P-66 Examining Cancer Stigma and its Role on Cervical Cancer Prevention within Highrisk Caribbean Countries

Methods: A cross sectional qualitative study design was employed using focus groups in Grenada, Jamaica, and Trinidad & Tobago to understand stigma and its role in cervical cancer prevention behaviors. Thematic analysis was conducted using MAXQDA data analysis software.

Results: Three focus groups were conducted in each country. Major themes surrounding the impact of stigma on cervical cancer prevention efforts included fatalism, cultural views, and confidentiality. Participants were knowledgeable about the sexually transmitted nature of HPV that causes cervical cancer -- this fed into the stigmatization of cervical cancer. Stigma was associated with unfounded associations with female promiscuity. Expressed as blame and the belief that women with cervical cancer ought to feel ashamed, this stigmatization of cervical cancer creates major barriers to HPV vaccination and pap testing. Cancer is often considered a death sentence and seldom discussed among family and friends -- further barring women from screening and early detection and getting support. Fear and misinformation associated with the pap testing procedure and perceived lack of medical confidentiality also hinder screening.

Conclusion: Both generalized cancer stigma (death sentence) and specific cervical cancer stigma (shame, blame) negatively influence cervical cancer prevention efforts. Additional research measuring the multiple dimensions of cancer stigma is required to inform interventions for improving cervical cancer screening and HPV vaccination in the Caribbean.