University of Nevada School of Medicine, USA
Arya Payan completed his Bachelors degree in Biology at the University of California, Irvine. He later went on to receive his Masters in Nutrition from Columbia University in the City of New York. Currently he is a second year medical student at Touro University Nevada, College of Osteopathic Medicine and is working towards a residency in pediatrics.
Background: In the setting of progressive immunosuppression, as with a HIV infection, the incidence of cervical dysplasia is increased. Paradoxically, among certain ethnicities and economic levels, HIV-infected women have a lower rate of screening for cervical cancer via Papanicolaou smear (Pap smear) compared to HIV-negative women. Understanding barriers to cervical cancer screening among HIV-infected women is important to develop an intervention to increase adherence to guidelines. Methods: Between February 2014 and July 2014, we conducted a cross-sectional survey among a cohort of HIV-infected women receiving care at a university-affiliated outpatient center. Investigators contacted patients via telephone during three separate attempts to complete an investigator administered 30-item questionnaire that included: date of their last Pap smear, perceived barriers, benefit and preferred method(s) of provider reminder for Pap smear. Results: Among our cohort of 318 patients, 141 patients were reached and 77 completed the survey (completion rate=55%). Among these, 46% did not receive Pap smears in the past year. Lack of insurance (14%, 95% CI: 6% to 22%), cost (23%, 95% CI: 13% to 33%), transportation (12%, 95% CI: 4% to 20%) and comfort level with physician (6%, 95% CI: 0% to 12%) were not found to be probable barriers to receiving a Pap smear. However, 45% of patients that did not receive an annual Pap smear reported that being contacted via text messaging would best aid them to come in regularly (95% CI: 31% to 59%). Conclusion: Automated text messaging is increasingly the preferred mode of contact for HIV-infected women. Clinics should be flexible with their mode of communication to match the needs of a population overwhelmed with medical exams and appointments.
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