Women In Miami Research Articles

Using unsupervised machine learning to classify behavioral risk markers of bacterial vaginosis.

This study used an unsupervised machine learning algorithm, sidClustering and random forests, to identify clusters of risk behaviors of Bacterial Vaginosis (BV), the most common cause of abnormal vaginal discharge linked to STI and HIV acquisition. METHODS: Participants were 391 cisgender women in Miami, Florida, with a mean of 30.8 (SD = 7.81) years of age; 41.7% identified as Hispanic; 41.7% as Black and 44.8% as White. Participants completed measures of demographics, risk behaviors [sexual, medical, and reproductive history, substance use, and intravaginal practices (IVP)], and underwent collection of vaginal samples; 135 behavioral variables were analyzed. BV was diagnosed using Nugent criteria. We identified four clusters, and variables were ranked by importance in distinguishing clusters: Cluster 1: nulliparous women who engaged in IVPs to clean themselves and please sexual partners, and used substances frequently [n = 118 (30.2%)]; Cluster 2: primiparous women who engaged in IVPs using vaginal douches to clean themselves (n = 112 (28.6%)]; Cluster 3: primiparous women who did not use IVPs or substances [n = 87 (22.3%)]; and Cluster 4: nulliparous women who did not use IVPs but used substances [n = 74 (18.9%)]. Clusters were related to BV (p < 0.001). Cluster 2, the cluster of women who used vaginal douches as IVPs, had the highest prevalence of BV (52.7%). Machine learning methods may be particularly useful in identifying specific clusters of high-risk behaviors, in developing interventions intended to reduce BV and IVP, and ultimately in reducing the risk of HIV infection among women.

Cuban American Perspectives on Sexual Dysfunction Following Pelvic Radiotherapy: A Qualitative Study.

Participation in sexual medicine research may depend on a patient's willingness to speak openly about sex, sexual function, or other sensitive topics. These topics may be difficult or uncomfortable to talk about, and this discomfort may be further amplified when a patient comes from a cultural background that stigmatizes open conversation about sex and sexuality. We used qualitative analysis to better understand the intersection between cultural identity, the experience of sexual dysfunction as a side-effect of pelvic radiotherapy, and willingness to communicate about sexual dysfunction with healthcare providers, in Cuban American women in Miami, Florida. Doing so, we found four unique themes among Cuban American participants regarding the intersection of national identity, Hispanic identity, Catholic religion, and their experience of radiotherapy-related sexual dysfunction: Marianismo, Machismo, Familismo, and Espiritismo. These themes, a reflection of the cohort's shared identity, were found to have an effect on participant views of sexual health, romantic relationships, coping strategies, and relative comfort discussing problems with intercourse. These cultural values served as barriers to openly discussing sexual dysfunction with not just medical providers and research teams but also their partners, families, and friends. In order to encourage Cuban American participation in sexual medicine studies, future research should evaluate strategies to overcome these barriers.

PrEP awareness and use among reproductive age women in Miami, Florida.

Miami, Florida is an epicenter of the HIV epidemic in the US, with 20% of new HIV infections occurring in women. Despite effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV, only 10% of eligible women benefit from its use. This study evaluates PrEP awareness and use, and factors associated with PrEP awareness among sexually active women in Miami, Florida. Results reported in this study included cross-sectional data that were collected as part of a baseline visit from a parent study. Cis-gender, HIV-negative, 18-45-year-old, sexually active women were recruited as part of a study evaluating recurrent bacterial vaginosis and HIV risk. Participants completed questionnaires assessing socio-demographics, HIV risk factors, prior history of HIV testing and reproductive tract infections, PrEP awareness and use. Relationships between variables and PrEP awareness were analyzed and multivariable logistic regression identified variables strongly associated with PrEP awareness. Among the 295 women enrolled, median age was 31 (24-38) years, 49% Black, 39% White, and 34% Hispanic. Of 63% who knew about PrEP, only 5% were on PrEP. Women with income below poverty line (OR = 2.00[1.04,3.87];p = 0.04), more male sexual partners in past month (OR = 1.30[1.01,1.68];p = 0.04), lifetime HIV testing (OR = 6.42[2.83,14.52];p<0.01), and current bacterial vaginosis (OR = 2.28[1.18,4.40];p = 0.01) were more likely to be aware of PrEP. Lower odds of PrEP awareness were associated with being Black (OR = 0.38[0.15,0.96];p = 0.04), Hispanic (OR = 0.18[0.08,0.39];p<0.01), heterosexual (OR = 0.29[0.11,0.77];p<0.01), and reporting inconsistent condom use during vaginal sex (OR = 0.21[0.08,0.56];p<0.01). PrEP awareness is low among reproductive age women in a high-risk setting. Culturally tailored interventions are needed to increase PrEP awareness and uptake, especially among Black and Hispanic women with inconsistent condom use during vaginal sex with male partners.

2086. PrEP Knowledge and Use among Reproductive Age Women in Miami, Florida

Abstract Background Miami, FL is the epicenter of the HIV epidemic in the US, with 20% of new HIV infections occurring in women. Despite the effectiveness of PrEP, only 10% of eligible women benefit from its use. This study evaluates PrEP awareness and use, and factors associated with PrEP awareness among reproductive age sexually active women in Miami. Methods From 2018 to 2022, cis-gender, HIV-negative, 18-45-year-old, sexually active women were recruited as part of a study evaluating HIV risk. Participants completed questionnaires assessing socio-demographics, HIV risk behaviors, prior HIV testing, PrEP awareness and use, and were tested for STIs (chlamydia, gonorrhea, trichomoniasis) and bacterial vaginosis (BV). Factors associated with PrEP awareness were analyzed by Chi-square, Fisher’s exact test, or studentized t-test. Multivariable logistic regression (MLR) was performed to identify factors associated with PrEP awareness. Results 295 women were enrolled; median age 31 (24-38) years, 49% Black, 39% White, 34% Hispanic, 46% income below poverty line, 24% consistent condom use, 1.6 (±2.57) mean number of partners in the previous month, 80% heterosexual, 73% previously tested for HIV, 22% STI, and 50% BV. Of the 63% who knew about PrEP, only 5% were on PrEP. Women aware of PrEP were more likely to be Black, non-Hispanic, have income below poverty line, non-heterosexual, report prior HIV testing, and have a STI or BV (all p&amp;lt; 0.05). Condom use and number of partners were not associated with PrEP awareness. In MLR, women with income below poverty line (OR=2.00 [1.04,3.87]; p=0.04), more sexual partners (OR=1.30 [1.01,1.68]; p=0.04), prior HIV testing (OR=6.42 [2.83,14.52]; p&amp;lt; 0.01), and BV (OR=2.28 [1.18,4.40]; p=0.01) were more likely to be aware of PrEP. Lower odds of PrEP awareness were associated with being Black (OR=0.38 [0.15,0.96]; p=0.04), Hispanic (OR=0.18 [0.08,0.39]; p&amp;lt; 0.01), Heterosexual (OR=0.29 [0.11,0.77]; p&amp;lt; 0.01), and reporting occasional condom use (OR=0.21 [0.08,0.56]; p&amp;lt; 0.01). Conclusion Despite broad PrEP awareness, PrEP use is alarming low among those women at greatest risk. HIV testing presents an opportunity to increase PrEP awareness, but interventions to increase PrEP uptake are needed to end the HIV epidemic among women. Disclosures Maria L L. Alcaide, MD, Gilead: Advisor/Consultant.

A Patient Decision Aid (i.ARTs) to Facilitate Women's Choice Between Oral and Long-Acting Injectable Antiretroviral Treatment for HIV: Protocols for its Development and Randomized Controlled Pilot Trial.

BackgroundMany women with HIV (WWH) have suboptimal adherence to oral antiretroviral therapy (ART) due to multilevel barriers to HIV care access and retention. A long-acting injectable (LAI) version of ART was approved by the US Food and Drug Administration in January 2021 and has the potential to overcome many of these barriers by eliminating the need for daily pill taking. However, it may not be optimal for all WWH. It is critical to develop tools that facilitate patient-provider shared decision making about oral versus LAI ART modalities to promote women’s adherence and long-term HIV outcomes.ObjectiveThis study will develop and pilot test a web-based patient decision aid called i.ART+support (i.ARTs). This decision aid aims to support shared decision making between WWH and their providers, and help women choose between oral and LAI HIV treatment.MethodsThe study will occur in 3 phases. In phase 1, we will utilize a mixed methods approach to collect data from WWH and medical and social service providers to inform i.ARTs content. During phase 2, we will conduct focus groups with WWH and providers to refine i.ARTs content and develop the web-based decision aid. In phase 3, i.ARTs will be tested in a randomized controlled trial with 180 women in Miami, Florida, and assessed for feasibility, usability, and acceptability, as well as to evaluate the associations between receiving i.ARTs and viral suppression, ART pharmacy refills, and clinic attendance.ResultsThis study was funded in March 2021. Columbia University’s IRB approved the study protocols (approval number IRB-AAAT5314). Protocols for phase 1 interviews have been developed and interviews with service providers started in September 2021. We will apply for Clinicaltrials.gov registration prior to phase 3, which is when our first participant will be enrolled in the randomized controlled trial. This is anticipated to occur in April 2023.ConclusionsThis study is the first to develop a web-based patient decision aid to support WWH choices between oral and LAI ART. Its strengths include the incorporation of both patient and provider perspectives, a mixed methods design, and implementation in a real-world clinical setting.International Registered Report Identifier (IRRID)DERR1-10.2196/35646

Perception of Breast Density Information Among Women in Miami, FL: a Qualitative Study.

The US Food and Drug Administration has proposed requiring that all women undergoing mammography receive written information about their breast density. Past research suggests many women may misperceive the meaning of breast density. Additionally, women with dense breasts may not understand the risks and benefits of pursuing additional imaging studies. The goal of this study was to explore women's beliefs about breast density and their preferences for how this information is conveyed. Women with increased breast density detected on mammography at a university-based breast imaging center in South Florida were recruited for a series of focus groups. Twenty-five women participated, ranging in age from 42 to 65years. Nine women (36%) self-identified as Hispanic/Latina, eight (32%) as Black, four (16%) as White, three (12%) as Asian, and one as "other." Four focus groups were conducted in English and one in Spanish by professional moderators using a semi-structured format. A constant comparative method was used to identify common themes using a general inductive approach. Areas explored included understanding of the term breast density; personal reaction to being informed of dense breasts; questions about breast density; understanding of supplemental screening; and preferences for how to convey breast density information. Subthemes identified included a misperception that breast density is palpable; a feeling of fear on learning of increased breast density results; a concern about what causes increased breast density and whether it can be reversed; a desire to proceed with supplemental ultrasound imaging; and a preference for simple messages explaining the concept of breast density in multiple formats including video. Participants voiced the incorrect belief that caffeine intake could increase breast density and stated that they wanted to know specific details about their personal results. There is a need for better tools to communicate breast density in a way that allays anxiety while enabling women to make fully informed decisions about their breast health. Clinicians and cancer educators should be aware of misperceptions women may have about breast density. Policymakers should keep in mind potential public confusion about this complex topic when crafting density notification rules.

Knowledge and Perceptions of Zika Virus Among Reproductive-aged Women in Miami, Florida [11I

INTRODUCTION: To understand the knowledge and perceptions of Zika Virus among reproductive aged women living in Miami, Florida, the first area of the United States with local transmission. METHODS: Participants included reproductive-aged women attending a gynecology clinic visit in Miami-Dade County during the four weeks immediately following the announcement of local Zika virus transmission. The survey evaluated knowledge and perceptions of Zika Virus in three categories: pathogenesis and transmission, sequelae of infection, and epidemiology and public health information. RESULTS: Fifty-nine women (age range 18-45) completed the survey. Patients who desired or were unsure about desiring pregnancy in the next year (n=15) and those who did not desire pregnancy (n=44) received most of their information about Zika virus from the media rather than their doctors. All had a high level of knowledge in all three categories; there existed no statistically significant difference between the two groups regarding knowledge of Zika virus. Concern about spread of Zika virus in the community was greater in those desiring pregnancy (n=14, 93.3%) than those not desiring pregnancy (n=21, 79.5%, p=0.24). Personal concern about becoming infected with Zika virus was significantly higher in those considering pregnancy (n=13, 86.7% vs n=21, 47.7%, p=0.01). CONCLUSION: In the weeks following recognized local transmission of Zika virus, reproductive aged women had a high level of knowledge about Zika virus, but it was those considering pregnancy who had the greatest concern about personal risk of infection.

Presentation, Treatment, and Outcomes of Haitian Women With Breast Cancer in Miami and Haiti: Disparities in Breast Cancer-A Retrospective Cohort Study.

PurposeWe compared a cohort of Haitian immigrants with residents in Haiti with breast cancer (BC) to evaluate the effects of location on presentation, treatment, and outcomes.Patients and MethodsParticipants were Haitian women with BC living in Miami who presented to the University of Miami/Jackson Memorial Hospital and women with BC living in Haiti who presented to the Innovating Health International Women’s Cancer Center. The primary outcome was the relationship between location, cancer characteristics, and survival. The secondary objective was to compare our results with data extracted from the SEER database. Cox regression was used to compare survival.ResultsOne hundred two patients from University of Miami/Jackson Memorial Hospital and 94 patients from Innovating Health International were included. The patients in Haiti, compared with the patients in Miami, were younger (mean age, 50.2 v 53.7 years, respectively; P = .042), presented after a longer duration of symptoms (median, 20 v 3 months, respectively; P < .001), had more advanced stage (44.7% v 25.5% with stage III and 27.6% v 18.6% with stage IV BC, respectively), and had more estrogen receptor (ER) –negative tumors (44.9% v 26.5%, respectively; P = .024). The percentage of women who died was 31.9% in Haiti died compared with 17.6% in Miami. Median survival time was 53.7 months for women in Haiti and was not reached in Miami. The risk of death was higher for women in Haiti versus women in Miami (adjusted hazard ratio, 3.09; P = .0024).ConclusionWomen with BC in Haiti experience a significantly worse outcome than immigrants in Miami, which seems to be related to a more advanced stage and younger age at diagnosis, more ER-negative tumors, and lack of timely effective treatments. The differences in age and ER status are not a result of access to care and are unexplained.

‘Love and trust, you can be blinded’: HIV risk within relationships among Latina women in Miami, Florida

ABSTRACTObjectives: Latina women are disproportionately affected by HIV in the US, and account for 30% of all HIV infections in Miami-Dade County, Florida. The main risk for Latina women is heterosexual contact. Little is known about the relational and cultural factors that may impact women’s HIV risk perception. This study aims to describe Latina women’s perception of their HIV risk within a relational, cultural, and linguistic context. Design: Eight focus groups of Latina women (n = 28), four English speaking groups and four Spanish speaking groups, were conducted between December 2013 and May 2014. Women were recruited from a diversion program for criminal justice clients and by word of mouth. Eligibility criteria included the following: self-identify as Hispanic/Latino, 18–49 years of age, and self-identify as heterosexual. A two-level open coding analytic approach was conducted to identify themes across groups. Results: Most participants were foreign-born (61%) and represented the following countries: Cuba (47%), Honduras (17.5%), Mexico (12%), as well as Nicaragua, Puerto Rico, Colombia, and Venezuela (15%). Participant ages ranged between 18 and 49, with a mean age of 32 years. Relationship factors were important in perceiving HIV risk including male infidelity, women’s trust in their male partners, relationship type, and getting caught up in the heat of the moment. For women in the English speaking groups, drug use and trading sex for drugs were also reasons cited for putting them at risk for HIV. English speaking women also reported that women should take more responsibility regarding condom use. Conclusion: Findings emphasize the importance of taking relational and cultural context into account when developing HIV prevention programs for Latina women. Interventions targeting English speaking Latina women should focus on women being more proactive in their sexual health; interventions focused on Spanish speaking women might target their prevention messages to either men or couples.

Get Vaccinated! and Get Tested! Developing Primary and Secondary Cervical Cancer Prevention Videos for a Haitian Kreyòl-Speaking Audience

Although routine screening reduces cervical cancer rates between 60% and 90%, thousands of women worldwide are diagnosed with the disease on an annual basis because of inadequate screening. Haitian women in South Florida experience a disproportionate burden of cervical cancer, with disease rates 4 times higher than the average for women in Miami. An ongoing community-based participatory research initiative to assess and reduce this burden has revealed that a complex interplay of factors contributes to a lack of access to screening in this community, including socioeconomics, language barriers, and traditional understandings of health and disease. In an effort to address some of these barriers and encourage uptake of primary and secondary cervical cancer prevention strategies, 2 videos on cervical cancer prevention were created using a community-based participatory research framework. The video screenplays were created by a Haitian screenwriter using evidence-based medical information provided by academic researchers. The films feature Haitian actors speaking a Haitian Kreyòl dialogue with a storyline portraying friends and family discussing human papillomavirus disease and vaccination, Papanicolaou testing, and cervical cancer. Focus groups held with Haitian women in South Florida suggested that the films are engaging; feature relatable characters; and impact knowledge about human papillomavirus, cervical cancer development, and current prevention recommendations.

Family and cultural influences on cervical cancer screening among immigrant Latinas in Miami-Dade County, USA

Cervical cancer disproportionately affects minorities, immigrants and low-income women in the USA, with disparities greatest among Latino immigrants. We examined barriers and facilitators to cervical cancer screening practices among a group of immigrant Latino women in Florida, USA. Between January and May 2013, six focus group discussions, involving 35 participants, were conducted among Hispanic women in Miami to explore their knowledge, beliefs about cervical cancer and facilitators and barriers to cervical cancer screening using a theoretical framework. The data showed that family support, especially from female relatives, was an important facilitator of screening and treatment. Women, however, reported prioritising family health over their own, and some expressed fatalistic beliefs about cancer. Major obstacles to receiving a Pap smear included fear that it might result in removal of the uterus, discomfort about being seen by a male doctor and concern that testing might stigmatise them as being sexually promiscuous or having a sexually transmitted disease. Targeted education on cancer and prevention is critically needed in this population. Efforts should focus on women of all ages since younger women often turn to older female relatives for advice.

HIV risk and awareness and interest in pre-exposure and post-exposure prophylaxis among sheltered women in Miami.

Pre- and non-occupational post-exposure prophylaxis for the prevention of HIV infection are recommended for adults at substantial risk of HIV. Women experiencing homelessness have increased risk of HIV infection compared with stably-housed women. We conducted a survey of 74 sheltered women at Lotus House Women's Shelter (Lotus House) in Miami to assess risk behaviour as well as knowledge and perception of pre- and non-occupational post-exposure prophylaxis in this population. Of surveyed women, 58.1% engaged in vaginal and/or anal sex while sheltered, and of sexually-active women 55.4% reported inconsistent condom use. 83.8% of women reported no concern regarding HIV acquisition due to their behaviour. Few women surveyed (20.8%) had previously heard of pre- or non-occupational post-exposure prophylaxis. The majority (58.3%) of respondents indicated receptiveness to these prevention methods when introduced. Those indicating that they would consider pre- or non-occupational post-exposure prophylaxis were significantly younger than those indicating that they would not consider these prevention strategies (p = 0.004). Education and referral for pre- and non-occupational post-exposure prophylaxis should be considered for sheltered women at risk of HIV infection. Additional research to optimise implementation of biomedical prevention strategies in this population is needed.

Human Papilloma Virus and Cervical Cancer Education Needs among HIV-Positive Haitian Women in Miami

BackgroundHaitian immigrant women, the largest growing Black ethnic group in Miami, experience the highest rates of cervical cancer and account for one of the largest populations diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in South Florida. Using community-based participatory research methods, we conducted a pilot study to examine human papilloma virus (HPV)/cervical cancer knowledge and identify intervention preferences among HIV positive Haitian women. MethodsCommunity health workers conducted three focus groups with 21 HIV-positive Haitian women. All sessions were conducted in Haitian Kreyol, digitally recorded, and subsequently interpreted and transcribed into English. The first focus group assessed HPV/cervical cancer knowledge, the second session explored HPV/cervical cancer considerations specific to HIV-positive women, and the third focus group discussed HPV/cervical cancer screening and intervention preferences. Data analysis was guided by a grounded theory approach. FindingsOur sample had limited HPV/cervical cancer knowledge. Misconceptions about screening, transmission, and treatment were common. Participants felt that stigma by providers impacted negatively the care they received and that stigma by the community diminished social support. Strong support for culturally tailored interventions to improve HPV/cervical cancer knowledge was expressed. Although no participants had participated in research previously, all were willing to participate in future trials. ConclusionsThere is critical need for culturally relevant interventions to improve HPV/cervical cancer knowledge among HIV-positive Haitian women.

Cancer Screening Utilization Among Immigrant Women in Miami, Florida.

Routine cancer screening for cervical, breast, and colorectal cancers reduces disease-associated morbidity and mortality through early detection and treatment. Lack of access to health care is a major barrier to screening in immigrant populations. We aimed to characterize compliance with national cancer screening guidelines and to assess predictors of screening compliance among women residing in each of two distinct immigrant communities in Miami-Dade County--Little Haiti (Haitian) and Hialeah (Cuban). Through a collaborative community-based participatory research (CBPR) initiative, researchers, key community stakeholders, and community members developed the study design. Data were collected from a total of 234 women via a rapid assessment survey administered by community health workers (CHWs). Compliance with national screening guidelines for breast, cervical, and colorectal screening was low in both community samples relative to national averages, and for cervical cancer screening was significantly lower in Little Haiti than Hialeah (p<.01). In addition, knowledge of cervical cancer etiology was significantly greater in Hialeah than in Little Haiti (p<.01). Health insurance and having a usual source of health care were significant correlates of cancer screening. Given the disparities in cancer screening between our samples and the larger sociodemographic groups in which they are often included, targeted approaches that address structural barriers (lack of health insurance or usual source of care) may improve access to cancer screening among recent immigrants. Community partnerships may be essential in facilitating the interventions needed to overcome cancer-related disparities in these groups.

Cancer Screening Utilization Among Immigrant Women in Miami, Florida

Cancer Screening Utilization Among Immigrant Women in Miami, Florida

Abstract B58: Differences in cervical cancer knowledge among minority women in Miami

Abstract Background: Minority women suffer disproportionately from cervical cancer incidence and mortality. Education initiatives aimed at improving cervical cancer knowledge may lead to increased appropriate screening and reductions in morbidity. Baseline data describing the variable levels of knowledge among specific minority and underserved communities will aid the design of such programs. Methods: The South Florida Center for Reducing Cancer Disparities is a comprehensive NCI initiative focused on the reduction and ultimate elimination of cervical cancer disparities in Miami-Dade County. As part of an ongoing randomized intervention study, we collected baseline data on cervical cancer knowledge among three minority communities: Little Haiti, Hialeah (90% Latino), and West Perrine (mixed community). Eligibility criteria included women aged 30-65 years and not having had a Pap smear in the past three years. Knowledge was assessed using questions from the NCI's Health Information National Trends Survey (HINTS), which we translated and back translated into Haitian Kreyol and Spanish. We used Fisher's exact test to examine differences in knowledge across minority subgroups. We then used univariate and multivariate logistic regression models to control for additional sociodemographic correlates of higher cervical cancer knowledge. Results: Among the 334 women enrolled to date, 53% are Latina, 39% Haitian, and 8% African American (AA). We found 44% of Latinas, 25% of AAs and 7% of Haitians answered &amp;gt;50% of questions correctly (P&amp;lt;0.0001). Years of education and marital status, but not age, were significantly associated with higher levels of knowledge (P&amp;lt;0.05). In multivariate analysis, adjusting for these potential confounders, Haitians (OR=0.17; 95%CI: 0.08-0.38; P&amp;lt;0.0001) and AAs (OR=0.56; 95%CI: 0.2-1.53; P=0.2565) were less likely to answer &amp;gt;50% of questions correctly compared to Latinas. In a subgroup analysis of Latinas, we found 49% of Cubans (n=101) answered &amp;gt;50% of questions correctly versus 37% of non-Cubans (n=76), however there was no significant difference in knowledge between groups, including when adjusting for potential confounders (OR =1.41; 95%CI: 0.74-2.69; P=0.2957). Conclusions: Among minority women in Miami who had not been adequately screened for cervical cancer, Haitians had the lowest levels of cervical cancer knowledge, even after correcting for sociodemographic differences. Among Latinas, Cubans had a higher level of knowledge but this result was not statistically significant. As more women are enrolled in our study (target 600) we will have greater power to detect potential differences among AAs. We have developed and are now testing culturally tailored educational interventions aimed at decreasing the cervical cancer knowledge gap in these vulnerable groups. Citation Format: Kumar Ilangovan, Tulay Koru-Sengul, Erin Kobetz-Kerman, Olveen Carrasquillo. Differences in cervical cancer knowledge among minority women in Miami. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B58. doi:10.1158/1538-7755.DISP13-B58

Abstract A45: HPV awareness prevents positive infections

Abstract Background: Haitian Immigrant women, the largest growing Black ethnic group in Miami, experience the highest rates of cervical cancer and account for one of the largest populations diagnosed with HIV/AIDS in South Florida. Objective: Using community-based participatory research methods, we examined HPV/cervical cancer knowledge and intervention preferences among HIV positive Haitian women. This data was used to develop and pilot test a culture-specific educational intervention among HIV positive and sexually active HIV negative Haitian women in Miami, Florida. The pilot study was conducted in two phases. Methods: Phase 1: Qualitative, August 2011: Three focus groups with 21 HIV-positive Haitian women living in Miami, Florida were completed in Haitian Kreyol, digitally recorded, and later interpreted and transcribed into English. The first focus group assessed HPV Knowledge; the second session explored HPV considerations specific to HIV positive women, and the third focus group discussed HPV Screening and intervention preferences. Phase 2: Quantitative, July 2012 – Nov 2012: Using feedback from the focus groups, a flip-chart with educational illustrations was developed. Five small group (3-10 participants) HPV/Cervical Cancer education sessions led by a community health worker were conducted with 25 sexually active Haitian women (8 HIV + and 13 HIV –). Surveys assessing HPV/Cervical Cancer knowledge, screening behaviors, and research participation were administered at baseline and 3 months post-study. Results: Three month follow up data was collected on 21 of the 25 women who participated in Phase 2 of the study. Participants' mean age was 52+8yrs, 71% lived in US &amp;gt; 5 years, and 71% were uninsured. At post study, the percent of women answering &amp;gt; 4/6 questions correct increased from 10% to 28% and the number of women who heard of HPV increased from 48% to 81%. All (100%) of participants were willing to participate in a research study. Conclusions: An intensive one time small group educational intervention was associated with small improvements in cervical cancer / HPV knowledge at 3 months. Our findings show strong support for increased clinical research targeting low SES Haitian women. Citation Format: Sonjia Kenya, Marie Fatil, Tulay Koru-Sengul, Erin Kobetz, Olveen Carrasquillo. HPV awareness prevents positive infections. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A45. doi:10.1158/1538-7755.DISP13-A45

Does a Bite Cause Cancer? Misperceptions of Breast Cancer Etiology among Low-Income Urban Women in Miami, Florida

To explore breast cancer beliefs among a cohort of low-income, urban, English-speaking women in Miami, Florida, who had undergone screening mammography. Four focus groups of 34 women were conducted. Discussions were transcribed verbatim and transcripts were analyzed separately by two investigators using an immersion-and-crystallization approach. Common risk factors were identified by consensus. Participants were predominantly African American (82%) women of low income (77% with a household income <$20,000/year). Common risk factors included family history, environmental factors, trauma, and sexual activity. There also was a perception that breast cancer grows rapidly and causes detectable symptoms. Women voiced some accurate and numerous inaccurate beliefs regarding the causes of breast cancer, suggesting a lack of knowledge about the potential benefits and harms of screening mammography before undergoing examination. These findings highlight the importance of identifying women's underlying beliefs when initiating a discussion of breast cancer screening and prevention to ensure that messages are mutually understood.

Cervical cancer prevention

Cervical cancer is the second most common female tumor worldwide, and its incidence is disproportionately high (>80%) in the developing world. In the United States, in which Papanicolaou (Pap) tests have reduced the annual incidence to approximately 11,000 cervical cancers, >60% of cases are reported to occur in medically underserved populations as part of a complex of diseases linked to poverty, race/ethnicity, and/or health disparities. Because carcinogenic human papillomavirus (HPV) infections cause virtually all cervical cancer, 2 new approaches for cervical cancer prevention have emerged: 1) HPV vaccination to prevent infections in younger women (aged < or =18 years) and 2) carcinogenic HPV detection in older women (aged > or =30 years). Together, HPV vaccination and testing, if used in an age-appropriate manner, have the potential to transform cervical cancer prevention, particularly among underserved populations. Nevertheless, significant barriers of access, acceptability, and adoption to any cervical cancer prevention strategy remain. Without understanding and addressing these obstacles, these promising new tools for cervical cancer prevention may be futile. In the current study, the delivery of cervical cancer prevention strategies to these US populations that experience a high cervical cancer burden (African-American women in South Carolina, Alabama, and Mississippi; Haitian immigrant women in Miami; Hispanic women in the US-Mexico Border; Sioux/Native American women in the Northern Plains; white women in the Appalachia; and Vietnamese-American women in Pennsylvania and New Jersey) is reviewed. The goal was to inform future research and outreach efforts to reduce the burden of cervical cancer in underserved populations.

Attitudes towards neonatal male circumcision among Hispanic men and women in Miami, Florida

Attitudes towards neonatal male circumcision among Hispanic men and women in Miami, Florida