Women's experiences, responses, and coping strategies when testing positive for human papillomavirus in cervical cancer screening: A qualitative study

INTRODUCTION: Many countries, including Denmark, are adopting human papillomavirus-based cervical screening due to its higher sensitivity compared to cytology. However, the sexually transmitted nature of HPV may evoke psychosexual distress. We aimed to explore: (1) women's psychosexual experiences, and (2) factors that shape their experiences and coping strategies in relation to routine cervical cancer screening. MATERIAL AND METHODS: We conducted a qualitative study at the Department of Obstetrics and Gynecology, Gødstrup Hospital, Denmark from September 2024 to February 2025. We included women aged 30-60 referred to colposcopy due to a high-risk HPV-positive screening. Women were excluded if they had a previous history of excisional treatment. We conducted in-depth semi-structured interviews. All interviews were audiotaped and transcribed verbatim, after which a thematic analysis was performed using a phenomenological approach. RESULTS: We included 21 women with a median age of 42.5 years (range: 32-55 years). Receiving a high-risk HPV result by mail left women without immediate support or information, causing feelings of anxiety about cancer risk, confusion about their health and next steps in treatment. The general practitioner (GP) was perceived as a source of reassurance, but was not always easily accessible. Recognizing the impact of HPV as a sexually transmitted virus triggered feelings of guilt, shame, and embarrassment, as well as sensations of uncleanliness and bodily disconnection. The diagnosis also strained relationships and disrupted sexual intimacy. Although the follow-up gynecological consultation with colposcopy was reassuring, it was experienced as complex due to emotional burdens such as stigma and shame. A sense of needing to simply "comply" also hindered open discussion about the sexual nature of HPV and the expression of personal concerns. CONCLUSIONS: Based on a practice theoretical framework, this study shows that women's experiences following a high-risk HPV diagnosis in the context of cervical screening are not merely individual responses to medical information, but should be understood within a broader psychological, social, and cultural context that shapes how women process and cope with the diagnosis. These findings underscore the need for a holistic approach to patient care that fosters supportive and informative practices for women affected by HPV, coupled with a broader societal effort to reduce stigma and increase public awareness.