“That’s our culture…”: Understanding cervical cancer stigma through Caribbean voices

IF 2 Q3 HEALTH POLICY & SERVICES
Kamilah Thomas-Purcell , Diadrey-Anne Sealy , Donrie Purcell , Christine Richards , Althea Bailey , Gaole Song , Kimlin Ashing
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引用次数: 0

Abstract

Background

Cervical cancer remains a major public health concern in the Caribbean, where cultural beliefs, stigma, and healthcare barriers hinder prevention and early detection. While stigma has been recognized as a barrier globally, few studies have qualitatively examined how cervical cancer stigma is constructed and experienced within Caribbean cultural contexts. This study uniquely explores the intersecting social and cultural factors influencing cervical cancer-related stigma, screening behaviors, and HPV vaccination in Grenada, Jamaica, and Trinidad and Tobago, filling a critical research gap in understanding stigma beyond patient populations and across national settings.

Methods

A qualitative study was conducted using nine focus groups with 69 participants (54 women, 15 men) recruited from community organizations, health centers, and cancer support networks. Semi-structured interviews explored perceptions of cervical cancer, its causes, screening, and healthcare experiences. Thematic analysis identified key patterns in stigma and barriers to prevention.

Results

Six major themes emerged: (1) Cancer-related stigma and fear, with fatalistic views of cancer as a death sentence; (2) Cultural beliefs, including associations between cervical cancer, promiscuity, and divine punishment; (3) Knowledge gaps and misinformation, contributing to screening and vaccine hesitancy; (4) Gender and societal expectations, reinforcing stigma and discouraging health-seeking behaviors; (5) Health system challenges, such as healthcare mistrust, confidentiality concerns, and financial constraints; and (6) Family history concerns, where secrecy surrounding cancer within families limited awareness and early detection.

Conclusion

Women in low-income settings faced compounded barriers due to gendered norms, limited education, and economic constraints. Healthcare confidentiality concerns further discouraged prevention. Addressing these challenges requires culturally tailored public health campaigns, stronger confidentiality protections, and expanded access to affordable screening and treatment. A regionally coordinated approach to HPV vaccination and cervical cancer prevention is needed to reduce stigma and improve equitable access to care across the Caribbean.

Policy summary

This study identifies key policy gaps in cervical cancer prevention and HPV vaccination. Findings highlight the need for improved confidentiality protections, enhanced healthcare system trust, and culturally relevant public health interventions to combat stigma and misinformation. Policies should also increase financial access to screening and promote family health communication to improve awareness of hereditary cancer risks. Addressing these gaps can reduce stigma, increase screening and vaccination uptake, and improve cervical cancer outcomes across the region.
“这是我们的文化……”:透过加勒比海之声了解子宫颈癌的污名。
背景:在加勒比地区,子宫颈癌仍然是一个主要的公共卫生问题,在那里,文化信仰、耻辱和保健障碍阻碍了预防和早期发现。虽然耻辱在全球范围内被认为是一种障碍,但很少有研究定性地考察了加勒比文化背景下宫颈癌耻辱是如何形成和经历的。本研究独特地探讨了格林纳达、牙买加和特立尼达和多巴哥影响宫颈癌相关耻辱感、筛查行为和HPV疫苗接种的交叉社会和文化因素,填补了在理解患者群体和国家环境之外的耻辱感方面的关键研究空白。方法:从社区组织、健康中心和癌症支持网络中招募了9个焦点小组,69名参与者(54名女性,15名男性)进行了定性研究。半结构化访谈探讨了人们对宫颈癌的看法、原因、筛查和医疗保健经历。专题分析确定了污名化的主要模式和预防障碍。结果:出现了六个主要主题:(1)癌症相关的耻辱和恐惧,将癌症视为死刑的宿命论观点;(2)文化信仰,包括宫颈癌、滥交和神的惩罚之间的联系;(3)知识差距和错误信息,导致筛查和疫苗犹豫;(4)性别和社会期望,强化了耻辱感,阻碍了求医行为;(5)卫生系统挑战,如医疗不信任、保密问题和财政限制;(6)家族史问题,家族内部对癌症的保密限制了对癌症的认识和早期发现。结论:由于性别规范、受教育程度有限和经济约束,低收入地区的妇女面临着复杂的障碍。医疗保密问题进一步阻碍了预防。要应对这些挑战,就需要开展有文化特色的公共卫生运动,加强保密保护,并扩大获得负担得起的筛查和治疗的机会。需要对人乳头瘤病毒疫苗接种和宫颈癌预防采取区域协调的方法,以减少耻辱感并改善整个加勒比地区公平获得护理的机会。政策总结:本研究确定了宫颈癌预防和HPV疫苗接种方面的关键政策空白。研究结果强调,需要改善保密保护,增强卫生保健系统的信任,并采取与文化相关的公共卫生干预措施,以打击污名化和错误信息。政策还应增加获得筛查的资金,并促进家庭健康交流,以提高对遗传性癌症风险的认识。解决这些差距可以减少耻辱感,增加筛查和疫苗接种,并改善整个区域的宫颈癌结局。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Cancer Policy
Journal of Cancer Policy Medicine-Health Policy
CiteScore
2.40
自引率
7.70%
发文量
47
审稿时长
65 days
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