HPV knowledge, attitudes, and cultural beliefs among Hispanic men and women living on the Texas–Mexico border

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Abstract
Background. US Hispanic women have higher cervical cancer incidence rates than non-Hispanic White and African-American women and lower rates of cervical cancer screening. Knowledge, attitudes, and cultural beliefs may play a role in higher rates of infection of human papillomavirus (HPV) and decisions about subsequent diagnosis and treatment of cervical cancer. Study aim. To explore the level of HPV knowledge, attitudes, and cultural beliefs among Hispanic men and women on the Texas–Mexico border. Methodological approach. Informed by feminist ethnography, the authors used an interpretive approach to understand local respondents’ concerns and interests. Focus group sessions were analyzed using thematic content analysis. Recruitment and sample. Promotoras (lay health workers) recruited participants using convenience sampling methods. Group sessions were held in public service centers in Brownsville. Participants’ ages ranged from 19 to 76 years. Methods analysis. Focus group discussions were audio-recorded and transcribed in Spanish. Researchers read and discussed all the transcripts and generated a coding list. Transcripts were coded using ATLAS.ti 5.0. Key findings. Participants had little understanding about HPV and its role in the etiology of cervical cancer. Attitudes and concerns differed by gender. Women interpreted a diagnosis of HPV as a diagnosis of cancer and expressed fatalistic beliefs about its treatment. Men initially interpreted a diagnosis of HPV as an indication of their partners’ infidelity, but after reflecting upon the ambiguity of HPV transmission, attributed their initial reaction to cultural ideals of machismo. Men ultimately were interested in helping their partners seek care in the event of a positive diagnosis. Implications for practice. Results suggest that understanding Hispanics’ cultural norms and values concerning disease, sexuality, and gender is essential to the design and implementation of interventions to prevent and treat HPV and cervical cancer.