Motivated by mortality:-Women living with HIV and their perceptions regarding the HPV vaccination

Human immunodeficiency virus (HIV) remains a significant public health issue in the United States. Among women living with HIV (WLHIV), one of the most serious health risks is co-infection with human papillomavirus (HPV). WLHIV are more likely to acquire and retain high-risk HPV strains, which increases their risk of developing cervical cancer.

This study aimed to characterize the attitudes, beliefs, and vaccination status of WLHIV residing in Tennessee regarding the HPV vaccine series, as well as the impact of their HIV status and antiretroviral treatment on these factors.

A qualitative approach using narrative interviews was utilized to encourage fluid and flexible storytelling from WLHIV. Eligibility criteria included WLHIV aged 18 to 45, of various ethnicities, residing in Tennessee, English-speaking, and willing to share their experiences related to HIV and HPV. The narrative interviews were conducted over the phone in 2024 and audio recorded. The recordings were then transcribed by a third-party, and the data were analyzed using narrative analysis in Dedoose®, a qualitative software.

A total of 19 WLHIV were interviewed over a six-month period, and all participants identified as Black, with a mean age of 39 years. Three themes were identified and illustrate the experiences of the participants: Theme 1: HIV diagnosis: "I thought it was the end of the world. I thought it was over for me."; Theme 2: Intrinsic motivators for taking antiretroviral treatment; Theme 3: Limited awareness of .HPV; Sub-Theme 1: Intrinsic motivators to receive the HPV Vaccine: role of the healthcare provider; Sub-theme 2: Fear of cancer as a motivator to be vaccinated: "Cancer kills!"

The data highlighted that some participants had limited awareness of HPV, despite it being the most prevalent sexually transmitted infection in the U.S. Detailed evidence of the intrinsic motivators that contribute to adherence to antiretroviral treatment were provided. Additionally, various factors affecting both treatment adherence and the uptake of the HPV vaccine were emphasized.