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Megan Justine Huchko

Megan Justine Huchko

Hollier Family Associate Professor of Global Health
Obstetrics and Gynecology, Women's Community & Population Health
megan.huchko@duke.edu
Box 90519, Durham, NC 27708
310 Trent Drive, Room 204, Durham, NC 27708

Selected Publications

Experience with the mobile health application 'mSaada' to facilitate home-based human papillomavirus testing in Western Kenya.

Journal Article BMC Glob Public Health · October 17, 2025 BACKGROUND: Cervical cancer screening using human papillomavirus (HPV) DNA testing is an essential component of prevention efforts. Countries with limited health care infrastructure need innovative strategies to make HPV-based screening feasible. Our team ... Full text Link to item Cite

Applying the Information-Motivation-Behavioral Skills model to a video-assisted HPV intervention to promote self-screening uptake: a qualitative study in Western Kenya.

Journal Article BMJ Glob Health · May 6, 2025 INTRODUCTION: Human papillomavirus (HPV) is the leading source of cervical cancer in Kenya. HPV, like other sexually transmitted infections, is stigmatised, which hinders efforts to address the disease. Education and empowerment are crucial in combating HP ... Full text Link to item Cite

Updated Review for Guidelines for Cervical Cancer Screening in Immunosuppressed Women Without HIV Infection.

Journal Article J Low Genit Tract Dis · April 1, 2025 OBJECTIVE: The purpose of this review was to examine new evidence since the authors' 2019 guidelines for cervical cancer (CC) screening in non-HIV immunocompromised persons and to provide updated recommendations based on literature review and expert opinio ... Full text Link to item Cite

Automated Image Clarity Detection for the Improvement of Colposcopy Imaging with Multiple Devices.

Journal Article Biomed Signal Process Control · February 2025 UNLABELLED: The proportion of women dying from cervical cancer in middle- and low-income countries is over 60%, twice that of their high-income counterparts. A primary screening strategy to eliminate this burden is cervix visualization and application of 3 ... Full text Link to item Cite

Development of Image Pre-processing Toolbox to Boost Cervical Cancer Detection

Conference Progress in Biomedical Optics and Imaging Proceedings of SPIE · January 1, 2025 Globally, inequitable resources and access cause cervical cancer remain the fourth leading cause of death in women. Risk stratification with human papilloma virus (HPV) screening is fundamental in identifying vulnerable populations. Visual inspection with ... Full text Cite

Predictors of delay in the cervical cancer care cascade in Kampala, Uganda.

Journal Article Res Sq · December 18, 2024 BACKGROUND: Cervical cancer is the fourth most common cancer among women with significant global disparities in disease burden. In lower-resource settings, where routine screening is uncommon, delays in diagnosis and treatment contribute to morbidity and m ... Full text Link to item Cite

Primary HPV screening compared with other cervical cancer screening strategies in women with HIV: a cost-effectiveness study.

Journal Article AIDS · December 1, 2024 OBJECTIVE: To compare the model-predicted benefits, harms, and cost-effectiveness of cytology, cotesting, and primary HPV screening in US women with HIV (WWH). DESIGN: We adapted a previously published Markov decision model to simulate a cohort of US WWH. ... Full text Link to item Cite

Usability of a smartphone-compatible, confocal micro-endoscope for cervical cancer screening in resource-limited settings.

Journal Article BMC Womens Health · September 2, 2024 BACKGROUND: More efficient methods to detect and treat precancerous lesions of the cervix at a single visit, such as low-cost confocal microscopy, could improve early diagnosis and hence outcomes. We piloted a prototype smartphone-compatible confocal micro ... Full text Link to item Cite

The impact of text message reminders on cryotherapy uptake among women testing positive for HPV in western Kenya: a prospective cohort study.

Journal Article BMC Womens Health · January 13, 2024 BACKGROUND: Mobile health (mHealth) has become an increasingly popular strategy to improve healthcare delivery and health outcomes. Communicating results and health education via text may facilitate program planning and promote better engagement in care fo ... Full text Link to item Cite

Contraceptive Provision to Women With Intellectual and Developmental Disabilities Enrolled in Medicaid.

Journal Article Obstet Gynecol · December 1, 2023 OBJECTIVE: To compare contraceptive provision to women with and without intellectual and developmental disabilities enrolled in North Carolina Medicaid. METHODS: Our retrospective cohort study used 2019 North Carolina Medicaid claims to identify women aged ... Full text Link to item Cite

Contraceptive Provision to Women With Intellectual and Developmental Disabilities Enrolled in Medicaid.

Journal Article Obstet Gynecol · October 26, 2023 OBJECTIVE: To compare contraceptive provision to women with and without intellectual and developmental disabilities enrolled in North Carolina Medicaid. METHODS: Our retrospective cohort study used 2019 North Carolina Medicaid claims to identify women aged ... Full text Link to item Cite

The impact of text message reminders on uptake of cryotherapy among women testing positive for HPV in western Kenya.

Journal Article Res Sq · June 9, 2023 BACKGROUND: Mobile health (mHealth) has become an increasingly popular strategy to improve healthcare delivery and health outcomes. Communicating results and health education via text may facilitate program planning and promote better engagement in care fo ... Full text Link to item Cite

A Qualitative Exploration of Barriers to Treatment Among HPV-Positive Women in a Cervical Cancer Screening Study in Western Kenya.

Journal Article Oncologist · January 18, 2023 BACKGROUND: Cervical cancer screening through self-collected high-risk human papillomavirus (HPV) testing has increased screening uptake, particularly in low-resource settings. Improvement ultimately depends, however, on women with positive results accessi ... Full text Link to item Cite

Clinical readiness for essential maternal and child health services in Kenya: A cross-sectional survey.

Journal Article PLOS Glob Public Health · 2023 High rates of maternal and neonatal morbidity and mortality in Kenya may be influenced by provider training and knowledge in emergency obstetric and neonatal care in addition to availability of supplies necessary for this care. While post-abortion care is ... Full text Link to item Cite

Evaluation of video-assisted HPV education in government-supported clinics in Western Kenya.

Journal Article PLOS Glob Public Health · 2023 Despite prevalent preventative methods of human papillomavirus (HPV), cervical cancer remains the foremost cause of cancer-related death among women of reproductive age in Western Kenya. HPV self-sampling is a preventative measure that can improve accessib ... Full text Link to item Cite

Big Data, Machine Learning and Contraceptive Use: A Scoping Review

Journal Article Oxford Open Digital Health · January 1, 2023 AbstractThe use of big data sources, like Twitter, and big data analytical techniques, like machine learning, have increased in popularity in almost every area of scientific inquiry. However, recent reviews ... Full text Cite

Data from: Clinical knowledge among health care providers of essential maternal and child health services in Kenya: A cross-sectional survey

Dataset · September 14, 2022 We conducted a cross-sectional survey of providers at health facilities in western Kenya providing inpatient maternity services. Providers estimated facility capacity through perceived availability of both general and specialized supplies. Providers report ... Full text Cite

Development and initial validation of a pictorial survey to assess for symptomatic pelvic organ prolapse and urinary incontinence in western Kenya.

Journal Article Int Urogynecol J · September 2022 INTRODUCTION AND HYPOTHESIS: Visual tools are a valuable tool for ascertaining patient symptoms, especially in populations with low literacy rates. The objective was to develop and validate a pictorial scale for assessing symptomatic pelvic organ prolapse ... Full text Link to item Cite

Barriers and Facilitators to Cervical Cancer Screening in Western Kenya: a Qualitative Study.

Journal Article J Cancer Educ · August 2022 About nine out of 10 cervical cancer deaths occur in low-resource countries, with a particularly high burden in sub-Saharan Africa. The objectives of this study were to assess barriers and facilitators to cervical cancer screening in western Kenya from the ... Full text Link to item Cite

Using the Consolidated Framework for Implementation Research to Inform the Design of the Mobile Inspección Visual con Ácido Acético System: Mixed Methods Case Study.

Journal Article JMIR Form Res · June 23, 2022 BACKGROUND: There is growing evidence supporting the use of mobile health (mHealth) interventions in low- and middle-income countries to address resource limitations in the delivery of health information and services to vulnerable populations. In parallel, ... Full text Link to item Cite

Mobile Phone Ownership and Use Among Women Screening for Cervical Cancer in a Community-Based Setting in Western Kenya: Observational Study.

Journal Article JMIR Public Health Surveill · June 7, 2022 BACKGROUND: Mobile phone ownership among women of reproductive age in western Kenya is not well described, and our understanding of its link with care-seeking behaviors is nascent. Understanding access to and use of mobile phones among this population as w ... Full text Link to item Cite

Uptake and correlates of cervical cancer screening among women attending a community-based multi-disease health campaign in Kenya.

Journal Article BMC Womens Health · April 18, 2022 INTRODUCTION: Despite the increased risk of cervical cancer among HIV-positive women, many HIV-care programs do not offer integrated cervical cancer screening. Incorporating self-collected Human Papillomavirus (HPV) testing into HIV programs is a potential ... Full text Link to item Cite

Iterative Development of a Mobile Phone App to Support Community Health Volunteers During Cervical Cancer Screening in Western Kenya: Qualitative Study.

Journal Article JMIR Form Res · February 24, 2022 BACKGROUND: To achieve the World Health Organization targets for cervical cancer elimination, low- and middle-income countries will need to develop innovative strategies to provide human papillomavirus (HPV)-based screening at a population level. Although ... Full text Link to item Cite

Developing a framework to describe stigma related to cervical cancer and HPV in western Kenya.

Journal Article BMC Womens Health · February 11, 2022 BACKGROUND: Despite a high prevalence of human papillomavirus (HPV) and cervical cancer in low and middle-income countries, stigma remains an issue. Addressing HPV and cervical cancer stigma could significantly improve health outcomes for these conditions. ... Full text Link to item Cite

Knowledge, attitudes, and practices regarding cervical cancer screening among women in metropolitan Lima, Peru: a cross-sectional study.

Journal Article BMC Womens Health · August 18, 2021 BACKGROUND: Cervical cancer is a leading cause of cancer deaths among women of reproductive age in Peru. Screening and early identification of pre-cancerous lesions are a cornerstone of the cervical cancer prevention strategy. Yet, there is limited literat ... Full text Link to item Cite

Digital Health Strategies for Cervical Cancer Control in Low- and Middle-Income Countries: Systematic Review of Current Implementations and Gaps in Research.

Journal Article J Med Internet Res · May 27, 2021 BACKGROUND: Nearly 90% of deaths due to cervical cancer occur in low- and middle-income countries (LMICs). In recent years, many digital health strategies have been implemented in LMICs to ameliorate patient-, provider-, and health system-level challenges ... Full text Link to item Cite

Primary HPV and Molecular Cervical Cancer Screening in US Women Living With Human Immunodeficiency Virus.

Journal Article Clin Infect Dis · May 4, 2021 BACKGROUND: Primary human papillomavirus (HPV) screening (PHS) utilizes oncogenic human papillomavirus (oncHPV) testing as the initial cervical cancer screening method and typically, if positive, additional reflex-triage (eg, HPV16/18-genotyping, Pap testi ... Full text Link to item Cite

Achieving equity in cervical cancer screening in low- and middle-income countries (LMICs): Strengthening health systems using a systems thinking approach.

Journal Article Prev Med · March 2021 The World Health Organization (WHO) is leading a call to action to eliminate cervical cancer by the end of the century through global implementation of two effective evidence-based preventive interventions: HPV vaccination and cervical screening and manage ... Full text Link to item Cite

Scaling up cervical cancer prevention in Western Kenya: Treatment access following a community-based HPV testing approach.

Journal Article Int J Gynaecol Obstet · January 2021 OBJECTIVE: To evaluate access to treatment after community-based HPV testing as testing within screen-and-treat programs has the potential to lower mortality from cervical cancer in low-resource settings. METHODS: A prospective cohort study was conducted i ... Full text Link to item Cite

Developing a tool to measure intersectional stigma related to HIV and cervical cancer

Conference INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE · 2021 Cite

Surgical candidacy and treatment initiation among women with cervical cancer at public referral hospitals in Kampala, Uganda: a descriptive cohort study.

Journal Article BMJ Open · December 12, 2020 OBJECTIVES: This study aimed to report the proportion of women with a new diagnosis of cervical cancer recommended for curative hysterectomy as well as associated factors. We also report recommended treatments by stage and patterns of treatment initiation. ... Full text Link to item Cite

Barriers to the uptake of cervical cancer services and attitudes towards adopting new interventions in Peru.

Journal Article Prev Med Rep · December 2020 Cervical cancer mortality is high among Peruvian women of reproductive age. Understanding barriers and facilitators of cervical cancer screening and treatment could facilitate development of contextually-relevant interventions to reduce cervical cancer inc ... Full text Link to item Cite

A public health approach to cervical cancer screening in Africa through community-based self-administered HPV testing and mobile treatment provision.

Journal Article Cancer Med · November 2020 The World Health Organization (WHO) refers to cervical cancer as a public health problem, and sub-Saharan Africa bears the world's highest incidence. In the realm of screening, simplified WHO recommendations for low-resource countries now present an opport ... Full text Link to item Cite

Comparison of the costs of HPV testing through community health campaigns versus home-based testing in rural Western Kenya: a microcosting study.

Journal Article BMJ Open · October 27, 2020 OBJECTIVES: To estimate the cost of human papillomavirus (HPV)-based screening through community health campaigns (CHCs) and home-based testing. SETTING: CHCs and home-based testing in six communities in rural Western Kenya. PARTICIPANTS: CHCs and home-bas ... Full text Link to item Cite

A novel speculum-free imaging strategy for visualization of the internal female lower reproductive system.

Journal Article Scientific reports · October 2020 Fear of the speculum and feelings of vulnerability during the gynecologic exams are two of the biggest barriers to cervical cancer screening for women. To address these barriers, we have developed a novel, low-cost tool called the Callascope to reimagine t ... Full text Cite

Digital Health Strategies for Cervical Cancer Control in Low- and Middle-Income Countries: Systematic Review of Current Implementations and Gaps in Research (Preprint)

Journal Article · August 17, 2020 BACKGROUNDNearly 90% of deaths due to cervical cancer occur in low- and middle-income countries (LMICs). In recent years, many digital health strategies have been implemented in LMICs to ... Full text Cite

Safety and Acceptability of Thermal Ablation for Treatment of Human Papillomavirus Among Women Living With HIV in Western Kenya.

Journal Article JCO Glob Oncol · July 2020 PURPOSE: The WHO now recommends thermal ablation as an alternative to cryotherapy within "screen-and-treat" cervical cancer programs in low- and middle-income countries (LMICs). We conducted a safety and acceptability clinical trial of thermal ablation in ... Full text Link to item Cite

Effectiveness of 'catch-up' human papillomavirus vaccination to prevent cervical neoplasia in immunosuppressed and non-immunosuppressed women.

Journal Article Vaccine · June 15, 2020 It is unknown whether the HPV vaccine is effective in immunocompromised women during catch-up ages. We performed a case-control study of 4,357 women with incident CIN2+ (cases) and 5:1 age-matched, incidence-density selected controls (N = 21,773) enrolled ... Full text Link to item Cite

Mobile Technologies and Cervical Cancer Screening in Low- and Middle-Income Countries: A Systematic Review.

Journal Article JCO Glob Oncol · April 2020 PURPOSE: Cervical cancer screening is not well implemented in many low- and middle-income countries (LMICs). Mobile health (mHealth) refers to utilization of mobile technologies in health promotion and disease management. We aimed to qualitatively synthesi ... Full text Link to item Cite

"A Résumé for the Baby": Biosocial Precarity and Care of Substance-Using, Pregnant Women in San Francisco.

Journal Article Cult Med Psychiatry · March 2020 In the United States, the historical condemnation and punitive legal consequences of substance use during pregnancy-ranging from incarceration to termination of parental custody of a newborn-render pregnant women in state of biosocial precarity. Yet pregna ... Full text Link to item Cite

HPV-based cervical cancer screening in low-resource settings: Maximizing the efficiency of community-based strategies in rural Kenya.

Journal Article Int J Gynaecol Obstet · March 2020 OBJECTIVE: To characterize the efficiency of screening through high-volume community health campaigns (CHCs) by comparing the costs and population reach and identify factors associated with gains in efficiency. Access to effective cervical cancer screening ... Full text Link to item Cite

A Qualitative Exploration of Women's Experiences with a Community Health Volunteer-Led Cervical Cancer Educational Module in Migori County, Kenya.

Journal Article J Cancer Educ · February 2020 Detection and treatment of human papillomavirus (HPV) and cervical precancer through screening programs is an effective way to reduce cervical cancer deaths. However, high cervical cancer mortality persists in low- and middle-income countries. As screening ... Full text Link to item Cite

Impact of healthcare access and HIV testing on utilisation of cervical cancer screening among US women at high risk of HIV infection: cross-sectional analysis of 2016 BRFSS data.

Journal Article BMJ Open · January 6, 2020 OBJECTIVE: Previous studies identified several factors associated with cervical cancer screening. However, many of them used samples from the general population and limited studies focused on women with high-risk health behaviours. We aimed to disentangle ... Full text Link to item Cite

Systems-level barriers to treatment in a cervical cancer prevention program in Kenya: Several observational studies.

Journal Article PLoS One · 2020 OBJECTIVE: To identify health systems-level barriers to treatment for women who screened positive for high-risk human papillomavirus (hrHPV) in a cervical cancer prevention program in Kenya. METHODS: In a trial of implementation strategies for hrHPV-based ... Full text Link to item Cite

Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers.

Journal Article MDM Policy Pract · 2020 Purpose. In 2018, the US Preventive Services Task Force (USPSTF) endorsed three strategies for cervical cancer screening in women ages 30 to 65: cytology every 3 years, testing for high-risk types of human papillomavirus (hrHPV) every 5 years, and cytology ... Full text Open Access Link to item Cite

Using a Chord Diagram to Visualize Dynamics in Contraceptive Use: Bringing Data into Practice.

Journal Article Glob Health Sci Pract · December 23, 2019 We applied a novel approach to visualizing contraceptive histories from the Demographic and Health Surveys (DHS) contraceptive calendar to elucidate patterns of contraceptive switching and discontinuation (e.g., "churn" in contraceptive use across 2 points ... Full text Link to item Cite

Female perspectives on male involvement in a human-papillomavirus-based cervical cancer-screening program in western Kenya.

Journal Article BMC Womens Health · August 8, 2019 BACKGROUND: To be effective, population-based cervical cancer prevention programs must be tailored to meet the needs of the target population. One important factor in cervical cancer screening may include male involvement. To iteratively improve a screenin ... Full text Link to item Cite

'I'm here to save my life': a qualitative study of experiences navigating a cryotherapy referral system for human papillomavirus-positive women in western Kenya.

Journal Article BMJ Open · July 24, 2019 BACKGROUND: We sought to understand the beliefs, social norms and logistical factors that affect human papillomavirus (HPV)-positive women's uptake of cryotherapy treatment as part of a two-part cervical cancer screening strategy in rural Kenya. METHODS: I ... Full text Link to item Cite

Estimated Quality of Life and Economic Outcomes Associated With 12 Cervical Cancer Screening Strategies: A Cost-effectiveness Analysis.

Journal Article JAMA Intern Med · July 1, 2019 IMPORTANCE: Many cervical cancer screening strategies are now recommended in the United States, but the benefits, harms, and costs of each option are unclear. OBJECTIVE: To estimate the cost-effectiveness of 12 cervical cancer screening strategies. DESIGN, ... Full text Link to item Cite

Perspectives of women participating in a cervical cancer screening campaign with community-based HPV self-sampling in rural western Kenya: a qualitative study.

Journal Article BMC Womens Health · June 13, 2019 BACKGROUND: Despite cervical cancer being preventable with effective screening programs, it is the most common cancer and the leading cause of cancer-related death among women in many countries in Africa. Screening involving pelvic examination may not be f ... Full text Link to item Cite

How Providing Cervical Cancer Screening Results via Cell Phone Affects Patient Follow-Up Rates in Western Kenya.

Journal Article J Glob Oncol · June 2019 PURPOSE: Human papillomavirus (HPV) testing is being more widely used in simplified cervical cancer screening protocols in low-resource settings. One challenge to successful implementation is the multiple visits necessary to provide results and follow-up. ... Full text Link to item Cite

Guidelines for Cervical Cancer Screening in Immunosuppressed Women Without HIV Infection.

Journal Article J Low Genit Tract Dis · April 2019 EXECUTIVE SUMMARY: The risk of cervical cancer (CC) among women immunosuppressed for a variety of reasons is well documented in the literature. Although there is improved organ function, quality of life and life expectancy gained through use of immunosuppr ... Full text Link to item Cite

Prevalence, correlates, and predictive value of high-risk human papillomavirus mRNA detection in a community-based cervical cancer screening program in western Uganda.

Journal Article Infect Agent Cancer · 2019 BACKGROUND: New strategies are needed to combat the high incidence of cervical cancer in resource-limited settings such as sub-Saharan Africa. Screening for high-risk human papillomavirus (hrHPV) DNA is sensitive for pre-cancer, but its lack of specificity ... Full text Link to item Cite

Patient factors affecting successful linkage to treatment in a cervical cancer prevention program in Kenya: A prospective cohort study.

Journal Article PLoS One · 2019 OBJECTIVE: To identify patient factors associated with whether women who screened positive for high-risk human papillomavirus (hrHPV) successfully accessed treatment in a cervical cancer prevention program in Kenya. METHODS: A prospective cohort study was ... Full text Link to item Cite

A Novel, Versatile Speculum-free Callascope for Clinical Examination and Self-Visualization of the Cervix

Journal Article · 2019 Background Invasive cervical cancer is preventable, yet affects 500,000 women worldwide each year, and over half these women die. Barriers to cervical cancer screening include lack of awareness of cervical cancer and the cervix, fear of the specul ... Full text Cite

Effectiveness of catch-up human papillomavirus vaccination on incident cervical neoplasia in a US health-care setting: a population-based case-control study.

Journal Article Lancet Child Adolesc Health · October 2018 BACKGROUND: The population effectiveness of human papillomavirus (HPV) catch-up vaccination, defined in the USA as first vaccination at ages 13-26 years, has not been studied extensively. We aimed to assess the risk of cervical intraepithelial neoplasia (C ... Full text Link to item Cite

Evidence-Based Improvisation: Facing the Challenges of Cervical Cancer Care in Uganda

Journal Article Obstetrical and Gynecological Survey · October 1, 2018 Full text Cite

Evaluating a community-based cervical cancer screening strategy in Western Kenya: a descriptive study.

Journal Article BMC Womens Health · July 3, 2018 BACKGROUND: The incidence of cervical cancer in Kenya is among the highest in the world. Few Kenyan women are able to access screening, thus fueling the high cervical cancer burden. Self-collected human papilloma Virus (HPV) tests, administered during comm ... Full text Link to item Cite

Building on the HIV chronic care platform to address noncommunicable diseases in sub-Saharan Africa: a research agenda.

Journal Article AIDS · July 1, 2018 OBJECTIVE: The remarkable progress made in confronting the global HIV epidemic offers a unique opportunity to address the increasing threat of noncommunicable diseases (NCDs). However, questions remain about how to enhance the HIV platforms to deliver inte ... Full text Link to item Cite

Cost of HPV screening at community health campaigns (CHCs) and health clinics in rural Kenya.

Journal Article BMC Health Serv Res · May 25, 2018 BACKGROUND: Cervical cancer is the most frequent neoplasm among Kenyan women, with 4800 diagnoses and 2400 deaths per year. One reason is an extremely low rate of screening through pap smears, at 13.8% in 2014. Knowing the costs of screening will help plan ... Full text Link to item Cite

Evidence-based improvisation: Facing the challenges of cervical cancer care in Uganda.

Journal Article Gynecol Oncol Rep · May 2018 There is significant disparity in the prevalence of cervical cancer globally, with low- and middle-income countries (LMICs) shouldering a disproportionate share of disease incidence and an even greater proportion of morbidity and mortality. Available resou ... Full text Link to item Cite

Cervical cancer screening through human papillomavirus testing in community health campaigns versus health facilities in rural western Kenya.

Journal Article Int J Gynaecol Obstet · April 2018 OBJECTIVE: To determine the effectiveness of community health campaigns (CHCs) as a strategy for human papillomavirus (HPV)-based cervical cancer screening in rural western Kenya. METHODS: Between January and November 2016, a cluster-randomized trial was c ... Full text Link to item Cite

Human Immunodeficiency Virus (HIV)- and Non-HIV-Associated Immunosuppression and Risk of Cervical Neoplasia.

Journal Article Obstet Gynecol · January 2018 OBJECTIVE: To estimate the risk of cervical intraepithelial neoplasia grade 2, 2-3, 3, adenocarcinoma in situ, or cancer (CIN 2 or worse) among women with human immunodeficiency virus (HIV)- and non-HIV-associated immunosuppression. METHODS: We performed a ... Full text Link to item Cite

Comparison of patient flow and provider efficiency of two delivery strategies for HPV-based cervical cancer screening in Western Kenya: a time and motion study.

Journal Article Glob Health Action · 2018 BACKGROUND: Improving patient flow and reducing over-crowding can improve quality, promptness of care, and patient satisfaction. Given low utilization of preventive care in low-resource countries, improved patient flows are especially important in these se ... Full text Open Access Link to item Cite

Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya.

Journal Article BMC Cancer · December 6, 2017 BACKGROUND: Despite guidelines for cervical cancer prevention in low-resource countries, a very small proportion of women in these settings undergo screening, and even fewer women are successfully treated. Using pilot data from western Kenya and World Heal ... Full text Link to item Cite

WOMEN'S EMPOWERMENT AND FAMILY PLANNING: A REVIEW OF THE LITERATURE.

Journal Article J Biosoc Sci · November 2017 This paper reviews the literature examining the relationship between women's empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web o ... Full text Link to item Cite

Cervical Cancer Screening.

Journal Article Med Clin North Am · July 2017 Cervical cancer screening in the United States has accompanied profound decreases in cancer incidence and mortality over the last half century. Two screening strategies are currently endorsed by US-based guideline groups: (1) triennial cytology for women a ... Full text Link to item Cite

Performance of p16INK4a ELISA as a primary cervical cancer screening test among a large cohort of HIV-infected women in western Kenya: a 2-year cross-sectional study.

Journal Article BMJ Open · September 13, 2016 OBJECTIVE: A biomarker with increased specificity for cervical dysplasia compared with human papillomavirus (HPV) testing would be an attractive option for cervical cancer screening among HIV-infected women in resource-limited settings. p16(INK4a) has been ... Full text Link to item Cite

Cervical Cancer Stigma in Rural Kenya: What Does HIV Have to Do with It?

Journal Article J Cancer Educ · June 2016 Cervical cancer is a leading cause of cancer-related death amongst women in sub-Saharan Africa, largely due to the lack of early screening and treatment. In addition to poor access to screening services, inadequate uptake of available services is a barrier ... Full text Link to item Cite

Cervical Cancer Screening Knowledge and Behavior among Women Attending an Urban HIV Clinic in Western Kenya.

Journal Article J Cancer Educ · September 2015 Cervical cancer is a highly preventable disease that disproportionately affects women in developing countries and women with HIV. As integrated HIV and cervical cancer screening programs in Sub-Saharan Africa mature, we have an opportunity to measure the i ... Full text Link to item Cite

My Obstetrician Got Me Fired: How Work Notes Can Harm Pregnant Patients and What to Do About It.

Journal Article Obstet Gynecol · August 2015 Prenatal care providers are frequently asked to provide employment notes for their patients requesting medical leave or changes to work duties. Writing employment notes correctly can help patients negotiate for and obtain medically indicated workplace acco ... Full text Link to item Cite

Barriers to Cervical Cancer Screening in Rural Kenya: Perspectives from a Provider Survey.

Journal Article J Community Health · August 2015 Although cervical cancer is highly preventable through screening, it remains the number one cause of cancer-related death in Kenyan women due to lack of funding and infrastructure for prevention programs. In 2012, Family AIDS Care and Education Services in ... Full text Link to item Cite

Changing knowledge, attitudes, and behaviors regarding cervical cancer screening: The effects of an educational intervention in rural Kenya.

Journal Article Patient Educ Couns · July 2015 OBJECTIVE: Cervical cancer screening uptake may be influenced by inadequate knowledge in resource-limited settings. This randomized trial evaluated a health talk's impact on cervical cancer knowledge, attitudes, and screening rates in rural Kenya. METHODS: ... Full text Link to item Cite

Outcomes Up to 12 Months After Treatment With Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia Among HIV-Infected Women.

Journal Article J Acquir Immune Defic Syndr · June 1, 2015 INTRODUCTION: HIV-infected women may have higher rates of recurrent cervical precancer after treatment. Knowledge about rates and predictors of recurrence could impact guidelines and program planning, especially in low-resource settings. METHODS: In this p ... Full text Link to item Cite

Knowledge about cervical cancer screening and perception of risk among women attending outpatient clinics in rural Kenya.

Journal Article Int J Gynaecol Obstet · March 2015 OBJECTIVE: To evaluate cervical cancer knowledge, risk perception, and screening intention among women attending outpatient clinics in rural Kenya. METHODS: A cross-sectional oral survey was conducted among non-pregnant women aged 23-64 years who attended ... Full text Link to item Cite

Accuracy of visual inspection with acetic acid to detect cervical cancer precursors among HIV-infected women in Kenya.

Journal Article Int J Cancer · January 15, 2015 Visual inspection with acetic acid (VIA) is becoming a more widely recommended and implemented screening tool for cervical cancer prevention programs in low-resource settings. Many of these settings have a high prevalence of HIV-infected women. We carried ... Full text Link to item Cite

Acceptability and Accuracy of Cervical Cancer Screening Using a Self-Collected Tampon for HPV Messenger-RNA Testing among HIV-Infected Women in South Africa.

Journal Article PLoS One · 2015 BACKGROUND: HIV increases women's risk for high-risk human papillomavirus (hrHPV) infection and invasive cervical cancer. South Africa has a high HIV prevalence but low cervical cancer screening coverage. Self-collection of cervical specimens and hrHPV tes ... Full text Link to item Cite

The time has come to make cervical cancer prevention an essential part of comprehensive sexual and reproductive health services for HIV-positive women in low-income countries.

Journal Article J Int AIDS Soc · 2015 INTRODUCTION: HIV and cervical cancer are intersecting epidemics that disproportionately affect one of the most vulnerable populations in the world: women in low- and middle-income countries (LMICs). Historically, the disparity in cervical cancer risk for ... Full text Link to item Cite

A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol's Iodine for cervical cancer screening in HIV-infected women.

Journal Article PLoS One · 2015 Visual inspection with Acetic Acid (VIA) and Visual Inspection with Lugol’s Iodine (VILI) are increasingly recommended in various cervical cancer screening protocols in low-resource settings. Although VIA is more widely used, VILI has been advocated as an ... Full text Open Access Link to item Cite

Men's knowledge and attitudes about cervical cancer screening in Kenya.

Journal Article BMC Womens Health · November 22, 2014 BACKGROUND: A number of studies have identified male involvement as an important factor affecting reproductive health outcomes, particularly in the areas of family planning, antenatal care, and HIV care. As access to cervical cancer screening programs impr ... Full text Open Access Link to item Cite

Women's empowerment and fertility: a review of the literature.

Journal Article Soc Sci Med · August 2014 Women's empowerment has become a focal point for development efforts worldwide and there is a need for an updated, critical assessment of the existing evidence on women's empowerment and fertility. We conducted a literature review on studies examining the ... Full text Link to item Cite

Factors associated with recurrence of cervical intraepithelial neoplasia 2+ after treatment among HIV-infected women in Western Kenya.

Journal Article J Acquir Immune Defic Syndr · June 1, 2014 HIV-infected women are at increased risk for recurrence of cervical dysplasia after treatment. Short-term recurrence rates may reflect treatment efficacy and therefore impact screening protocols and follow-up planning. We conducted a prospective study of 2 ... Full text Link to item Cite

A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya.

Journal Article Bull World Health Organ · March 1, 2014 OBJECTIVE: To determine the optimal strategy for cervical cancer screening in women with human immunodeficiency virus (HIV) infection by comparing two strategies: visual inspection of the cervix with acetic acid (VIA) and VIA followed immediately by visual ... Full text Link to item Cite

Risk factors for cervical precancer detection among previously unscreened HIV-infected women in Western Kenya.

Journal Article Int J Cancer · February 1, 2014 HIV and cervical cancer are intersecting epidemics in many low-resource settings, yet there are few accurate estimates of the scope of this public health challenge. To understand disease prevalence and risk factors for cervical intraepithelial neoplasia 2 ... Full text Link to item Cite

Cervical cancer precursors and hormonal contraceptive use in HIV-positive women: application of a causal model and semi-parametric estimation methods.

Journal Article PLoS One · 2014 OBJECTIVE: To demonstrate the application of causal inference methods to observational data in the obstetrics and gynecology field, particularly causal modeling and semi-parametric estimation. BACKGROUND: Human immunodeficiency virus (HIV)-positive women a ... Full text Open Access Link to item Cite

Prevalence, characteristics, and outcomes of HIV-positive women diagnosed with invasive cancer of the cervix in Kenya.

Journal Article Int J Gynaecol Obstet · December 2013 OBJECTIVE: To determine the prevalence of invasive cervical cancer (ICC) and assess access to, and outcomes of, treatment for ICC among HIV-infected women in Kisumu, Kenya. METHODS: We performed a retrospective chart review to identify women diagnosed with ... Full text Link to item Cite

Impact of loop electrosurgical excision procedure for cervical intraepithelial neoplasia on HIV-1 genital shedding: a prospective cohort study.

Journal Article BJOG · September 2013 OBJECTIVE: We sought to examine the impact of the loop electrosurgical excision procedure (LEEP) on the rate and magnitude of HIV-1 genital shedding among women undergoing treatment for cervical intraepithelial neoplasia 2/3 (CIN2/3). DESIGN: Prospective c ... Full text Link to item Cite

Reproductive and maternal health in the post-2015 era: cervical cancer must be a priority.

Journal Article PLoS Med · August 2013 Ruby Singhrao and colleagues propose four arguments for why cervical cancer screening and treatment should be prioritized. Please see later in the article for the Editors' Summary ... Full text Link to item Cite

Association of cervical biopsy with HIV type 1 genital shedding among women on highly active antiretroviral therapy.

Journal Article AIDS Res Hum Retroviruses · July 2013 HIV-1 genital shedding is associated with increased HIV-1 transmission risk. Inflammation and ulceration are associated with increased shedding, while highly active antiretroviral therapy (HAART) has been shown to have a protective effect. We sought to exa ... Full text Link to item Cite

Is there an association between HIV-1 genital shedding and cervical intraepithelial neoplasia 2/3 among women on antiretroviral therapy?

Journal Article J Low Genit Tract Dis · July 2013 OBJECTIVE: Given the high prevalence of cervical intraepithelial neoplasia (CIN) grade 2/3 among HIV-infected women, we sought to examine the relationship between CIN 2/3 and HIV-1 genital shedding among women on highly active antiretroviral therapy (HAART ... Full text Link to item Cite

A systematic review of randomized trials assessing human papillomavirus testing in cervical cancer screening.

Journal Article Am J Obstet Gynecol · May 2013 Our objective was to assess the sensitivity and specificity of human papillomavirus (HPV) testing for cervical cancer screening in randomized trials. We conducted a systematic literature search of the following databases: MEDLINE, CINAHL, EMBASE, and Cochr ... Full text Link to item Cite

Direct questioning is more effective than patient-initiated report for the detection of sexually transmitted infections in a primary care HIV clinic in Western Kenya.

Journal Article Sex Transm Dis · February 2013 In resource-limited settings, detection of sexually transmitted infections (STIs) often relies on self-reported symptoms to initiate management. We found self-report demonstrated poor sensitivity for STI detection. Adding clinician-initiated questions abou ... Full text Link to item Cite

Loop electrosurgical excision procedure: safety and tolerability among human immunodeficiency virus-positive Kenyan women.

Journal Article Obstet Gynecol · September 2011 OBJECTIVES: To estimate the safety, tolerability, and acceptability of loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2 or 3) in human immunodeficiency virus (HIV)-positive women performed by nonphysician health ... Full text Link to item Cite

Building capacity for cervical cancer screening in outpatient HIV clinics in the Nyanza province of western Kenya.

Journal Article Int J Gynaecol Obstet · August 2011 OBJECTIVE: To evaluate outcomes of cervical cancer screening within HIV care and treatment clinics in Kenya. METHODS: Beginning in October 2007, visual inspection with acetic acid (VIA), colposcopy, and loop electrosurgical excision procedure (LEEP) were a ... Full text Link to item Cite

P3-S1.08 Are there acceptable alternatives to syndromic management for the diagnosis of sexually transmitted infections in HIV positive Kenyan women?

Journal Article Sexually Transmitted Infections · July 2011 BackgroundControl of sexually transmitting infections (STIs) is an important aspect of HIV prevention and care. Syndromic management for vaginal discharge, despite a recognised low sensitivity and specificity, is ... Full text Cite

The association of HIV counseling and testing with HIV risk behaviors in a random population-based survey in Kisumu, Kenya.

Journal Article AIDS Behav · May 2011 HIV testing has been promoted as a key HIV prevention strategy in low-resource settings, despite studies showing variable impact on risk behavior. We sought to examine rates of HIV testing and the association between testing and sexual risk behaviors in Ki ... Full text Open Access Link to item Cite

Safety of the loop electrosurgical excision procedure performed by clinical officers in an HIV primary care setting.

Journal Article Int J Gynaecol Obstet · October 2010 Outpatient treatment of cervical precancer using LEEP was performed safely and effectively by nonphysician healthcare workers in an HIV primary care clinic in Kisumu, Kenya. ... Full text Link to item Cite

Antenatal steroid use and predictors of preterm labor

Conference OBSTETRICS AND GYNECOLOGY · April 1, 2007 Link to item Cite

Rectus sheath hematoma after transvaginal follicle aspiration: a rare complication of in vitro fertilization.

Journal Article Fertil Steril · July 2005 OBJECTIVE: To discuss the diagnosis and management of rectus sheath hematomas after transvaginal follicle aspiration. DESIGN: Case report. SETTING: A single healthy patient in an academic IVF center. PATIENT(S): A healthy patient undergoing routine transva ... Full text Link to item Cite