"That's our culture…": Understanding cervical cancer stigma through Caribbean voices.

BACKGROUND: Cervical cancer remains a major public health concern in the Caribbean, where cultural beliefs, stigma, and healthcare barriers hinder prevention and early detection. While stigma has been recognized as a barrier globally, few studies have qualitatively examined how cervical cancer stigma is constructed and experienced within Caribbean cultural contexts. This study uniquely explores the intersecting social and cultural factors influencing cervical cancer-related stigma, screening behaviors, and HPV vaccination in Grenada, Jamaica, and Trinidad and Tobago, filling a critical research gap in understanding stigma beyond patient populations and across national settings.

METHODS: A qualitative study was conducted using nine focus groups with 69 participants (54 women, 15 men) recruited from community organizations, health centers, and cancer support networks. Semi-structured interviews explored perceptions of cervical cancer, its causes, screening, and healthcare experiences. Thematic analysis identified key patterns in stigma and barriers to prevention.

RESULTS: Six major themes emerged: (1) Cancer-related stigma and fear, with fatalistic views of cancer as a death sentence; (2) Cultural beliefs, including associations between cervical cancer, promiscuity, and divine punishment; (3) Knowledge gaps and misinformation, contributing to screening and vaccine hesitancy; (4) Gender and societal expectations, reinforcing stigma and discouraging health-seeking behaviors; (5) Health system challenges, such as healthcare mistrust, confidentiality concerns, and financial constraints; and (6) Family history concerns, where secrecy surrounding cancer within families limited awareness and early detection.

CONCLUSION: Women in low-income settings faced compounded barriers due to gendered norms, limited education, and economic constraints. Healthcare confidentiality concerns further discouraged prevention. Addressing these challenges requires culturally tailored public health campaigns, stronger confidentiality protections, and expanded access to affordable screening and treatment. A regionally coordinated approach to HPV vaccination and cervical cancer prevention is needed to reduce stigma and improve equitable access to care across the Caribbean.

POLICY SUMMARY: This study identifies key policy gaps in cervical cancer prevention and HPV vaccination. Findings highlight the need for improved confidentiality protections, enhanced healthcare system trust, and culturally relevant public health interventions to combat stigma and misinformation. Policies should also increase financial access to screening and promote family health communication to improve awareness of hereditary cancer risks. Addressing these gaps can reduce stigma, increase screening and vaccination uptake, and improve cervical cancer outcomes across the region.