1. Stigma and cervical cancer prevention: A scoping review of the U.S. literature
- Author
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Elizabeth R. Nussbaum, Abigail Silva, Deepika Khanna, J. Andrew Dykens, Caryn E. Peterson, Sage J. Kim, Elise Z. Hu, Ian G. Jasenof, Natalia P. Ongtengco, and Abigail Goben
- Subjects
medicine.medical_specialty ,Epidemiology ,media_common.quotation_subject ,Population ,Social Stigma ,Psychological intervention ,Shame ,Stigma (botany) ,111799 Public Health and Health Services not elsewhere classified ,Uterine Cervical Neoplasms ,FOS: Health sciences ,medicine ,Humans ,Mass Screening ,Papillomavirus Vaccines ,education ,Prejudice (legal term) ,Early Detection of Cancer ,media_common ,Cervical cancer ,education.field_of_study ,business.industry ,Papillomavirus Infections ,Vaccination ,Public Health, Environmental and Occupational Health ,HPV infection ,medicine.disease ,Family medicine ,Female ,business - Abstract
Cervical cancer is preventable through HPV vaccination and screening however, uptake falls below national targets. A scoping review was conducted to describe stigmas related to HPV infection and vaccination and cervical cancer and screening in the US. Results were organized into the domains proposed by Stangl and colleagues' Health Stigma and Discrimination Framework. Common drivers of stigma were fear of social judgement and rejection, self-blame, and shame. Positive facilitators included social norms that provided motivation to receive HPV vaccination and screening. Gender and social norms were notable negative facilitators of stigma. HPV infection and cervical cancer resulted in stigma marking through the belief that both result from incautious behavior—either multiple sexual partners or failing to get screening. Stereotyping and prejudice were stigma practices attributed to HPV infection and cervical cancer through these same behaviors. Stigma experiences related to HPV infection, cervical cancer, and abnormal screening results included altered self-image based on perceived/anticipated stigma, as well as discrimination. This review advances understanding of the multiple dimensions of stigma associated with these outcomes in the US population. Three areas warrant additional consideration. Future studies should 1) assess how stigma dimensions affect uptake of cervical cancer preventions efforts; 2) focus on US women most affected by cervical cancer incidence and mortality to identify potential differences in these dimensions and tailor interventions accordingly; 3) include women from geographic areas of the US with high rates of cervical cancer to adapt interventions that address potential regional variations in resources and need.
- Published
- 2021