Assessment of Reproductive and Sexual Health Literacy of Women in Armenia

Abstract

Background: In Armenia, women’s health and reproductive choices are limited. According to the World Health Organization (WHO), the incidence of cervical cancer in Armenia has risen from 11 to 14 per 100,000 women in the last 15 years [1]. The WHO also reports that poor knowledge about HIV prevention contributes to low rates of condom use and thus year-to-year increasing rates of HIV particularly among migrant male populations, people who inject drugs, men who have sex with men and sex workers in Armenia [2]. Our study sought to obtain data exploring knowledge of Armenian women around issues related to women’s health, specifically sexually transmitted infections (STIs) and cervical cancer while also assessing their contraceptive choices. Methods: Study consisted of 173 female participants (medical personnel and general respondents) from villages of Armavir and Lori Marz in the Northern Armenia who completed confidential self-filled and validated surveys in Armenian. Questions covered demographics and addressed risk factors, symptoms, and modes of prevention of STIs and cervical cancer as well as contraceptive choices of women. Respondents’ answers were tabulated, and common themes identified. Comparison was made between general population and health care workers level of knowledge on specific topic. Results: Both general population and medical personnel demonstrated lack of knowledge of diseases classified as STIs, with only 13% and 41% of respondents being able to correctly identify a disease as an STI entity respectively. Overall knowledge of human papilloma virus (HPV) as a cause of cervical cancer was low among both groups, with only 7% of general population and 31% health professionals being able to link HPV to the risk of developing cervical cancer. Most participants correctly identified PAP smear as a method of cervical cancer prevention; however, only 11% of general population and none of the surveyed health care workers believed that HPV vaccination can prevent cervical cancer. Most respondents (88%) used no mode of contraception. Among those who used contraception, condoms were the most common method (22%) with 5% of respondents using oral combination pills. Nearly third of all respondents marked having had at least one abortion. Conclusion: In this study, we identified a significant deficit of knowledge regarding reproductive health, specifically, STIs and cervical cancer modes of prevention and methods of effective contraception. Furthermore, the poor knowledge of these subjects was shared by medical professionals. Improvements in the area of health education are needed to promote safe sexual practices proven to decrease the risk of STI exposure, support HPV vaccination campaign and use of modern methods of contraception.