Perception of Anal HPV Infection by HIV-Positive Men Practicing male-male-sex

201 Pages·2015·3.61 MB·English

by  Philecia Simone Mullings

Walden University
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Walden Dissertations and Doctoral Studies
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2015
Perception of Anal HPV Infection by HIV-Positive
Men Practicing male-male-sex
Philecia Simone Mullings
Walden University
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Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by
Philecia Mullings

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Derrick Copper, Committee Chairperson, Psychology Faculty
Dr. Augustine Baron, Committee Member, Psychology Faculty
Dr. Mona Hanania, University Reviewer, Psychology Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2015
Perceptions of Anal HPV Infection by HIV-Positive Men Practicing
Male-to-Male Sex
Philecia Mullings

MS, Central Michigan University, 2007
BSN, State University of New York, 2005

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Psychology

Walden University
November 2015
Abstract
Human papillomavirus (HPV) is a preventable, sexually transmitted infection whose
prevalence has been rising dramatically among men who have sex with men (MSM) in
the United States since 2008. The HPV infection rate for MSM is rising even faster for
MSM who are infected with the human immunodeficiency virus (HIV) and for those who
have developed acquired immune deficiency syndrome (AIDS). It is not clear whether
MSM in general and MSM with HIV have the knowledge necessary to prevent infection
of themselves and their partners. This phenomenological study explored the knowledge,
health perceptions, attitudes, and norms of the community of MSM and HIV-positive
MSM relative to HPV, using private, semi-structured, detailed interviews with 37 HIV-
positive MSM between 18 and 26 years of age; interviews were conducted at 3 outpatient
clinics and 2 private medical practices. Interview transcripts were analyzed; these
findings revealed that the study population of HIV-positive MSM had a basic
understanding of HPV but knew little about the transmission of HPV or about the
availability and cost of HPV vaccines. This study promotes positive social change by
identifying specific opportunities to improve health education policy and programs
targeting HIV-positive MSM. It also supports primary prevention efforts that have the
potential to be life-saving. Through educating MSMs, the potential exists to reach more
MSMs with primary prevention life-saving efforts. Study recommendations include
developing inclusive education programs addressing different aspects of, and behavioral
approaches to, the reduction of HPV infection risk; further exploration of a cost-benefit
analysis of the HPV vaccine; and support for policy change regarding insurance coverage
for male HPV vaccine in the United States.
Abstract
Perceptions of Anal HPV Infection by HIV-Positive Men Practicing
Male-to-Male Sex
by
Philecia Mullings

MS, Central Michigan University, 2007
BSN, State University of New York, 2005

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Health Psychology

Walden University
November 2015
Dedication
To God, my Heavenly Father, who strengthens me when I am a weak and opens
door when they are closed.
I dedicate my dissertation work to my family who supported my journey: To my
husband Conway, who taught me that quitting is not an option and shared the journey
from start to finish; to my daughter Roshawn, who embraces me as her role model; to my
sons Conway and Kyle who never left my side and who help me develop my technology
skills.
Special thanks go out to my parents, Gretel and Milton, whose push for education
rings in my ear. I also dedicate this dissertation to my friends who supported and prayed
with me. Claudette, I appreciate the time you took to proofread my paper. Vivienne, your
words of encouragement motivated me. Audrey, Catherine, and Shauna, you are my
cheerleaders. Georgeann, you are the source of inspiration that kept me humble.
This dissertation is dedicated to all those who seek to expand knowledge and
understanding through social sciences research.
Acknowledgments
I wish to acknowledge the contributions of my Chair, Dr. Copper, you are the
rock who stood strong through the process. Your patience, countless hours of reading my
paper, and encouragement made this accomplishment possible. To Drs. Baron and
Hanania, Thank you for your service.
Dr. T., I will always be grateful. Thank you also to Drs. Paul, Ifudu, and Uter,
each of whom was instrumental in the choice of my research topic and contributed to my
success.
Table of Contents
List of Tables ..................................................................................................................... iv
Chapter 1: Introduction to the Study ....................................................................................1
Introduction ....................................................................................................................1
Background of the Study ...............................................................................................4
Statement of the Problem ...............................................................................................7
Purpose of the Study ......................................................................................................7
Research Questions ........................................................................................................8
Theoretical Framework ..................................................................................................9
Nature of the Study ......................................................................................................10
Definitions of Terms ....................................................................................................11
Assumptions .................................................................................................................13
Scope and Delimitations ..............................................................................................13
Limitations ...................................................................................................................13
Significance of the Study .............................................................................................14
Summary ......................................................................................................................14
Chapter 2: Literature Review .............................................................................................17
Introduction to the Literature .......................................................................................17
Literature Search Strategies .........................................................................................17
Theoretical Framework ................................................................................................18
Conclusion ...................................................................................................................60
Summary ......................................................................................................................61
Chapter 3: Research Method ..............................................................................................63
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Qualitative Research Design and Rationale .................................................................63
Methodology ................................................................................................................65
Role of the Researcher .................................................................................................66
Data Analysis ...............................................................................................................70
Evidence of Trustworthiness........................................................................................71
Ethical Issues ...............................................................................................................72
Chapter 4: Findings ............................................................................................................76
Introduction ..................................................................................................................76
Setting ..........................................................................................................................77
Demographics ..............................................................................................................78
Data Collection ............................................................................................................87
Data Analysis ...............................................................................................................89
Evidence of Trustworthiness........................................................................................93
Findings........................................................................................................................95
Summary ....................................................................................................................116
Chapter 5: Discussion ......................................................................................................118
Introduction ................................................................................................................118
Summary of Findings .................................................................................................119
Interpretation of the Findings.....................................................................................121
Conceptual Framework Consideration ......................................................................121
Limitations of the Study.............................................................................................130
Recommendations ......................................................................................................133
Implications................................................................................................................135
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Reflections .................................................................................................................138
Conclusion .................................................................................................................139
References ........................................................................................................................142
Appendix A: Authorization Letters .................................................................................169
Appendix B: Flyer/Invitation ...........................................................................................172
Appendix C: Interview Questions ....................................................................................173
Appendix D: Consent Form .............................................................................................178
Appendix E: Brochure .....................................................................................................180
Appendix F: Thematic Categories ...................................................................................182

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