HIV阳性妇女参与宫颈癌筛查行为及其障碍因素的质性研究

A qualitative research on cervical cancer screening behavior and its barrier factors among HIV-positive women

目的:研究HIV阳性妇女参与宫颈癌筛查行为及其障碍因素。方法:通过质性研究中的现象学研究方法,采用目的抽样法,选取2019年8月—2020年1月在湖南省某两个市各1所传染病医院艾滋病门诊就诊的15名HIV阳性妇女作为研究对象进行半结构式访谈,采用Colaizzi 7步分析法进行资料分析。结果:提炼出3个主题和9个次主题,包括被忽视的宫颈癌风险筛查(HIV阳性妇女对宫颈癌风险缺乏关注、医务人员缺乏对HIV阳性妇女宫颈癌防治的宣教);与HIV感染相关的宫颈癌筛查障碍因素(担心被非HIV定点医院拒诊、担心被歧视、害怕筛查导致HIV感染信息泄露、HIV感染相关的身体虚弱、HIV感染相关的悲观情绪);对宫颈癌筛查服务的期望(在HIV门诊开设宫颈癌筛查、与病友一起参与筛查)。结论:HIV阳性妇女的宫颈癌筛查现状不容乐观,该群体在参与宫颈癌筛查方面存在特异性的障碍因素。本研究的结果为促进该群体参与筛查提供了参考依据,HIV门诊的医务人员应为该群体开展宫颈癌防治相关的健康宣教,并可以考虑在HIV门诊开展妇科健康检查服务以提高该群体参与筛查的积极性。

Objective:To explore cervical cancer screening behavior and its barriers among HIV-positive women.Methods:Phenomenological research method was employed.Using the purposive sampling method,totally 15 HIV-positive women were recruited in two HIV clinics of the infectious diseases hospitals from two cities of Hunan province.These women were semi-structured interviewed from August 2019 to January 2020.The data was categorized and analyzed by Colaizzi’s 7-step method.Results:There were 3 themes and 9 sub-themes,including neglected cervical cancer risk screening(lack of attention to cervical cancer risk among HIV-positive women,and lack of education by medical staff on cervical cancer prevention and treatment among HIV-positive women);HIV infection-related obstacles to cervical cancer screening(fear of being rejected by non-HIV-designated hospitals,fear of being discriminated against,fear of information leakage of HIV infection due to screening,physical weakness related to HIV infection,pessimism related to HIV infection);expectations(enrollment of cervical cancer screening in HIV clinics,participation in screening with patients).Conclusion:The current status of cervical cancer screening in HIV-positive women is not optimistic,and there are specific barriers to participation in cervical cancer screening for this group.The results of this study provide a reference for promoting the participation of this group in screening.Medical staff in HIV clinics should carry out health education related to cervical cancer prevention and treatment for this group,and may consider providing gynecological health examination services in HIV clinics to improve the participation of this group in screening.