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Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0000000000000153
Original Research Articles: Cervix and HPV

Intimate Partner Violence and Barriers to Cervical Cancer Screening: A Gynecologic Oncology Fellow Research Network Study

Levinson, Kimberly L. MD, MPH1; Jernigan, Amelia M. MD2; Flocke, Susan A. PhD3; Tergas, Ana I. MD, MPH4; Gunderson, Camille C. MD5; Huh, Warner K. MD6; Wilkinson-Ryan, Ivy MD7; Lawson, Peter J. MPH, MBA3; Fader, Amanda N. MD1; Belinson, Jerome L. MD2,8

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Abstract

Objectives: The aims of the study were to examine barriers to cervical cancer screening among women who have experienced intimate partner violence (IPV) and accessed domestic violence shelters, to compare barriers among those up-to-date (UTD) and not UTD on screening, and to evaluate acceptability of human papillomavirus self-sampling.

Materials and Methods: This is a cross-sectional survey in which domestic violence shelters in Ohio were identified and women completed an anonymous survey assessing UTD screening status, barriers related to screening, history of IPV, intention to follow up on abnormal screening, and acceptability of self-sampling. Characteristics of UTD and not UTD women were compared using Mann-Whitney U tests.

Results: A total of 142 women from 11 shelters completed the survey. Twenty-three percent of women were not UTD. Women who were not UTD reported more access-related barriers (mean = 2.2 vs 1.8; p = .006). There was no difference in reported IPV-related barriers between women who were not UTD and those who are UTD (mean = 2.51 in not UTD vs 2.24 in UTD; p = .13). Regarding future screening, of the women who expressed a preference, more women not UTD preferred self-sampling than UTD women (32% vs 14%; p = .05).

Conclusions: In this study, access-related barriers were more commonly reported among women not UTD with screening. Addressing these barriers at domestic violence shelters may improve screening among not UTD women. Self-sampling may also be one feasible approach to support screening in this population.

Copyright © 2016 by the American Society for Colposcopy and Cervical Pathology

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