OBJECTIVE: To explore reasons for variations in anxiety in women testing positive for human papillomavirus (HPV) with normal cytology at routine HPV primary cervical cancer screening. METHODS: In-depth interviews were conducted with 30 women who had tested HPV-positive with normal cytology, including 15 with low-to-normal anxiety and 15 with high anxiety. Data were analysed using Framework Analysis to compare themes between low and high anxiety groups. RESULTS: Several HPV-related themes were shared across anxiety groups, but only highly anxious women expressed fear and worry, fatalistic cognitions about cancer, fertility-related cognitions, adverse physiological responses, and changes in health behaviour(s). In comparison to those with low anxiety, women with high anxiety more strongly voiced cognitions about relationship infidelity, the 12-month wait for follow-up screening, a lower internal locus of control, and HPV-related symptom attributions. CONCLUSIONS: Receiving an HPV-positive with normal cytology result related to various emotional, cognitive, behavioural, and physiological responses; some of which were specific to, or more pronounced in, women with high anxiety. If our observations are confirmed in hypothesis-driven quantitative studies, the identification of distinct themes relevant to women experiencing high anxiety can inform targeted patient communications and HPV primary screening implementation policy. This article is protected by copyright. All rights reserved
