Motivations and experiences of women who accessed “see and treat” cervical cancer prevention services in Zambia

BACKGROUND: In Zambia, a country with a generalized HIV epidemic, age-adjusted cervical cancer incidence is among the highest worldwide. In 2006, the UAB-Center for Infectious Disease Research in Zambia and the Zambian Ministry of Health launched a visual inspection with acetic acid (VIA)-based “see and treat” cervical cancer prevention program in Lusaka. All services were integrated within existing government-operated primary health care facilities. OBJECTIVE: Study aims were to: 1) identify women's motivations for cervical screening; 2) document women's experiences with screening; and 3) describe the potentially reciprocal influences between women undergoing cervical screening and their social networks. DESIGN & METHODS: Focus group discussions (FGD) and in-depth interviews (IDI) were conducted with women who accepted screening and with care providers. Low-level content analysis was performed to identify themes evoked by participants. Between September, 2009 and July, 2010, 60 women and 21 care providers participated in 8 FGD and 10 IDI. RESULTS: Women presented for screening with varying needs and expectations. A majority discussed their screening decisions and experiences with members of their social networks. Key reinforcing factors and obstacles to VIA screening were identified. CONCLUSIONS: Interventions are needed to gain support for the screening process from influential family members and peers