• [Show abstract] [Hide abstract]
    ABSTRACT: There is now overwhelming evidence that high-risk, sexually transmitted types of human papillomavirus (HPV) are the main causal agent in cervical cancer. Biobehavioral and psychosocial research is uniquely capable of addressing many of the issues raised by HPV and its link with cervical cancer. In this article we review current findings in this area and identify issues for future research. The first of the three sections explores issues associated with the introduction of HPV testing for the detection and management of cervical abnormalities and the impact of growing public awareness of the sexually transmitted nature of cervical cancer. The implications for public understanding of cervical cancer, psychosocial issues associated with screening, and the potential impact on screening uptake are discussed. The second section addresses the role of biobehavioral factors in the persistence and progression of HPV infection as well as possible interventions to minimize the risk of persistence. Finally, primary prevention of HPV is discussed.
    Annals of Behavioral Medicine 03/2004; 27(1):68-79. DOI:10.1207/s15324796abm2701_9 · 4.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To describe the psychological impact on women of being tested for human papillomavirus (HPV) when smear test results are borderline or mildly dyskaryotic. Cross sectional questionnaire study. Two centres participating in an English pilot study of HPV testing in women with borderline or mildly dyskaryotic smear test results. Women receiving borderline or mildly dyskaryotic smear test results tested for HPV and found to be HPV positive (n = 536) or HPV negative (n = 331); and women not tested for HPV with borderline or mildly dyskaryotic smear results (n = 143) or normal smear results (n = 366). State anxiety, distress, and concern about test result, assessed within four weeks of receipt of results. Women with borderline or mildly dyskaryotic smear results who were HPV positive were more anxious, distressed, and concerned than the other three groups. Three variables independently predicted anxiety in HPV positive women: younger age (beta = -0.11, P = 0.03), higher perceived risk of cervical cancer (beta = 0.17, P < 0.001), and reporting that they did not understand the meaning of test results (beta = 0.17, P = 0.001). Testing HPV negative was not reassuring: among women with abnormal smear test results, those who were HPV negative were no less anxious than those who were not tested for HPV. Informing women more effectively about the meaning of borderline or mildly dyskaryotic smear test results and HPV status, in particular about the absolute risks of cervical cancer and the prevalence of HPV infection, may avoid some anxiety for those who are HPV positive while achieving some reassurance for those who test HPV negative.
    BMJ (online) 05/2004; 328(7451):1293. DOI:10.1136/bmj.328.7451.1293 · 16.38 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the psychosocial impact of testing positive for high risk human papillomavirus (HPV) among women attending primary cervical screening. Cross sectional survey. Measures were taken at baseline and one week after the receipt of HPV and cytology screening results. Well women's clinic in London, UK. Population or Sample Four hundred and twenty-eight women aged 20-64 years. Postal questionnaire survey. Psychosocial and psychosexual outcomes were anxiety, distress and feelings about current, past and future sexual relationships. Women with normal cytology who tested positive for HPV (HPV+) were significantly more anxious and distressed than women who were negative (HPV-) using both a state anxiety measure [F(1,267) = 29, P < 0.0001] and a screening specific measure of psychological distress [F(1,267) = 69, P < 0.0001]. Women with an abnormal or unsatisfactory smear result, who tested HPV+, were significantly more distressed than HPV- women with the same smear result [F(1,267) = 8.8, P = 0.002], but there was no significant difference in state anxiety. Irrespective of cytology result, HPV+ women reported feeling significantly worse about their sexual relationships. Approximately one-third of women who tested positive reported feeling worse about past and future sexual relationships compared with less than 2% of HPV- women. The findings suggest that testing positive for HPV may have an adverse psychosocial impact, with increased anxiety, distress and concern about sexual relationships. Psychosocial outcomes of HPV testing need further investigation and must be considered alongside clinical and economic decisions to include HPV testing in routine cervical screening.
    BJOG An International Journal of Obstetrics & Gynaecology 01/2005; 111(12):1437-43. DOI:10.1111/j.1471-0528.2004.00279.x · 3.86 Impact Factor
Show more