Women’s perspectives on the acceptability and feasibility of an HPV screen-and-treat approach to cervical cancer prevention in Iquitos, Peru: a qualitative study
Rachel M. Morse, Joanna Brown, Helen E. Noble, E. Jennifer Ríos López, Anna Kohler-Smith, Sandra Soto, Daniel Lenin del Cuadro, Karina Gonzales Díaz, Magaly Figueredo Escudero, Giannina Vásquez del Aguila, Lita E. Carrillo Jara, Hermann Silva Delgado, Victor A. Palacios, Carlos Santos-Ortiz, Patti E. Gravitt, Valerie A. Paz‐Soldán, the Proyecto Precancer Study Group, Meda Del Carpio-Morgan, Esther Y. Garcia Satalay, Sarah D. Gilman, José Jerónimo, Alcedo Jorges, Magdalena Jurczuk, Margaret Kosek, Gabriela Ladrón de Guevarra, Renso López Liñán, Andrea Matos Orbegozo, Jaime Marín, Graciela Meza, Reyles Ríos Reátegui, Karina Román, Anne F. Rositch, Nolberto Tangoa, Javier Vásquez Vásquez, Giannina Vásquez del Aguila, Karen Zevallos
Abstract
BACKGROUND: The objective of this study was to explore women's experiences of a screen-and-treat approach with ablative therapy (referred to by the Spanish acronym TVT-TA) as a method of treatment following a positive HPV test in Iquitos, Peru. METHODS: A total of 111 in-depth interviews were conducted with 47 HPV positive women who attended the TVT-TA procedure at a primary-level healthcare facility. Interviews were conducted immediately before, immediately after, and six-weeks after TVT-TA. RESULTS: Most interviewed women reported experiencing moderate pain during ablative therapy and minimal pain immediately after and six weeks after ablative therapy. Women also stated that the pain was less intense than they had expected. The most common physical after-effects of treatment were bleeding and vaginal odor. Women experienced oscillating emotions with fear upon receiving a positive HPV result, calming after hearing about ablative therapy treatment, worry about pain from the treatment itself, relaxation with counseling about the procedure, and relief following treatment. CONCLUSIONS: Nearly all participants emphasized that they were pleased with the TVT-TA process even if they had experienced pain during TVT-TA, recommended that TVT-TA be expanded and available to more women, and stated that TVT-TA was faster and easier than expected. This study found that TVT-TA is a feasible and acceptable means of treating HPV according to the women receiving the treatment.