Human immunodeficiency virus (HIV) remains a significant public health issue in the United States. Among women living with HIV (WLHIV), one of the most serious health risks is co-infection with human papillomavirus (HPV). WLHIV are more likely to acquire and retain high-risk HPV strains, which increases their risk of developing cervical cancer. This study aimed to characterize the attitudes, beliefs, and vaccination status of WLHIV residing in Tennessee regarding the HPV vaccine series, as well as the impact of their HIV status and antiretroviral treatment on these factors. A qualitative approach using narrative interviews was utilized to encourage fluid and flexible storytelling from WLHIV. Eligibility criteria included WLHIV aged 18 to 45, of various ethnicities, residing in Tennessee, English-speaking, and willing to share their experiences related to HIV and HPV. The narrative interviews were conducted over the phone in 2024 and audio recorded. The recordings were then transcribed by a third-party, and the data were analyzed using narrative analysis in Dedoose®, a qualitative software. A total of 19 WLHIV were interviewed over a six-month period, and all participants identified as Black, with a mean age of 39 years. Three themes were identified and illustrate the experiences of the participants: Theme 1: HIV diagnosis: “I thought it was the end of the world. I thought it was over for me.”; Theme 2: Intrinsic motivators for taking antiretroviral treatment; Theme 3: Limited awareness of .HPV; Sub-Theme 1: Intrinsic motivators to receive the HPV Vaccine: role of the healthcare provider; Sub-theme 2: Fear of cancer as a motivator to be vaccinated: “Cancer kills!” The data highlighted that some participants had limited awareness of HPV, despite it being the most prevalent sexually transmitted infection in the U.S. Detailed evidence of the intrinsic motivators that contribute to adherence to antiretroviral treatment were provided. Additionally, various factors affecting both treatment adherence and the uptake of the HPV vaccine were emphasized.

Background: The introduction of the human papilloma virus (HPV) vaccine has allowed for incredible strides in the reduction in HPV-related cancers. Despite widespread availability and a recent age group expansion for the vaccine, uptake remains low. Particularly, concerning disparities exist in the state of Tennessee and among minority women. This study aimed to identify key influences of decision-making to receive the HPV vaccine in minority women living in Tennessee. Methods: This study used a prospective, observational, qualitative methods approach. Minority women residing in Tennessee were recruited through flyers posted in various community-based locations around the state. Narrative interviews of participants were conducted until thematic saturation was achieved. Interviewing occurred telephonically, with questions focused on participant perceptions of HPV and its vaccine. Verbatim transcripts were created via external software, and then inductively coded by three researchers. These codes were grouped into categories based on similarities, which facilitated the emergence of themes. Results: A total of 21 participants were interviewed between July and October 2024. Thematic analysis revealed two themes: (1) Awareness of HPV: Determining if the Vaccine is Right for Me; and (2) Intrinsic Motivators for HPV Vaccine adoption: “Like going to the salon and getting your hair half-done”. While some participants had an accurate understanding of HPV, its health consequences, and had received the vaccine, most were unvaccinated and had little understanding of the benefits of this preventative method. Those who received the HPV vaccination were influenced by proactive healthcare workers who provided in-depth education about its benefits. Those who did not elect to receive the vaccine described how its lack of mandate and seldom informational opportunities impacted their decision. Conclusions: Overall, minority women in Tennessee could benefit from improved access to information regarding HPV and its vaccine, as well as direct provider influence and counseling on receiving the vaccine to avoid detrimental health consequences.

Background: Human papillomavirus (HPV) continues to cause an estimated 4000 preventable cancer deaths each year in the United States. Given the prevalence of HPV-related disease and suboptimal vaccination rates, this study explores perceptions of HPV vaccination among HIV-negative females and females living with HIV in Tennessee. Methods: This prospective, observational qualitative study consisted of narrative interviews which were conducted with HIV-negative and HIV-positive participants, focusing on their perceptions of HPV and its vaccine. Interviews were conducted by phone, and the verbatim transcripts were inductively coded by three researchers. The inductive codes were then grouped into categories based on similarities which facilitated the emergence of themes. Results: A total of 40 participants were interviewed between July 2024 and December 2024. Narrative analysis revealed three themes: (1) “I had never heard of it until I saw the flier.” Gaps in Understanding of HPV and Its Health Implications, (2) Navigating Adolescent Health Decisions and Emotional Influence, and (3) Barriers to Uptake—Skepticism, Trust, and the Need for Tailored Information. Two subthemes emerged: Cohort-Specific Skepticism, and Parental Influence and Communication Gaps. Conclusions: This study revealed significant gaps in HPV knowledge and vaccination uptake among HIV-negative women and women living with HIV in Tennessee. Provider communication was key to vaccine decisions, but clear recommendations were often missed in clinical encounters.