Fan Lee

Lee, Fan

Nominated From: University of Washington

Research Site: Kenya

Research Area: Women’s Health, Cervical Cancer Screening, HIV

Primary Mentor: Michael H. Chung

Research Project

Exploring the attitudes and knowledge of cervical cancer among Kenyan male partners and their potential role in the screening and treatment of cervical cancer

Cervical cancer is the second most frequent cancer among women in Kenya and the leading cause of cancer deaths in women of reproductive age. Adding to the complexity, HIV significantly increases the risk of HPV infection and cancer progression. The Kenyan government has advocated the use of visual inspection with acetic acid (VIA) as a primary method to screen for cervical cancer, however no specific recommendations are made concerning HIV-positive patients. Since 2009 the Coptic Hope Center in Nairobi, Kenya in partnership with the University of Washington (UW) has successfully implemented multiple cervical cancer screening initiatives, which have included VIA and Pap smear.

Currently, a randomized clinical trial (RCT) investigating the clinical efficacy and cost effectiveness of different treatment modalities, i.e. LEEP versus cryotherapy, is being conducted at the Hope Center. However, even if efficacious cervical cancer screening and treatment strategies are identified, the implementation of these strategies into successful programs may ultimately depend on psychosocial factors that affect uptake and acceptability of cancer preventative efforts among HIV-positive women in Kenya. In Kenyan households, men play a significant role in the healthcare behaviors of women, and studies in Kenya have identified lack of spousal support as an impediment to women’s access to cervical cancer screening and treatment. Therefore, one of the most important factors may involve the knowledge and attitudes of male partners towards the screening and treatment of cervical cancer. This proposed qualitative study aims to explore the knowledge, attitudes and beliefs regarding cervical cancer screening and treatment among male partners of HIV-positive women who have received cervical cancer screening and treatment at the Hope Center.

 

Research Significance

Gender power relations play a crucial role in sexual and reproductive health around the world. In patriarchal societies like Kenya, where male partners hold significant power over health seeking behavior of family members, involvement of men is critical for the success of cervical cancer prevention programs. Our novel effort to engage and explore male partners’ awareness and attitude of cervical cancer screening will provide a critical perspective that will inform the development of interventions to engage partners not only in the screening process, but all aspects of female reproductive care. Potential interventions could be to incorporate partner counseling during screening, educational programs for men who accompany their female partners to follow-ups, peer education programs among men or large-scale media campaigns to encourage male partner support. We believe that the more men are able to understand the implications of reproductive health and preventative care for their female partners, the more they will be able to provide encouragement and support. This study hopes to explore perspectives of not only women, but men, on the barriers to partner support as well as the actual and potential role as supportive partners in cervical cancer screening. This information will be helpful in developing strategies to implement sustainable interventions to include male partners in the cervical cancer screening process.

 

Advice for Future Applicants

  • Identify a mentor early on if you are interested in applying to Fogarty for funding
  • Establish a potential project with your mentor that is doable in one year – maybe a project that can be nested in an existing project
  • Begin drafting the project proposal and IRB early
  • Submit IRB early, two-three months ahead of the time you are to start in your host country

 

Mentors

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