Low-income minority women at risk for cervical cancer: a process to improve adherence to follow-up recommendations

2001 ◽  
Vol 116 (6) ◽  
pp. 608-616 ◽  
Author(s):  
Virginia A Cardin ◽  
Richard M Grimes ◽  
Zhi Dong Jiang ◽  
Nancy Pomeroy ◽  
Luther Harrell ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
At Risk ◽  
Low Income ◽  
Minority Women

scholarly journals 859. Same-Day HIV Pre-exposure Prophylaxis (PrEP) Initiation During Drop-in STD Clinic Appointments Is a Safe, Feasible, and Effective Method to Engage Patients at Risk for HIV in PrEP Care

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S20-S20 ◽  
Author(s):  
Kevin Kamis ◽  
Kenneth Scott ◽  
Edward Gardner ◽  
Karen Wendel ◽  
Grace Marx ◽  
...  
Keyword(s):  
At Risk ◽  
Logistic Regression ◽  
Health Insurance ◽  
Low Income ◽  
Median Income ◽  
Navigation Support ◽  
Patients At Risk ◽  
Exposure Prophylaxis ◽  
Research Grant

Abstract Background Patients at risk for HIV generally do not have immediate access to PrEP. We hypothesized that by offering free, 30-day PrEP starter packs and navigation support during drop-in STD clinic appointments, individuals would be likely to initiate and continue PrEP. Methods Individuals aged ≥18 years presenting for drop-in appointments in the Metro Denver STD Clinic and indicated for PrEP were eligible for the study. Exclusion criteria were history of renal dysfunction, chronic hepatitis B (HBV), HIV, pregnancy, and indications for postexposure prophylaxis. Eligible individuals were provided PrEP education and offered a free, 30-day PrEP starter pack and navigation support for cost assistance. Participants were tested for creatinine, HBV, HIV, and pregnancy at enrollment, and navigated to an appointment for ongoing PrEP care. Participants’ medical records were reviewed for a minimum of 4 months after enrollment. Descriptive statistics and logistic regression were used to characterize the study population and follow-up. Results From April to October 2017, 100 individuals filled a tenofovir–emtricitabine prescription (figure). Median participant age was 28 years, 98% were male, 53% were non-Hispanic White, 8% non-Hispanic Black, and 34% Hispanic. Median annual income was $24,000, 62% had health insurance, 26% had a primary care provider (PCP), and 50% had a recent bacterial STI. No participants had abnormal baseline creatinine or HBV. 77% completed ≥1 PrEP follow-up visit during the study period; 57% completed their first visit within 31 days. 56% completed a second follow-up visit. No HIV seroconversions were detected during follow-up. Factors significantly associated with attending ≥1 follow-up appointment were age ≥ 30 years, higher income, and having health insurance or a PCP at enrollment. In multivariate logistic regression, only higher income was associated with attending ≥1 follow-up appointment (median income for those with ≥1 follow-up visit vs. no follow-up: $24,960 vs. $14,000, P <0.01). Conclusion Providing immediate access to PrEP during drop-in STD clinic visits is a safe and feasible approach to initiation of PrEP care. Additional resources are needed to support PrEP continuity care, particularly for low-income individuals. Disclosures K. Kamis, Gilead Scienes: Research Coordinator, Research grant. S. Rowan, Gilead Sciences: Investigator, Research grant.

scholarly journals Knowledge and perceptions regarding triage among human papillomavirus–tested women: A qualitative study of perspectives of low-income women in Argentina

2020 ◽  
Vol 16 ◽  
pp. 174550652097601
Author(s):  
Sánchez Antelo Victoria ◽  
Kohler Racquel E ◽  
Szwarc Lucila ◽  
Paolino Melisa ◽  
Kasisomayajula Viswanath ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Low Income ◽  
Economic Cost ◽  
Cervical Cancer Prevention ◽  
Attitudes And Beliefs ◽  
Health Providers ◽  
Pap Screening

Objectives: Among cancer prevention studies, little is known about knowledge, attitudes, and beliefs toward triage adherence in the context of the human papillomavirus self-collection test. This formative research aims to identify knowledge, attitudes, and beliefs related to human papillomavirus and cervical cancer prevention specifically about adherence to Pap triage among women residing in a low-income province in Argentina. Methods: We conducted six focus groups, stratified by residence and age. All participants were aged 30 or older and had performed human papillomavirus self-collection. Data collection and thematic analysis were carried out using constructs from the Health Belief Model. Results: Misinformation regarding human papillomavirus and cervical cancer was common and was a source of distress. Women could not distinguish Pap screening from triage; human papillomavirus risk perception was limited but cervical cancer was perceived as a threatening disease. Women were willing to follow-up after receiving an abnormal screening result. Negative views about clinician-collected screening/triage were common, defined as painful and shameful, and comes with an economic cost (transport/time). Lack of help from family/friends was an obstacle to adhering to triage. Health issues in the family’s records and a physician’s recommendation were a cue to adhere to triage. Conclusion: Lack of knowledge or misinformation of the causes of cervical cancer, human papillomavirus, and the multi-step screening and triage process are barriers to follow-up adherence. Interventions to improve communication between women and health providers about screening results and follow-up are needed. Also, health services should be organized to respond to women’s needs and reduce access barriers to follow-up.

scholarly journals Use of Short Messaging Service to Improve Follow-Up for Abnormal Pap Test Results in Minority and Medically Underserved Women in North Carolina: Questionnaire on Attitudes and Acceptability

10.2196/12675 ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. e12675 ◽  
Author(s):  
LaHoma Smith Romocki ◽  
Andrea Des Marais ◽  
Leslie Cofie ◽  
Chelsea Anderson ◽  
Theresa Curington ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Low Income ◽  
Text Messaging ◽  
Text Message ◽  
Pap Test ◽  
Text Messages ◽  
Test Results ◽  
Follow Up Care ◽  
To Receive

Background An estimated one in eight cervical cancer cases are due to a lack of follow-up care for abnormal Pap test results. Low rates of completion of follow-up care particularly affect low-income minority women. The burden of cervical cancer could be reduced through interventions that improve timely colposcopy follow-up and treatment of abnormal screening results. Mobile communications via text messaging present a low-cost opportunity to increase rates of clinic return among women referred to follow-up after obtaining abnormal screening results. Objective Our aims were to determine the acceptability and feasibility of using text messaging to increase completion of follow-up care following abnormal cervical cancer screening (Pap test) results and to examine factors that may affect the acceptability and use of text messaging to increase communications between health care providers (HCP) and low-income minority women. Methods The study participants were 15 low-income women who had undergone a Pap test within the preceding 12 months. Semistructured interviews, including open- and closed-ended questions from a validated questionnaire, were conducted by phone or in person. Responses to closed-ended survey items were tabulated, and descriptive statistics were generated using Microsoft Excel. Responses to the open-ended questions were coded and analyzed using NVivo 11 qualitative analysis software. Results Nearly all participants (14/15, 93%) were comfortable receiving a text message from an HCP stating that their Pap test results were available (<40 years: 100%; ≥40 years: 86%). Over half (8/15; 53%) of the participants were comfortable receiving a text message stating that their Pap test results were abnormal, although many preferred to receive such information via a phone call (6/15; 40%). Most participants (9/15; 60%) believed that receiving a text reminder would make them more likely to attend their appointment. The preferred method for receiving a reminder appeared to vary by age, with older women preferring telephone reminders over text messaging reminders. Analysis of open-ended questions suggested that text messaging appeals to some women due to its wide use and convenience for communicating with HCPs. However, women cited concerns about the confidentiality of messages and barriers to understanding the messages, including the physical capacity to read and accurately interpret the content of the messaging. Conclusions Most participants indicated a willingness to receive text messages from their HCPs about cervical cancer screening results and believed that text messages were the best way to remind them of appointments for follow-up care. Potential concerns could be addressed by excluding explicit references to the nature of the appointment in the text message in order to avoid disclosure of sensitive health information to unauthorized individuals. Although text messaging seems promising to improve adherence to timely follow-up, personal preferences should be considered by allowing patients to opt-out of text communications.

Association Between Subjective Sleep Quality and Depression on Immunocompetence in Low-Income Women at Risk for Cervical Cancer

1999 ◽  
Vol 61 (4) ◽  
pp. 496-507 ◽  
Author(s):  
Josee Savard ◽  
Suzanne M. Miller ◽  
Megan Mills ◽  
Ann O'Leary ◽  
Heather Harding ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
At Risk ◽  
Sleep Quality ◽  
Low Income ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Low Income Women

Barriers to follow‐up of abnormal screening mammograms among low‐income minority women

1996 ◽  
Vol 1 (3) ◽  
pp. 221-228 ◽  
Author(s):  
Maria Rojas ◽  
Jeanne Mandelblatt ◽  
Kathleen Cagney ◽  
Jon Icerner ◽  
Harold Freeman ◽  
...  
Keyword(s):  
Low Income ◽  
Minority Women ◽  
Screening Mammograms

Predictors of compliance in colposcopy clinic follow-up among the uninsured

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20511-e20511
Author(s):  
L. Wenzel ◽  
D. Chase ◽  
J. Hawk ◽  
K. Osann ◽  
K. Tewari
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Low Income ◽  
Pap Smear ◽  
Median Income ◽  
Screening Programs ◽  
Low Income Population ◽  
History Of ◽  
Colposcopy Clinic

e20511 Background: Despite successful screening programs for cervical cancer, ethnic disparities persist. The no-show rate for follow-up appointments after HPV-related abnormal pap smears approximates 50% in high risk populations. We sought to identify factors that may influence follow-up compliance in a multi-ethnic, low income population at risk for cervical cancer. Methods: A longitudinal cohort study was conducted by chart review for all patients identified as having had a colposcopy exam for HPV-associated cervical dysplasia at a southern California inner city clinic from 2006 to 2007. Compliance was defined as obtaining a pap smear within 3 to 14 months from the initial colposcopy. The following variables were evaluated in a multivariate logistic regression model to identify factors which predicted follow-up compliance: race, age, preferred language, insurance, income, marital status, cytology, histology, history of a LLETZ, and pregnancy status. Results: During the study period, 438 patients attended the colposcopy clinic. This approximates 52% of the 912 scheduled clinic appointments during 2006. Patients’ median age was 28 years, 41% were Spanish speaking, with an estimated median income of less than $20,000 for half of the sample. Approximately 71% of patients had temporary publically-funded insurance. Only 55% (239/438) returned for recommended follow-up pap smear. In univariate and multivariate analysis, neither language, Spanish surname, median income, age, histology, nor insurance status predicted adequate follow-up (p=ns). A history of having undergone a large loop excision of the transformation zone (LLETZ) was the only factor which significantly predicted compliance with recommended follow-up pap smear (OR=1.76; 95% CI 1.08–2.895). Conclusions: Follow-up compliance for this high-risk, low income population is very poor. Identifying factors which predict noncompliance could inform strategies to improve care. In this analysis a history of LLETZ was the only variable which predicted whether follow-up care occurred as recommended. Results suggest that intensive, culturally-sensitive colposcopy clinic-based educational interventions should be developed and evaluated. No significant financial relationships to disclose.

HIV Testing in Women in Relation to Intimate Partner Violence and Substance Use: A Systematic Review

2018 ◽  
Vol 15 (1) ◽  
pp. 70-74
Author(s):  
Yukiko Washio ◽  
Elizabeth Novack ◽  
Anne M. Teitelman
Keyword(s):  
At Risk ◽  
Intimate Partner Violence ◽  
Substance Use ◽  
Hiv Testing ◽  
Low Income ◽  
Partner Violence ◽  
Intimate Partner ◽  
Minority Women ◽  
Ethnic Minority Women ◽  
Racial Ethnic

Background: Low-income racial/ethnic minority women are disproportionately represented in substance use and intimate partner violence (IPV) among those who are at risk for or live with HIV– collectively called the SAVA syndemic. Little is known about how IPV exposure and substance use impact HIV testing uptake among low-income racial/ethnic minority women. Aim: The objective of the current study is to conduct systematic literature review of SAVA syndemic on HIV testing among women. Design/Methods: A systematic literature review was conducted between February and September 2016 using databases of PubMed, Ovid/Medline, PsychINFO, Embase, and CINHAL/Nursing. Quantitative and qualitative peer-reviewed studies published in English that covered the topics of HIV testing, women, IPV, and substance use were reviewed. Study contents were summarized and reviewed to identify the gap in studying the impact of substance use and IPV on HIV testing in women. Results: Among women at risk for substance use and IPV (N = 6,259), HIV testing was perceived to be a priority especially if they were injecting drugs and engaging in risky sexual practice; however, barriers were also identified including stigma, privacy issue, convenience, and fear of receiving an HIV-positive result. Conclusions: Findings were informative in meeting the needs of HIV testing and counseling for women at risk for substance use and IPV while addressing the potential barriers to increase access to the service.

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