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Abnormal Pap Follow-Up among Criminal-Legal Involved Women in Three U.S. Cities by
Salyer, Chelsea Lipnicky, Ashlyn Bagwell-Gray, Meredith Lorvick, Jennifer Cropsey, Karen Ramaswamy, Megha
Salyer, Chelsea
Lipnicky, Ashlyn
Bagwell-Gray, Meredith
Lorvick, Jennifer
Cropsey, Karen
Ramaswamy, Megha
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Abstract
Criminal-legal involved women experience significant barriers to preventive cervical care, and consequently there is a higher incidence of cervical cancer in this population. The purpose of this study is to identify variables that may facilitate abnormal Pap follow-up among criminal-legal involved women living in community settings. The study included n = 510 women with criminal-legal histories, from three U.S. cities—Birmingham, AL; Kansas City, KS/MO; Oakland, CA. Participants completed a 288-item survey, with questions related to demographics, social advantages, provider communication, and reasons for missing follow-up care. There were n = 58 women who reported abnormal Pap testing, and n = 40 (69%) received follow-up care. Most women received either repeat Pap/HPV testing (n = 15, 38%), or colposcopy and/or biopsy (n = 14, 35%). Women who did not follow-up (n = 15, 26%) cited that they forgot (n = 8, 53%), were uninsured (n = 3, 20%), or were reincarcerated (n = 3, 20%). In a multivariate analysis, both having a primary care provider (OR 4.6, 95% CI 1.3–16.0) and receiving specific provider communication about follow-up (OR 3.8, 95% CI 1.1–13.2) were independent predictors for abnormal Pap follow-up. Interventions that offer linkages to providers in the community or ensure abnormal Pap care plans are communicated effectively may mitigate the disparate incidence of cervical cancer among criminal-legal involved women.
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2021-06-18
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MDPI
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Salyer_2021.pdf
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Keywords
Cervical cancer disparities, Criminal-legal involved women, Abnormal Pap follow-up
Citation
Salyer, C.; Lipnicky, A.; Bagwell-Gray, M.; Lorvick, J.; Cropsey, K.; Ramaswamy, M. Abnormal Pap Follow-Up among Criminal-Legal Involved Women in Three U.S. Cities. Int. J. Environ. Res. Public Health 2021, 18, 6556. https://doi.org/10.3390/ijerph18126556