Social and Structural Determinants of Cervical Health among Women Engaged in HIV Care

Cervical cancer prevention/control efforts among women living with HIV/AIDS (WLH) are socially and structurally challenging. Healthcare access and perceived HIV stigma and discrimination are factors that may challenge risk reduction efforts. This study examined socio-structural determinants of cervical cancer screening among women engaged in HIV care. 

One hundred forty-five WLH seeking health/social services from AIDS Service Organizations in the southeastern US completed a questionnaire assessing factors related to cervical cancer prevention/control. 

• 90% were African American, mean age 46.15 ± 10.65 years. 
• 81% had a Pap test <1 year ago. 
• Low healthcare access was positively associated with having a Pap test <1 year ago. 
• About 36 % reported ≥2 Pap tests during the first year after HIV diagnosis. 
• Lower educational attainment was positively associated with having ≥2 Pap tests. 
• 35% reported more frequent Pap tests after diagnosis. 
• Lower income was moderately associated with more frequent Pap tests post-diagnosis. 

Findings highlight the successes of HIV initiatives targeting socio-economically disadvantaged women and provide evidence that health policy aimed at providing and expanding healthcare access for vulnerable WLH has beneficial health implications.

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By:  Bynum SA1, Wigfall LT2,3,4, Brandt HM4,5, Julious CH6, Glover SH2,3, Hébert JR4,7.

• 1Division of AIDS, Behavioral, and Population Sciences, Center for Scientific Review, National Institutes of Health, 6701 Rockledge Drive, Bethesda, MD, 20892, USA. shalanda.bynum@nih.gov.
• 2Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
• 3Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
• 4South Carolina Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
• 5Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
• 6Palmetto AIDS Life Support Services, Inc., Columbia, SC, USA.
• 7Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. 
• AIDS Behav. 2016 Mar 8.

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