Cancer of the cervix and HIV: household knowledge and practice of preventive strategies in Ecuador Colombia and Paraguay.

Early detection of cervical cancer and the prevention of HIV are important components of PLAN Internationals reproductive health strategy in Latin America and the Caribbean. Baseline surveys of mothers of children under 2 years of age are being conducted to facilitate program design. Reported in this paper are the findings on knowledge of preventive measures against cervical cancer HIV and other sexually transmitted diseases (STDs) among mothers in Cali Colombia (n = 1088); Cuenca Ecuador (n = 300); and rural Paraguay (n = 600). The purpose of the Pap smear was known by 57% of mothers in Paraguay 78% of Colombian respondents and 25% of those in Ecuador. Knowledge scores increased with maternal age and level of education. 56.5% of women in Colombia 38.5% in Paraguay and 9.7% in Ecuador had had a Pap smear in the 2 years preceding the survey. Sexual intercourse was the most frequently cited mode of transmission of HIV and other STDs (61.2-76.9%) followed by blood transfusion (7.5-43.9%) restrooms and shared eating utensils (8.5-17.5%) and hugs and handshakes (7.1-10.8%). Few mothers at any site mentioned vertical transmission. Community and family education were the preventive measures most often cited (23.2-44.8%) followed by fewer sexual partners (10.3-33.2%) and condom use (4.7-44.8%). Overall mothers in Colombia were most likely to correctly identify HIV/STD risk factors and preventive strategies. In all three countries the percentage of mothers who identified condom use as a means of preventing HIV/STDs increased with increases in age education knowledge of sexual intercourse as a risk factor and awareness of the purpose of a Pap smear. Recommended on the basis of these findings are collaborative activities with government and private agencies to organize Pap testing at least every 3 years establish a referral and treatment system for women with a positive Pap smear distribute condoms and improve access to and the quality of local STD care.