"HPV is the nicer name for genital warts": beliefs, misconceptions, unanswered questions and factors influencing information needs among women who have a HPV test within routine follow-up

Publication date: 
August, 2012
Presentation type: 
Oral presentation
Related staff: 
Prof Linda Sharp (former staff)
Dr Mairead O'Connor (former staff)
Ms Lisa Costello (former staff)

Background: The causal relationship between certain strains of human papillomavirus (HPV) and cervical cancer is transforming prevention. Several screening programmes are implementing HPV testing as part of routine follow-up of women with abnormal cytology tests or who have been treated for cervical intra-epithelial neoplasia (CIN). Although it is important to understand women’s views of HPV testing, and their information needs, most previous research has included women asked to hypothetically think about having an HPV test or women tested within clinical research studies. 

Objectives: In women who had undergone testing for HPV infection in routine clinical practice, we: (1) explored beliefs and misconceptions about HPV; (2) identified common unanswered questions; and (3) identified factors influencing information needs.

Methods: In-depth interviews were conducted with 27 women who had HPV tests performed in a colposcopy clinic for triage following low-grade cytology tests or post-treatment surveillance. Interviews were transcribed verbatim, coded and analysed using a framework approach to identify main themes.

Results: Three main themes emerged relating to HPV beliefs and misconceptions. Some women believed the HPV test had been for genital warts; some believed that HPV infection is related to skin conditions such as warts or blisters; and for some the virus name triggered associations with sexually transmitted diseases. Women had more misconceptions if: they were unaware of links between HPV, cell changes and cervical cancer; or the information they had received had focused primarily on their cell changes. Women had many unanswered questions about HPV. These fell into five groups: symptoms; transmission & nature of the infection; prevention & treatment; consequences of infection; and the HPV test itself. Women who had more knowledge about HPV had more unanswered questions. Factors that impacted on women’s HPV information needs included: concerns surrounding abnormal cytology or diagnosis of CIN (which, for most, took precedence over HPV); awareness that HPV is sexually transmitted (which, for most, increased information needs); and amount of information already received about HPV, cell changes and/or treatment. For some women, having received more information about HPV increased their desire for further information.

Conclusion: This study reveals significant misconceptions, unanswered questions and unmet needs for information among women who have had a HPV test as part of routine follow-up. The results suggest that a “one size fits all” approach to HPV information provision is unlikely to be acceptable or effective. The challenge for screening programmes is to find a balance between providing women with clear, understandable, and sufficient information for their (varying) needs at appropriate stages during follow-up while avoiding information overload.

Published abstract: 
Sharp L, O'Connor M, Costello L, Murphy J, Prendiville W
Sharp L
Conference/meeting title: 
UICC World Congress on Cancer, 2012
Event date: 
28 Aug 2012
Montreal, Canada

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