{
  "abstract": "Background Cervical cancer is one of the leading causes of death among women in Africa, but stigma often delays cervical cancer prevention. We explore the perceptions, enablers and nurturers through the lens of intersectional stigma in the uptake of cervical cancer prevention services in Nigeria.Method Indepth interviews and focus group discussions were conducted among women aged 30–65 years and girls aged 9–26 years in Lagos, Nigeria. Data were analysed thematically. Using the relationships and expectation domain of the PEN-3 cultural model, we identified perceptions, enablers and nurturers related to the uptake of primary and secondary cervical cancer prevention services in Nigeria. We also explored how social identities may intersect with health-related stigmas and affect the uptake of these services.Result We interviewed 31 women and 31 girls. 61% of the participants were Christians and 39% were Muslims and were from the three major ethnic groups in Nigeria: Igbo (34%), Hausa (38%) and Yoruba (28%). Themes emerging from the data: (1) positive perceptions (self-efficacy): many women understood the importance of protecting themselves and their daughters from cervical cancer and strongly believed that they could educate their partners/husbands and would not let other people’s experiences with the vaccine influence them negatively. (2) Negative perceptions (anticipated stigma): some women expressed that because the human papillomavirus that causes cervical cancer is mainly sexually transmitted, they were concerned that they may be perceived as being promiscuous if they decide to commence routine cervical cancer screening. (3) Enablers (social support): nearly all women wanted the support of their spouses before receiving cervical cancer screening. (4) Nurturers (resilience): many clearly understood the complex social and economic realities faced by Nigerians that negatively affect their access to healthcare.Conclusion These findings offer intersectional insights into advancing public health and culturally anchored interventions to preventing cervical cancer-related stigma in Nigeria.",
  "authors": [
    {
      "affiliations": [
        "Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria"
      ],
      "name": "Agatha Eileen Wapmuk"
    },
    {
      "affiliations": [
        "Department of Behavioral Science and Health Equity, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA"
      ],
      "name": "Ifeoma Obionu"
    },
    {
      "affiliations": [
        "Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"
      ],
      "name": "Chisom Obiezu-Umeh"
    },
    {
      "affiliations": [
        "Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria",
        "Division of Infectious Diseases, Washington University School of Medicine in St. Louis, Saint Louis, Missouri, USA"
      ],
      "name": "Titilola Abike Gbaja-Biamila"
    },
    {
      "affiliations": [
        "Division of Infectious Diseases, Washington University School of Medicine in St. Louis, Saint Louis, Missouri, USA"
      ],
      "name": "Ekenechukwu Kokelu"
    },
    {
      "affiliations": [
        "Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"
      ],
      "name": "Ucheoma Nwaozuru"
    },
    {
      "affiliations": [
        "Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Eneyi E Kpokiri"
    },
    {
      "affiliations": [
        "Georgia State University School of Public Health, Atlanta, Georgia, USA"
      ],
      "name": "Collins O Airhihenbuwa"
    },
    {
      "affiliations": [
        "Department of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"
      ],
      "name": "Jennifer S Smith"
    },
    {
      "affiliations": [
        "Monitoring and Evaluation Unit, Nigerian Institute of Medical Research, Lagos, Nigeria"
      ],
      "name": "Musa Zaidat"
    },
    {
      "affiliations": [
        "Department of Research, Direct Consulting and Logistics LLC, Abuja, Nigeria"
      ],
      "name": "Chisom Obi-Jeff"
    },
    {
      "affiliations": [
        "Department of Community Health, Ebonyi State University, Abakaliki, Ebonyi, Nigeria"
      ],
      "name": "Benedict N Azuogu"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynaecology, Obafemi Awolowo University, Ife, Nigeria"
      ],
      "name": "Kayode Ajenifuja"
    },
    {
      "affiliations": [
        "Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK",
        "Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"
      ],
      "name": "Joseph D Tucker"
    },
    {
      "affiliations": [
        "Division of Infectious Diseases, Washington University School of Medicine in St. Louis, Saint Louis, Missouri, USA"
      ],
      "name": "Juliet Iwelunmor"
    },
    {
      "affiliations": [
        "Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria"
      ],
      "name": "Oliver C Ezechi"
    }
  ],
  "title": "Intersectional stigma and resilience in the uptake of cervical cancer prevention services in Nigeria: a qualitative study",
  "uid": "5afe99b0-a3be-5689-beb3-5605c6a1bb1f"
}