Barriers and motivators for uptake of cervical cancer prevention strategies in Eastern Europe: Perspective from Latvia

Methods: A mixed-methods study of Latvian women, consisting of questionnaire surveys and semi-structured interviews, was conducted in Riga, Latvia between September-October 2015.

Results: 158 surveys were completed and 10 interviews were conducted. 87%(n=135) had previously had a smear test. 67%(n=105) correctly identified that cervical cytology was performed to identify pre-cancerous changes. The practice of annual gynaecological reviews was prevalent and many believed it to be synonymous with cervical screening. Detailed knowledge of HPV and the HPV vaccine was deficient, although 73%(n=115) and 70%(n=90) respectively claimed to have heard of them. Negative attitudes existed regarding the HPV vaccine due to fear of potential side effects. On learning that HPV was an sexually transmitted infection, the notion of testing positive for HPV was met with shame and embarrassment.

Conclusions: A small proportion of Latvian women are over-screened whilst many women remain unscreened. The main contributing factor for this was their poor understanding of the roles cervical screening and HPV vaccination play in the prevention of cervical cancer.