“Easy women get it” - pre-existing stigma associated with HPV and cervical cancer in a low-resource setting prior to implementation of an HPV screen-and-treat program

Sep 24, 2026

Uploaded by Fans

Cervical cancer can be prevented through vaccination and early detection and treatment, but effective implementation depends on understanding and addressing stigma tied to HPV and cervical cancer. This study examines pre-existing stigma within a low-resource public healthcare system and community context in Iquitos, Peru. Thematic analysis uses interviews, focus groups, observations, a workshop, and document review, organized by the Socio-Ecological Model to identify drivers of stigma.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Background

Morse et al. BMC Public Health (2023) 23:2396 [https://doi.org/10.1186/s12889-023-17324-w](https://doi.org/10.1186/s12889-023-17324-w) BMC Public Health RESEARCH Open Access “Easy women get it”: pre-existing stigma associated with HPV and cervical cancer in a low-resource setting prior to implementation of an HPV screen-and-treat program Rachel M. Morse 1, Joanna Brown2, Julia C. Gage3, Bryn A. Prieto 1, Magdalena Jurczuk1, Andrea Matos4, Javier Vásquez Vásquez5, Reyles Ríos Reátegui5, Graciela Meza‑Sanchez5, Luis Antonio Díaz Córdova6, Patti E. Gravitt7, J. Kathleen Tracy8, Valerie A. Paz‑Soldan 1,2* and the Proyecto Precancer Study Group Abstract Background Cervical cancer is preventable with vaccination and early detection and treatment programs. How‑ ever, for these programs to work as intended, stigma related to HPV and cervical cancer must be understood and addressed. We explored pre‑existing stigma associated with HPV and cervical cancer in the public healthcare system and community of a low‑resource setting prior to implementation of an HPV screen‑and‑treat program. Methods This study conducted thematic analysis of data collected during implementation of a novel HPV screen‑ and‑treat system for cervical cancer early detection and treatment in Iquitos, Peru. We included 35 semi‑structured interviews (19 health professionals, 16 women with cervical precancer or cancer), eight focus groups (70 community women), one workshop (14 health professionals), 210 counseling observations (with 20 nurse‑midwives), and a docu‑ ment review. We used the Socio‑Ecological Model to organize the analysis. Results We identified three main themes: 1. the implication that women are to blame for their HPV infection through characterizations of being easy or promiscuous, 2. the implication that men are to blame for women’s HPV infections through being considered careless or unfaithful, 3. HPV is shameful, embarrassing, and something that should be hidden from others. Consequently, in some cases, women refrained from getting screened for HPV. These themes were seen at the individual level among women, relationship level among women, men, and family members, community level among healthcare staff, and societal level within components of cervical cancer guide‑ lines and male chauvinism. Conclusions Cervical cancer early detection and treatment programs in limited resource settings must address stigma entrenched throughout the entire healthcare system and community in order to sustainably and successfully implement and scale‑up new programs. Interventions to tackle this stigma can incorporate messages about HPV †Rachel M. Morse and Joanna Brown contributed equally to this work. *Correspondence: Valerie A. Paz‑Soldan [vpazsold@tulane.edu](vpazsold@tulane.edu) Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[. The Creative Commons Public Domain Dedication waiver (](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domai

FAQs

What problem does the study address about cervical cancer prevention programs?

It addresses how stigma related to HPV and cervical cancer can undermine the intended functioning of vaccination and early detection and treatment programs, making it necessary to understand and address stigma before implementation.

How was stigma analyzed in the study?

Researchers conducted thematic analysis of data collected during implementation of an HPV screen-and-treat system. The analysis used the Socio-Ecological Model and drew on interviews, focus groups, counseling observations, a workshop, and document review.

What main themes of pre-existing stigma did the study identify?

The study identified themes including blaming women for being “easy” or promiscuous, blaming men for women’s HPV infection through perceived carelessness or unfaithfulness, and viewing HPV as shameful and something that should be hidden—leading some women to avoid HPV screening.

Sep 24, 2026

Uploaded by Fans