Strategies to promote the prevention and control of human papilloma virus infection and its sequela among Ethiopian women

Abstract

Human Papilloma Virus (HPV) is the most common viral infection of the reproductive tract and is the cause of precancerous cervical lesions that may progress to cancer. Cervical cancer (CC) is the second most common cancer in women and the second leading cause of cancer deaths in Ethiopia. The two most effective strategies to prevent and control HPV infection and CC are high coverage of HPV vaccination and CC screening. The prevalence of HPV infection was 26.6%. The most oncogenic HR-HPV genotypes; HPV16 and HPV18 were found at significant proportions of 22.5% and 5.9% respectively. ‘’Other HR-HPV’’ genotypes altogether accounted for the highest proportion of HPV infection, 63.7%. Risk-factors, identified as having a statistically significant association with HPV infection were being divorced, post-coital bleeding, early sexual debut, having multiple sexual partners, STI, and being HIV-positive. The prevalence of precancerous cervical lesions was 12.5%, and most risk-factors mentioned above had significant association to development of precancerous lesions too. There was low perceived-susceptibility but high perceived-severity towards HPV infection and CC among women. Perceived-benefits of CC screening were early diagnosis and treatment of symptoms before they turned into cancer. Fear of results and negative peer pressure were perceived-barriers identified not to get screened. Strategies and education programmes pertaining to HPV infection and CC should be organised and implemented. The purpose of this study was to develop strategies to promote the prevention and control of HPV infection and CC among Ethiopian women. The research was conducted on 383 women in Adama, Ethiopia. The Health Belief Model (HBM) guided the study. Explanatory sequential mixed methods research was employed, which included an initial quantitative survey followed by qualitative interviews. Descriptive cross-sectional and an exploratory descriptive and contextual study designs were employed in the quantitative and qualitative phases, respectively. Data in the quantitative phase were collected via a systematic sampling technique and analysed statistically using SPSS version 26, while via a purposive sampling technique and analysed thematically using content analysis in the qualitative phase. Methodological triangulation was employed to integrate the quantitative and qualitative strands. The e-Delphi technique was applied to achieve common viewpoints from experts