Introduction
HPV is the most prevalent sexually transmitted infection among men and
women of reproductive age worldwide (1),
and its effect on cancer induction is well known
(2). HPV infections are significantly
associated with many alterations of reproductive function
(1).
In comparison to studies related to HPV oncogenic effect, there is a
lack of studies focused on the impacts that HPV may have on fertility
and reproductive systems. This aspect of HPV infection deserves more
attention because if HPV is not the leading cause of reduced fertility
or infertility, it must be considered as a risk factor of it
(3). It appears from the studies that HPV
can be associated with adverse pregnancy outcomes such as miscarriages
and premature delivery (3).
Existing evidence suggests that HPV testing reaches the maximum level of
accuracy in cervical screening (4). In
Iran, HPV screening recommendations established for all women aged
30–59 (5), which led to detecting many
new cases of HPV in women of childbearing age
(6).
Some studies have addressed the fertility and pregnancy concerns of
HPV-positive women. In a study conducted in the United States reported
that many women expressed fear associated with role of HPV in their
future pregnancy (7). In other studies,
women expressed worries surrounding HPV and female subfertility
(8-13). One study addressed women’s
concern about the HPV-associated risks of preterm delivery and
implications of natural delivery from an HPV-infected birth canal
(12). In another study women were worried
about the HPV transmission to the fetus
(14).
To date, several qualitative studies have been explored adverse
psychological responses to HPV diagnosis and the most of the
reproductive concerns emerged from these studies received far less
attention. It is worth noting that some HPV-positive women suffer from
genital warts (GWs) that must not be overlooked. Women with GWs often
excluded from the previous studies while these women may have additional
concerns. Given the effect HPV may have on women of reproductive age,
the provision of support and interventions for infected women requires a
deep understanding of their concerns. There have been no qualitative
studies to investigate reproductive concerns and informational needs of
HPV-positive women particularly in the Islamic cultural background.
Therefore, we conducted interviews with Iranian HPV-infected women to
better understand their reproductive concerns.