Dissertation Defense Announcement

School of Public Health announces the Final Dissertation Defense of

Siri Ogg

for the Degree of Doctor of Philosophy

December 7, 2018 at 2:30 PM in Robison Hall, Room 102

Advisor: Latrice Pichon

Pap Test Screening Experiences of HIV-Positive Women

ABSTRACT: The Human Papillomavirus (HPV) is the most common sexually transmitted disease, and is known to cause genital warts, cervical intraepithelial neoplasia (CIN), and cervical cancer. HIV-positive women are at greater risk of contracting HPV, experiencing CIN, having more advanced-grade CIN, and developing cervical cancer due to their compromised immune status. Since becoming an essential part of women's preventive healthcare, the Papanicolaou test, commonly known as the Pap smear, has helped to reduce cervical cancer incidence and mortality; however, many HIV-positive women do not meet recommended Pap test screening guidelines. This study addressed two research questions: 1.) What psychosocial, cultural, contextual, and organizational factors influence HIV-positive women's engagement in cervical cancer screening? and 2.) How do these factors intersect with each other to affect HIV-positive women's engagement in cervical cancer screening? Using a qualitative grounded theory approach, one-on-one interviews were conducted with 19 HIV-positive, African American women of childbearing age in Shelby County, TN. Additionally, participants completed a questionnaire to assess demographic and socioeconomic characteristics, health history, and Pap test screening knowledge. Seven major themes emerged from the data: General Lack of Knowledge, Benefits Outweigh Barriers, Limited Role of Social Support, Disconnect Between Health and Religious Beliefs, HIV as a Facilitator, Reliance on Healthcare Provider, and Intersectionality. The findings presented here provide insight into what motivates HIV-positive women to engage in regular Pap test screening as well as how factors across the social ecological spectrum relate to each other. This information will help public health practitioners to develop interventions for increasing and preserving cervical cancer screening compliance.