The association between knowledge of HPV and feelings of stigma, shame and anxiety

Abstract

Objectives: To test the hypotheses that: 1) women who know that HPV is sexually transmitted will anticipate higher levels of stigma, shame and anxiety if they test positive for the virus than women who are not aware of the mode of transmission and 2) women who are aware of the high prevalence of HPV infection will anticipate lower levels of stigma, shame and anxiety than women who underestimate the prevalence.

Methods: A web-based survey in which information provided about HPV was manipulated to generate a 2 x 2 design (awareness that HPV is sexually transmitted vs. no awareness; awareness of the high prevalence of HPV vs. no awareness). Participants (n=811) were female students. They were asked to imagine that they had tested positive for HPV. Outcome measures were anticipated stigma, shame and anxiety.

Results: There were significant differences in emotional reactions to imagining testing HPV positive between the four HPV knowledge groups. Prevalence knowledge was associated with lower levels of stigma, shame and anxiety. Knowledge that HPV is sexually transmitted was associated with higher levels of stigma and shame, but not anxiety. Women who knew that HPV is sexually transmitted but not that it is highly prevalent had the highest scores for stigma and shame.

Conclusions: Raising public awareness of the sexually transmitted nature of HPV has the potential to increase women's feelings of stigma and shame if they test positive for the virus. However, our findings suggest that ensuring that women are aware that HPV is very common may reduce these feelings and also reduce anxiety, perhaps by 'normalising' the infection.