Abstract
BackgroundMale spouses and partners play an important role in determining a woman’s willingness to participate in cervical cancer screening. However, the attitudes and behaviors by which they influence a woman’s decision to undergo Pap testing remain poorly understood.MethodsA series of semi-structured, qualitative interviews were conducted in Spanish with 19 recent Latino immigrants in Houston, Texas. The interview format was designed to establish each individual’s pattern of engagement with the United States healthcare system, assess baseline knowledge of cervical cancer screening and evaluate attitudes and patterns of communication with their female partners regarding health care. Interview questions were constructed using principles of the Theory of Reasoned Action. All interviews were conducted in Spanish. After translation, responses were coded and scored with the goal of identifying themes and key observations.ResultsMost subjects reported few, if any, interactions with the healthcare system since their arrival in the United States. Although most participants reported being aware that women should be seen by their doctors regularly, fewer than half could clearly indicate the purpose of a Pap test or could state with certainty the last time their female partner had undergone screening. Multiple subjects expressed a general distrust of the health care system and concern for its costs. Approximately half of subjects reported that they accompanied their female partner to the health care provider’s office and none of the participants reported that they were present in examination rooms at the time their partner underwent screening. Multiple participants endorsed that there may be some concerns within their community regarding women receiving frequent gynecologic care and distrust of the healthcare system. Almost all interviewed subjects stated that while they would allow their female partners to see male physicians, they also expressed the opinion that other men might be uncomfortable with this and that women would likely be more comfortable with female physicians.ConclusionsStrategies to enhance knowledge of HPV and cancer screening and improve trust in the health care system among male spouses or partners should be explored with the goal of promoting cervical cancer screening among immigrant Latinx populations.
Highlights
Male spouses and partners play an important role in determining a woman’s willingness to participate in cervical cancer screening
All subjects reported that they had immigrated to the United States from Spanish-speaking countries in North, Central, or South America
Patterns of subject interaction with the healthcare system Less than half of the participants indicated that they saw a doctor regularly themselves, and almost all of these saw their doctor every 6 to 12 months
Summary
Male spouses and partners play an important role in determining a woman’s willingness to participate in cervical cancer screening. The World Health Organization (WHO) estimates that 570,000 new cases of cervical cancer were diagnosed in 2018 and that 311,000 women died from this disease [1]. The incidence of cervical cancer in the U.S is significantly higher among Hispanic, American Indian, and non-Hispanic African American patients than their non-Hispanic White and Asian counterparts [2]. Hispanic women, those who born outside the U.S, are generally diagnosed with cervical cancer at later stages, and experience greater mortality from this disease than others [3, 4]. Multiple factors potentially account for this health disparity, including lower rates of cervical cancer screening among recent immigrants, difficulty accessing appropriate care, language barriers and rates of acculturation [5, 6]
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