Iranian HPV-positive Women's Needs and Preferences in Relation to Receiving Health Services: A Qualitative Study

Background: HPV testing is performed in primary care, and in case of abnormal results, the patient is referred to specialized care for follow-up and treatment. Participating in HPV test and receiving an HPV diagnosis can create adverse psychosocial responses. In developing countries that HPV testing recently has been integrated in cervical cancer screening program, to enhance the quality of health services provided to HPV-positive women we need to assess their perceptions. This qualitative study aims to explore HPV-positive women's needs and experiences of receiving health services. Methods: : We conducted 40 semi-structured interviews with HPV-positive women. Recorded interviews transcribed and analyzed using conventional content analysis approach. Results: : Women sought information on HPV types, transmission, prevalence, and clearance. They also required information about other STIs, potential benefits of HPV vaccine, and the risk of HPV-related cancers. Women with abnormal cytology asked about HPV cofactors for cervical cancer. Participants sought ways to improve immunity and sexual health. HPV-positive women's expectations of health care providers (HCPs) include professional principles, communication and counseling skills and HPV-knowledge. Women prefer that HCPs treat them with non-judgmental attitude and do not ask for HIV/hepatitis tests immediately after HPV-diagnosis. "Precancerous" and "high-risk" words and watching colposcopy monitor during procedure had made women anxious. Weak referral system and limited interactions among gynecologists and other HCPs highlighted by participants. Conclusion: The results of this study, based on the experiences and perceptions of HPV women receiving health care, contain messages to healthcare providers at the primary and specialized levels of care to facilitate patient-provider communication around HPV. These practical tips will improve the quality of care for HPV-positive women.