Date of Award

Summer 2019

Document Type

Open Access Dissertation

Department

Health Promotion, Education and Behavior

First Advisor

Heather M. Brandt

Abstract

Cervical cancer is one of the most preventable types of cancer; however, it continues to pose significant health challenges for women in low and middle-income countries (LMICs), particularly in Peru. Studies previously conducted in Peru have examined factors associated with cervical cancer screening, screening access, availability, and geographical determinants on cervical cancer incidence and mortality. These studies have suggested the need to explore sociocultural factors and the roles of men and women in screening decisions associated with excessive cervical cancer burden and low rates of screening among Peruvian women. The goal of the dissertation research was to explore influences of sociocultural factors on cervical cancer prevention and control among women and men in Cusco, Peru. The specific aims were: 1) to explore the influences of cultural beliefs and the marianismo-machismo gender ideologies on cervical cancer screening, and 2) to identify preferences for health communication channels to increase cervical cancer prevention and control behaviors among women and men in urban and rural areas of Cusco, Peru. A qualitative approach was used to elucidate root social causes related to the lack of cervical cancer prevention and control. Semi-structured interviews were conducted with women (n=20), men (n=13), and clinicians (n=6) across urban and rural communities of Cusco. Six themes related to cultural beliefs emerged: 1) the purpose of the Pap test, 2) causes of cervical cancer, 3) fear, 4) embarrassment caused by Pap tests, 5) community conversations about Pap tests and cervical cancer, and 6) willingness to talk about cervical cancer. Six themes related to gender dynamics emerged: 1) men’s knowledge about the Pap test and cervical cancer, 2) men’s attitudes toward the Pap test, 3) gender preference for the exam, 4) machismo, 5) marianismo, and 6) spousal support. Four categories of themes related to health communication emerged: 1) knowledge of HPV, the Pap test, and cervical cancer; 2) preference for communication channels, 3) interpersonal communication, and 4) preferred message content about cervical cancer. Findings suggested that cultural misconceptions about the Pap test and causes of cervical cancer influenced cervical cancer screening uptake primarily in the rural areas of the Cusco, Peru. Findings also suggested that male perspectives in rural communities played a large role in women’s participation in cervical cancer screening. In an effort to increase knowledge about HPV, the Pap test, and cervical cancer, communication channels to disseminate information were primarily through physicians or through some process of interpersonal communication. There is an overwhelming need for interventions addressing sociocultural influences on cervical cancer throughout Cusco, Peru particularly because male perspectives play a large role in cervical cancer screening decision making among women in this area. Current and future health communication interventions about HPV, Pap tests, and cervical cancer should be culturally tailored and relevant for both women and men in efforts to reduce the cervical cancer disparity in Cusco, Peru.

Rights

© 2019, Venice Elizabeth Haynes

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