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.