Abstract
BackgroundIn Malawi, numerous barriers may prevent women from accessing cervical cancer screening services — including social factors such as male partner involvement. We conducted surveys that included open- and closed-ended questions with married Malawian men to evaluate their knowledge and beliefs about cervical cancer.MethodsHIV-positive adult (≥18 years) men (married or in a stable relationship) were recruited from an antiretroviral therapy clinic in Lilongwe, Malawi. Men were asked a series of survey questions to assess their knowledge about cervical cancer, experience with cervical cancer, their female partner’s screening history, and their beliefs about gender norms and household decision-making. Following the survey, participants responded to a set of open-ended interview questions about cervical cancer screening, and men’s role in prevention.ResultsOne hundred-twenty men were enrolled with average age 44 years and 55% having completed secondary school or higher education. Despite only moderate knowledge about cervical cancer and screening (average assessment score of 62% correct), all men expressed support of cervical cancer screening, and most (86%) believed they should be involved in their female partner’s decision to be screened. Over half (61%) of men said their female partner had previously been screened for cervical cancer, and this was positively correlated with the male respondent having more progressive gender norms around sexual practices. Some men expressed concerns about the screening process, namely the propriety of vaginal exams when performed by male clinicians, and whether the procedure was painful.ConclusionsMale partners in Malawi want to be involved in decisions about cervical cancer screening, but have limited knowledge about screening, and hold rigid beliefs about gender norms that may affect their support for screening. Messaging campaigns addressing men’s concerns may be instrumental in improving women’s adoption of cervical cancer screening services in Malawi and similar settings.
Highlights
In Malawi, numerous barriers may prevent women from accessing cervical cancer screening services — including social factors such as male partner involvement
Women have reported that their male partners influence cervical cancer screening decisions [13, 18,19,20,21,22,23,24], and the World Health Organization recommends male-targeted outreach as a way to increase cervical cancer screening uptake [25] – very little is known about men’s perspectives on cervical cancer and screening approaches [26]
Of 165 men we approached for potential participation, 125 were eligible for inclusion and willing to participate
Summary
In Malawi, numerous barriers may prevent women from accessing cervical cancer screening services — including social factors such as male partner involvement. The literature on determinants of screening uptake in lower-resource settings has identified important factors including women’s cervical cancer knowledge, perceived efficacy of screening, and beliefs about disease severity and susceptibility [13,14,15,16,17,18]. Men have reported discomfort with male doctors performing exams, concerns about fertility-related complications, and concerns relating to care access ( travel time and cost) [29, 34, 37, 38]. It is unknown if and how men’s cervical cancer knowledge and beliefs affect their partner’s screening behavior
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