Psychological and sexual impact of human papillomavirus screening in women in Cameroon: a prospective cohort study.

BACKGROUND

Cervical cancer (CC) is a public health burden, particularly in low-and middle-income countries, but can be prevented by screening for Human Papillomavirus (HPV). Nevertheless, positive test results may have psychological and sexual impacts for women. This study aimed to assess the impact of HPV test results on anxiety and sexual dysfunction in Cameroonian women.

METHODS

This prospective cohort study conducted from 2020 to 2022 in Cameroon, included women previously enrolled in the 3T-Approach trial. Participants underwent a same-day consultation, organized as follows: HPV screening, triage of HPV-positive women and treatment by thermal ablation or Large Loop Excision of the Transformation Zone (LLETZ), if necessary. They completed anxiety (STAI) and sexual function (ASEX) questionnaires at 1, 6, and 12 months post-screening.

RESULTS

Among 273 women included in the study, 220 (80.6%) completed all time points. Upon inclusion, 24.5% were HPV-positive, of which 46.3% underwent treatment. Anxiety levels did not significantly differ by HPV status. Higher sexual dysfunction prevalence was observed in HPV-positive women at all intervals. Between 1 and 12 months HPV-positive women showed an increase in their mean sexual dysfunction score (+ 4.5, 95% CI: 0.5 to 8.4), which was not seen in HPV-negative women. This disparity persisted even after adjusting for socio-demographic factors.

CONCLUSION

HPV test results did not significantly impact anxiety levels in women in Cameroon. Nevertheless, HPV-positive women reported higher sexual dysfunction at one-year post-screening compared to HPV-negative women. Further research should focus on investigating the factors affecting sexual dysfunction, in order to propose strategies to maintain women's well-being without compromising screening rates.

TRIAL REGISTRATION: The protocol of the 3TApproach study was registered under ClinicalTrials.gov, (identifier NCT03757299) on 28, November, 2018.