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"Duchesne, Véronique"
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Acceptability of HPV screening among HIV-infected women attending an HIV-dedicated clinic in Abidjan, Côte d’Ivoire
by
Assoumou, Nelly
,
DeBeaudrap, Pierre
,
Dumont, Alexandre
in
Acetic acid
,
Acquired immune deficiency syndrome
,
Adult
2020
Background
Cervical cancer incidence is high among women living with HIV due to high-risk HPV persistence in the cervix. In low-income countries, cervical cancer screening is based on visual inspection with acetic acid. Implementing human papilloma virus (HPV) screening through self-sampling could increase women’s participation and screening performance. Our study aims to assess the preintervention acceptability of HPV screening among HIV-infected women in Abidjan, Côte d’Ivoire.
Methods
Applying the Health Belief Model theoretical framework, we collected qualitative data through in-depth interviews with 21 HIV-infected women treated in an HIV-dedicated clinic. Maximum variation sampling was used to achieve a diverse sample of women in terms of level of health literacy. Interviews were recorded and transcribed with the participants’ consent. Data analysis was performed using NVivo 12.
Results
Screening acceptability relies on cervical cancer representations among women. Barriers were the fear of diagnosis and the associated stigma disregard for HIV-associated health conditions, poor knowledge of screening and insufficient resources for treatment. Fees removal, higher levels of knowledge about cervical cancer and of the role of HIV status in cancer were found to facilitate screening. Healthcare providers are obstacle removers by their trusting relationship with women and help navigating through the healthcare system. Self-confidence in self-sampling is low.
Conclusions
Free access to cervical screening, communication strategies increasing cervical cancer knowledge and healthcare provider involvement will foster HPV screening. Knowledge gathered through this research is crucial for designing adequate HPV-based screening interventions for women living with HIV in this setting.
Journal Article
Implementation of HPV-based screening in Burkina Faso: lessons learned from the PARACAO hybrid-effectiveness study
by
DeBeaudrap, Pierre
,
Dumont, Alexandre
,
Pourette, Dolorès
in
Ablation
,
Acetic acid
,
Beliefs, opinions and attitudes
2021
Background
Cervical cancer screening in sub-Saharan countries relies on primary visual inspection with acetic acid (VIA). Primary human papillomavirus (HPV)-based screening is considered a promising alternative. However, the implementation and real-life effectiveness of this strategy at the primary-care level in limited-resource contexts remain under explored. In Ouagadougou, Burkina Faso, free HPV-based screening was implemented in 2019 in two primary healthcare centers. We carried out a process and effectiveness evaluation of this intervention.
Methods
Effectiveness outcomes and implementation indicators were assessed through a cohort study of screened women, observations in participating centers, individual interviews with women and healthcare providers and monitoring reports. Effectiveness outcomes were screening completeness and women’s satisfaction. Logistic regression models and concurrent qualitative analysis explored how implementation variability, acceptability by women and the context affected effectiveness outcomes.
Results
After a 3-month implementation period, of the 350 women included in the cohort, 94% completed the screening, although only 26% had their screening completed in a single visit as planned in the protocol. The proportion of highly satisfied women was higher after result disclosure (95%) than after sampling (65%). A good understanding of the screening results and recommendations increased screening completeness and women’s satisfaction, while time to result disclosure decreased satisfaction. Adaptations were made to fit healthcare workers’ workload.
Conclusion
Free HPV-based screening was successfully integrated within primary care in Ouagadougou, Burkina Faso, leading to a high level of screening completeness despite the frequent use of multiple visits. Future implementation in primary healthcare centers needs to improve counseling and reduce wait times at the various steps of the screening sequence.
Journal Article
Molecular cytogenetics analysis with whole chromosome paint probes of sperm nuclei from a (13;15) Robertsonian translocation carrier
by
Rives, Nathalie
,
Mousset-Siméon, Nathalie
,
Ravel, Célia
in
Biomedicine
,
Chromosome Painting
,
Chromosome Segregation - genetics
2005
Meiotic segregation of a Robertsonian translocation (13;15) was assessed in sperm nuclei using dual-color fluorescent in situ hybridization (FISH) with whole-chromosome paint probes. Most spermatozoa in the (13;15) translocation carrier resulted from alternate segregation. Although an increased frequency of unbalanced gametes was observed, spontaneous pregnancy led to the birth of a boy with a normal karyotype.
Journal Article