Abstract B107: Healthcare providers’ perspective on the barriers and facilitators to cervical cancer care among women living with HIV in Puerto Rico: A qualitative study

Abstract Introduction: Social determinants of health (SDoH) are well known to have a significant impact on cancer outcomes. Barries to care have been shown to exacerbate disparities across the cancer care continuum (prevention, diagnosis, and treatment). However, previous studies have not identified which factors significantly affect access to cervical cancer care among women living with HIV (WLWH). Moreover, Hispanic WLWH have a higher incidence of cervical cancer when compared to their White counterparts, and findings from previous studies suggest a higher excess incidence of cancer and HPV-related cancers, including cervical cancer, among Hispanic PLWH in Puerto Rico (P.R.) compared to other racial/ethnic groups in the U.S. This qualitative study aimed to identify multilevel SDoH factors that affect timely care for cervical cancer for Puerto Rican WLWH, according to healthcare providers. Methods: In-depth interviews were conducted with 21 key informants (KIs) to identify and understand the SDoH that may facilitate or hinder access to cervical care throughout the cancer continuum for Puerto Rican WLWH. KIs were eligible if they were 21 years or older, lived in Puerto Rico, and had worked in an organization providing cancer or HIV services for at least one year. To code the interviews, a collaborative codification process was carried out with three coding groups, and intercoder agreement was applied within each group. A thematic content analysis was used to identify key themes and the frequency with which these themes appeared in the interviews, using NVivo. Preliminary Results: Twenty-one KIs were interviewed; most were women (81.0%), medical providers (52.4%), and worked in HIV clinics (52.4%). For the overall population, the most reported barriers to cervical cancer care were health insurance problems (n=36), limited availability of clinical specialists (n=22), and the geographic location of services (n=12). The most common facilitators were patient navigation services (n=34), supportive interactions between providers and patients (n=29), and interprofessional communication (n=16). For WLWH specifically, the most common barriers included HIV-related stigma (n=7), concerns about HIV disclosure (n=5), and discrimination (n=4). Meanwhile, the most reported facilitators for WLWH were HIV routine care (n=13), interprofessional communication (n = 9), and supportive interactions between providers and patients (n=7). Conclusions: Our study highlights key barriers and facilitators to cervical cancer care among Puerto Rican WLWH. These factors are shaped by the local, social and systemic context, and warrant further investigation. Given the high risk of cervical cancer in WLWH and reported delays in cancer care among WLWH, particularly among Hispanics, addressing barriers to timely healthcare is essential for improving cancer outcomes in this population. The data obtained from this project will inform multilevel health interventions targeting SDoH to improve access to cervical cancer care for WLWH. Citation Format: Marievelisse Soto-Salgado, Melisa Ramos-Sepúlveda, Verónica García-Ramírez, Mariela Bournigal-Feliciano, Mayerli Dávila-Rivera, Karina Torres-Mojica, Rocío del Mar. Avilés-Mercado, Edna Acosta-Pérez, Naydi Pérez-Ríos, Tatiana Pérez-Rodríguez, Vivian Colón-López, Maribel Almonte, Sharee Umpierre, Lorena González-Sepúlveda, Ana P. Ortiz. Healthcare providers’ perspective on the barriers and facilitators to cervical cancer care among women living with HIV in Puerto Rico: A qualitative study abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A107.