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This Phase I qualitative study examined how stigma influenced women’s experiences receiving emerging self-administered topical therapy. Seventeen in-depth interviews (2024–2025) in Kisumu, Kenya, explored experiences among women diagnosed with cervical precancer using thematic analysis grounded in the Health Stigma and Discrimination Framework. Findings identified enacted, anticipated, and internalized stigma impacting relational autonomy and treatment completion, with some participants experiencing delays or intimate partner conflict.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/trying-to-heal-without-bringing-problems-navigating-cervical-precancer-stigma-in-a-phase-i-clinical-trial-in-western-kenya/433619/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/trying-to-heal-without-bringing-problems-navigating-cervical-precancer-stigma-in-a-phase-i-clinical-trial-in-western-kenya/433619.png","ImageObject",300,407,{"name":92,"@type":93},"Lucas Martin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the objective of the Phase I study?","Question",{"text":112,"@type":113},"To explore how stigma influenced women’s experiences with cervical precancer care in the context of emerging self-administered topical therapies.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the study conducted?",{"text":117,"@type":113},"The study used a qualitative approach with convenience sampling and collected seventeen in-depth interviews in Kisumu, Kenya (2024–2025). Participants had been diagnosed with cervical precancer and were recruited to self-administer intravaginal artesunate.",{"name":119,"@type":110,"acceptedAnswer":120},"What stigmas did participants report and how did these affect treatment?",{"text":121,"@type":113},"Women described enacted, anticipated, and internalized stigma related to partner blame, disclosure, and fear of diagnosis as imminent death. Stigma was linked to poverty, limited health care access, embarrassment around sexual health, community fears, patriarchal norms, and the disproportionate burden on women; relational autonomy helped some women navigate stigma and complete treatment, though some experienced delays or intimate partner violence/conflict.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},433619,1790913959,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","medRxiv preprint doi: [https://doi.org/10.1101/2025.10.24.25338728](https://doi.org/10.1101/2025.10.24.25338728); this version posted October 27, 2025. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY-NC 4.0 International license .  \n1 Title: Trying to Heal Without “Bringing Problems”: Navigating Cervical Precancer Stigma in a  \n2 Phase I Clinical Trial in Western Kenya 3  \n4 Authors: Anagha Guliam 1, Annum Sadana2,3, Elizabeth Opiyo4, Felix Adundo4, Katherine  \n5 Sorgi3, Erum Agha5, Chemtai Mungo, MD, MPH3,6,7  \n6 Affiliations  \n7 1. Columbia University Vagelos College of Physicians and Surgeons, New York, New  \n8 York, United States  \n9 2. New York University Grossman School of Medicine, New York, New York, United  \n10 States  \n11 3. Department of Obstetrics and Gynecology, School of Medicine, University of North  \n12 Carolina at Chapel Hill, Chapel Hill, North Carolina, United States  \n13 4. Center for Microbiology Research (CMR), Kenya Medical Research Institute (KEMRI), 14 Kisumu, Kenya  \n15 5. School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North  \n16 Carolina, United States  \n17 6. Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 450  \n18 West Dr, Chapel Hill, North Carolina, 27599, USA  \n19 7. Center for AIDS Research, University of North Carolina Chapel Hill, Chapel Hill, North  \n20 Carolina United States 21  \n22 Corresponding Author:  \n23 Anagha Guliam, [avg2131@cumc.columbia.edu](avg2131@cumc.columbia.edu)  \n1  \nNOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.  \nmedRxiv preprint doi: [https://doi.org/10.1101/2025.10.24.25338728](https://doi.org/10.1101/2025.10.24.25338728); this version posted October 27, 2025. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY-NC 4.0 International license .  \n24 Abstract:  \n25 Background Cervical cancer remains a leading cause of cancer-related deaths among women in  \n26 low-and middle-income countries, particularly in sub-Saharan Africa. Sociocultural barriers  \n27 including stigma significantly influence women's decisions around screening and treatment.  \n28 Objective To explore how stigma influences women's experiences with cervical precancer care  \n29 in the context of emerging self-administered topical therapies.  \n30 Design A qualitative approach using convenience sampling.  \n31 Methods Seventeen in-depth interviews were conducted between 2024 and 2025 in Kisumu, 32 Kenya, with women who had been diagnosed with cervical precancer. Participants were recruited  \n33 to self-administer intravaginal artesunate in a Phase I clinical trial, and interviews explored their  \n34 experiences. Thematic analysis was conducted using the Health Stigma and Discrimination  \n35 Framework.  \n36 Results All women discussed experiences indicative of enacted, anticipated, and internalized  \n37 stigmas related to partner blame, disclosure, and imagining the diagnosis as an imminent death  \n38 sentence. These stigmas were driven and facilitated by poverty and limited health care access, 39 embarrassment around sexual health, community fears of cervical cancer death, patriarchal  \n40 norms, and cervical precancer’s disproportionate burden on women. Women with cervical  \n41 precancer feel “marked” by medication usage, clinic visits, community expectations of a  \n42 “cancer” appearance, or painful sexual intercourse. By exercising relational autonomy, women in  \n43 this trial were able to navigate stigmas around sexual health and overcome the debilitating fear of  \n44 death. They were ultimately able to complete the self-administered ar","cbCaifZf77alTprL","https://ap.wps.com/l/cbCaifZf77alTprL","pdf",170268,31,"English","# Abstract\n## Background and Objective\n## Design, Methods, and Analysis\n## Results and Conclusion","[{\"question\":\"What was the objective of the Phase I study?\",\"answer\":\"To explore how stigma influenced women’s experiences with cervical precancer care in the context of emerging self-administered topical therapies.\"},{\"question\":\"How was the study conducted?\",\"answer\":\"The study used a qualitative approach with convenience sampling and collected seventeen in-depth interviews in Kisumu, Kenya (2024–2025). Participants had been diagnosed with cervical precancer and were recruited to self-administer intravaginal artesunate.\"},{\"question\":\"What stigmas did participants report and how did these affect treatment?\",\"answer\":\"Women described enacted, anticipated, and internalized stigma related to partner blame, disclosure, and fear of diagnosis as imminent death. Stigma was linked to poverty, limited health care access, embarrassment around sexual health, community fears, patriarchal norms, and the disproportionate burden on women; relational autonomy helped some women navigate stigma and complete treatment, though some experienced delays or intimate partner violence/conflict.\"}]","Trying to Heal Without “Bringing Problems” - Navigating Cervical Precancer Stigma in a Phase I Clinical Trial in Western Kenya | PDF",1790664825,78]