) women that were screened (n = 111), (3) women that received treatment (n = 283), (4) women that were considered non-adherent or lost to follow-up (LTFU) because they did not seek treatment at the county hospital within 60 days of receiving their results(n = 72)
Summary
Population-based cervical cancer prevention programs must be tailored to meet the needs of the target population. As programs are implemented in settings with limited health care infrastructure, there may be logistical barriers such as limited access to health facilities, costs, or a shortage of trained professionals Compounding these challenges to access, population risk perception and screening knowledge is low in many areas [3, 4]. Studies have shown that educational interventions and community based cervical cancer prevention campaigns can increase knowledge and uptake of screening and treatment services [4, 5]. In such settings, low uptake, despite educational interventions and community-based screening, suggests that additional psychological, social or interpersonal barriers may prevent women in LMICs from accessing care
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