Women's experiences, responses, and coping strategies when testing positive for human papillomavirus in cervical cancer screening: A qualitative study

Abstract

Introduction

Many countries, including Denmark, are adopting human papillomavirus‐based cervical screening due to its higher sensitivity compared to cytology. However, the sexually transmitted nature of HPV may evoke psychosexual distress. We aimed to explore: (1) women's psychosexual experiences, and (2) factors that shape their experiences and coping strategies in relation to routine cervical cancer screening.

Material and Methods

We conducted a qualitative study at the Department of Obstetrics and Gynecology, Gødstrup Hospital, Denmark from September 2024 to February 2025. We included women aged 30–60 referred to colposcopy due to a high‐risk HPV‐positive screening. Women were excluded if they had a previous history of excisional treatment. We conducted in‐depth semi‐structured interviews. All interviews were audiotaped and transcribed verbatim, after which a thematic analysis was performed using a phenomenological approach.

Results

We included 21 women with a median age of 42.5 years (range: 32–55 years). Receiving a high‐risk HPV result by mail left women without immediate support or information, causing feelings of anxiety about cancer risk, confusion about their health and next steps in treatment. The general practitioner (GP) was perceived as a source of reassurance, but was not always easily accessible. Recognizing the impact of HPV as a sexually transmitted virus triggered feelings of guilt, shame, and embarrassment, as well as sensations of uncleanliness and bodily disconnection. The diagnosis also strained relationships and disrupted sexual intimacy. Although the follow‐up gynecological consultation with colposcopy was reassuring, it was experienced as complex due to emotional burdens such as stigma and shame. A sense of needing to simply “comply” also hindered open discussion about the sexual nature of HPV and the expression of personal concerns.

Conclusions

Based on a practice theoretical framework, this study shows that women's experiences following a high‐risk HPV diagnosis in the context of cervical screening are not merely individual responses to medical information, but should be understood within a broader psychological, social, and cultural context that shapes how women process and cope with the diagnosis. These findings underscore the need for a holistic approach to patient care that fosters supportive and informative practices for women affected by HPV, coupled with a broader societal effort to reduce stigma and increase public awareness.

This study demonstrates that women's experiences following an hrHPV diagnosis within cervical screening extend beyond individual reactions to medical information, encompassing complex psychological, social, and cultural dimensions that influence how women interpret and manage the diagnosis.

Abbreviations

CIN

Cervical Intraepithelial Neoplasia

hrHPV

high‐risk human papillomavirus

STI

sexually transmitted infection

Key message.

Receiving a high‐risk HPV result without timely follow‐up caused anxiety and self‐blame. The sexually transmitted nature of HPV evoked shame, and women found the emotional aspects difficult to discuss during consultations, leaving questions unanswered, and feelings unresolved.

1. INTRODUCTION

Virtually all cervical cancers are caused by an infection with high‐risk human papillomavirus (hrHPV), ¹ , ² , ³ and several randomized trials have shown that primary screening for hrHPV provides better protection against cancer compared to cytology‐based screening. ⁴ Therefore, several countries, including Scandinavian countries, ⁵ have implemented HPV‐based screening as the primary screening test. HPV is the most common sexually transmitted infection (STI), with an estimated 80% of unvaccinated women likely to be infected at some point in their lives. ²

With HPV‐based screening, women are no longer screened for cytological abnormalities as the primary test, but for the etiologic agent, a sexually transmitted virus. It is important to understand how receiving a positive HPV screening result may affect women, as this knowledge supports informed decision‐making for both women and healthcare providers involved in cervical cancer screening and follow‐up.

Psychosexual distress, understood as emotional responses that affect body perception, intimacy, and sexual behavior, is a recognized consequence of STIs, including HPV. ⁶ , ⁷ , ⁸ , ⁹ Research from countries such as Australia, Canada, the USA, the UK, and Taiwan shows that women diagnosed with HPV often experience concerns related to infidelity, stigma, and diminished sexual self‐worth and that the diagnosis can strain relationships, disrupt sexual activity, ¹⁰ , ¹¹ , ¹² and complicate disclosure to partners due to fear of blame or rejection. ¹³ , ¹⁴

There is a need for context‐sensitive research, as cultural frameworks shape the interpretation of an HPV diagnosis. Denmark has a long‐standing tradition of publicly funded health education, including sexual education, ¹⁵ and may differ in terms of how sexual norms and HPV‐related stigma are expressed compared to other cultural contexts. Yet, there is still a lack of qualitative studies examining how women in Denmark, or in any Scandinavian context, experience an HPV diagnosis.

This study extends the evidence base by focusing on participants in the Danish National Cervical Cancer Screening Program who attended HPV‐based screening. We aimed to qualitatively explore: (1) women's psychosexual experiences with a high‐risk HPV diagnosis, and (2) factors that shape their experiences and coping strategies when participating in the Danish National Cervical Cancer Screening Program.

2. MATERIAL AND METHODS

2.1. Design

We conducted qualitative semi‐structured individual interviews to explore women's experiences of testing positive for hrHPV. This well‐established method of data collection, involving a systematic collection, organization, and analysis of data, ¹⁶ , ¹⁷ facilitated an in‐depth, contextual understanding of the meanings women assigned to their experience of testing positive for a sexually transmitted virus with oncogenic potential.

2.2. Setting

In Denmark, cervical cancer screening, diagnostic follow‐up, and treatment are provided free of charge to all residents. ¹⁸ Since 2021, HPV‐based screening has been implemented gradually for women aged 30–59 years, and was fully implemented in May 2025. ¹⁹ In the Danish cervical cancer screening program, women receive their screening results digitally via e‐Boks, a secure digital mailbox used for official communication from public authorities to the patient. Typically, the result is issued by the pathology department that analyzed the sample, although practices may vary slightly between regions. This email states that hrHPV has been detected and specifies the type of HPV using the term “high‐risk HPV” along with a number for precise classification. Additionally, it indicates that further examination is necessary and advises the recipient to contact their General Practitioner (GP) for further information if deemed needed by the patient. The email provides no additional information on what it means to have hrHPV detected or the potential risk of having cervical precancer or cancer.

2.3. Study participants

This study was conducted at the Department of Obstetrics and Gynecology, Gødstrup Hospital, Denmark, from September 2024 to February 2025. Women were eligible if they were aged 30–59, tested hrHPV positive on a routine cervical cancer screening test, and referred for colposcopy. Women were excluded if they had a previous record of a large loop excision of the cervical transformation zone (LLETZ) or hysterectomy. Eligible women were consecutively recruited by gynecologists using convenience sampling. Interested women received written information and were contacted by the first author (JH) by phone. Participants provided written informed consent before the interview was scheduled and conducted.

2.4. Data collection

The interview guide was developed by JH in collaboration with all Danish co‐authors and theoretically grounded in practice theory. ²⁰ Practice theory adopts the ontology that humans and social structures are mutually constitutive and emphasizes the complex interplay of bodily, mental, material, and social elements. This enabled us to examine how various dimensions shape and inform women's individual experiences. Open‐ended and follow‐up questions supported the interviews, summarized in Table 1. Questions regarding disclosure of the hrHPV diagnosis were included to support exploration of women's experiences of stigma, relational concerns, and coping strategies, although these were not analyzed as a separate thematic category. JH, a midwife with qualitative research experience, conducted the audio‐recorded interviews. Transcriptions were made verbatim using Sonix.AI. Transcript quality was systematically assessed by JH against audio recordings. Consent forms, audio, and transcripts were securely stored per Danish law. Interviews took place 2–3 weeks after participants' colposcopy follow‐up. Data quality was assessed iteratively to ensure sufficient information power for analysis. ²¹

TABLE 1.

Topics and examples of interview questions.

Topic	Sample interview questions
Emotional and psychological reactions	What were your first thoughts when you were diagnosed with HPV? How did you feel at that moment?
Personal, including bodily reactions	Have you shared with anyone that you are diagnosed with HPV? Has being diagnosed with HPV affected your view on your own health or body?
Relational circumstances	Have you shared with anyone that you have been diagnosed with HPV? Has it affected your personal relationships or intimate relationships? If so, how?
Understanding of HPV as a sexually transmitted virus	What were your thoughts about being infected with HPV? How did you think of HPV in relation to other sexually transmitted infections, such as chlamydia and gonorrhea?
Interaction with healthcare staff	How was the HPV diagnosis explained to you by the healthcare staff? (Who and elaborate on the specific situation.) Were there any considerations or thoughts that were important to you that you did not share?
To undergo a gynecological examination	How do you feel about having a gynecological examination? How did you experience the gynecological examination?
Experiences of automated messages about test results	The automated letter you received with your HPV test result – do you remember what it contained? How did it affect you?
Support and information	What kind of support have you received after being diagnosed with HPV? (family, friends, healthcare professionals) Is there anything you found particularly helpful? Could the healthcare staff/system have done anything differently?

2.5. Data analysis

Data were analyzed using an open, inductive coding approach in NVivo 15.0, with initial coding by JH and collaborative review and refinement of themes with co‐authors. Danish co‐authors provided feedback on selected interviews to enhance the thematic analysis. To ensure transparency between themes and supporting quotes, we present illustrative quotes for each theme (Table 2), which is referenced throughout the results section. In the Results section, references marked with the symbol # indicate the quote in Table 2 the text references.

TABLE 2.

Themes, subthemes, and supporting quotes.

Subtheme	Quote #	Illustrative quote
Theme 1: Women's initial experiences of receiving a high‐risk HPV test result
1.1: Limited Emotional Impact of a High‐Risk HPV Diagnosis	1	“… the thing about HPV is that 80% of us have it. I mean, of course it can develop into something, but it's only if it does that I would start to worry. So, it's not that I'm really reacting to it as such, but I called my sister, who's a nurse, just to ask: ‘What is this? And what does it actually mean?’” (ID12)
	2	“It didn't really take up much space, the HPV diagnosis. I mean, now and then it would pop into my mind, and I'd think: ‘What is this, actually?’ But it wasn't something I thought much about.” (ID10)
1.2: Anxiety and Fear in Response to a High‐Risk HPV Diagnosis: Focus on Cancer Risk	3	“My body just went completely into shock when I received that message: high‐risk HPV. … I cried almost constantly in the first few days after receiving the news because I was simply in shock over it.” (ID20)
	4	“I was deeply affected by the HPV diagnosis. The day after, when I went to work, I couldn't even stay. I just cried. People looked at me, and I felt overwhelmed with anxiety. At night, I had vivid dreams… in those dreams, I saw every single doctor from the outpatient clinic. I had consultations where I was told: ‘There's nothing to be done; you have cancer.’” (ID16)
	5	“I could barely concentrate at work and had to tell my colleagues that I was feeling really unwell. I felt uneasy … I was truly frightened, and it made me feel nauseous. Even though I consider myself highly educated and well‐informed, there was still this fear inside me.” (ID21)
	6	“What affected me the most was probably being suddenly confronted with the fact that I'm alone with my children. And then I think I just immediately imagined the worst. Like, ‘What if I have cancer? What if I suddenly have to go through a whole treatment process? There are people here I'm responsible for.’ You know, that was what hit me first. And then I just felt fragile in that moment. I found it really hard to be in that state of uncertainty.” (ID9)
	7	“My GP sent the HPV‐result via the health portal [A Danish digital platform where patients can access their own health information, communicate with their doctor, view test results, book appointments, and receive messages from the healthcare system], and it basically just said, ‘Cellular changes were found, and we refer you to further investigation at the hospital. You will receive a summons. Have a good day.’ There was no information. There wasn't that feeling of, like, you can just call if you have questions. It was just a bit harsh and blunt.” (ID3)
Theme 2: The impact of recognizing HPV as an STI on women and their partners
Subtheme 2.1: Navigating Moral Emotions, Intimacy, and Embodiment	8	“I kind of feel like saying that it's important to make it clear you don't have to be ‘slutty’ to have gotten this disease or to have been sexually active early, because I often hear that being thrown around. People say things like that, and I've been terribly affected by it. At least, I feel that I don't want to talk about my HPV diagnosis when it's framed like that… it makes me feel guilty, like, ‘Oh, so this is actually something I brought on myself.’ I thought, well, maybe I shouldn't have just relied on birth control pills with my partner. Maybe I shouldn't have had sex at all.” (ID19)
	9	“And honestly, since I didn't know much about it, all I could think was, ‘Shit, should I have used a condom? Have I contracted some deadly disease?’” (ID20)
	10	“I felt gross inside, almost as if I could physically sense that something was wrong, like a kind of pseudo‐feeling. I became very aware of it and felt a bit unclean, just knowing that I had this inside my body and that it could be dangerous if I didn't monitor it.… You become hyper‐aware of the entire ecosystem down there, whether you want to or not.” (ID5)
	11	“I started showering a bit more… kind of more often. Sometimes even a couple of times a day, and then again just to wash my genital area, simply because, yeah… I felt more ashamed that I suddenly had this.” (ID18)
	12	“Again, this feeling of not being able to sense it. And suddenly, you start thinking about symptoms. Did I overlook something? Why didn't I react to it? What could it possibly mean? I become kind of hyper‐focused on that part of my health… But yeah, I think that's been strange. And again, with your health, it's just… I don't feel like I can't do anything about it. It's just there. I can't control it.” (ID5)
Subtheme 2.2: The Impact of HPV Diagnosis on Women's Intimate Relationships with Partners	13	“The desire to have sex kind of disappeared. That whole need for intimacy just faded away. It's like feeling unclean because suddenly you have a virus you don't fully understand. Yeah, I know. But what you read is that it's a virus, and it's something that's transmitted through sexual intercourse. So, in a way, you end up feeling a bit dirty.” (ID18)
	14	“I thought, well, I know that I haven't been with anyone else. So, I actually thought he had been unfaithful to me. But he hasn't. I know that. It's just that thing when you see it's sexually transmitted, I've only been with him. So how did I get it? Can it really stay in the body for 10 years before it suddenly shows up?” (ID4)
	15	“Well, I actually first thought that I didn't want to have sex with my husband because I was afraid of infecting him and things like that.” (ID1)
	16	“Uh, yeah, well, the relationship is still new … and he was a bit unsure when we first started, wondering if it would really work and stuff like that. So, I can definitely be a little nervous that he might get scared and think, ‘Oh no, I don't want to get involved in this.’” (ID13)
	17	“It's still relatively new with the guy I'm seeing. And I wonder if this [HPV diagnosis] will have any consequences? Like, I'm not sure if he'll even want to sleep with me again. When things are still new, it's a bit vulnerable, you know? You're still figuring each other out.” (ID12)
	18	“I might infect someone else. That's why my desire for intimacy has been deeply affected. I've completely shut down any dating or anything like that. I don't see men at all because I don't want to be in a situation where I have to explain that, unfortunately, I can't be intimate with them because I have this virus. And what would they think? … You know that HPV can also cause genital warts, and then people associate it with an STI and assume you didn't protect yourself properly. I imagine that would be the automatic thought, and I simply won't put myself in that situation. I don't want anyone to feel disgusted by me because of this.” (ID16)
	19	“There's also a lot of focus on HPV in relation to men and throat cancer. I heard it in the news that it was us women who had the HPV virus. And it was the men who got throat cancer, and that there was an increase in men who had throat cancer. As if it's women's fault that men get throat cancer. And I've wondered if this will have consequences for my sex life. Like, I've thought about whether I can do the same things I usually do or what?” (ID12)

Theme 3: A complex meeting: Barriers to addressing the sexual nature of HPV
	20	“But I also know that, on that day, everything else took up a lot of space, I mean, everything else was also really overwhelming. So, I actually think that on that day, I left feeling like I had been told what I could handle for that day. I got the answers I needed right then. But yeah, it definitely would have been nice to know more. But there's also the thing about how much information you can actually take in in such a situation, when you're sitting there feeling a bit vulnerable and… yeah, I've been in uncertainty and still am. And I don't know.” (ID9)
	21	“I was worried about my own reaction [to break down and cry]. And I also got really upset up there. So, I was kind of worried, ‘Oh no, am I going to completely break down up there?’ And at the same time, it's in the back of your mind, the thought of, ‘Am I going to hear something that tells me it's really bad?’… I find my own reaction embarrassing, like not being able to keep it together, it feels humiliating and invasive.” (ID2)
	22	“Well, I wasn't really sure what was going to happen [during the consultation], or whether they would take the same samples at the hospital as they did at the GP's office.… I mean, I didn't feel very well [before the consultation], because you start thinking about whether there might be something bad, like receiving a bad result [a cancer diagnosis].” (ID15)
	23	“She [the gynecologist] asked if I knew what [HPV] was, and I said it was something about cell changes. I was a bit out of it because I was really nervous. Yeah, because I didn't know what was going to happen. I mean, what test was she going to take? Was she going to cut me? What was she going to do? Yeah, so I was a bit nervous during the conversation beforehand.” (ID8)
	24	“I thought, ‘Just do what needs to be done, and then I can move on.’ That thing about becoming a bit emotional and all that… I mean, because it makes you feel a bit vulnerable. You expose yourself… I mean, it's easy to fall into a hole and think, ‘Oh, it's cancer or something.’” (ID17)
	25	“Because sometimes, as a patient, when you walk into a room with doctors, nurses, and a medical student, you can definitely feel a bit intimidated and just think, ‘Okay, I just need to comply.’ You tend to be a bit deferential to authority. So, if I had just been asked a bit more about it, if they had dug a bit deeper.” (ID4)
	26	“Neither of us dared to ask each other these things beforehand, like, ‘What does this mean for our sex‐life?’ I mean, neither of us dared to talk about it, not with each other either. So, you can't bring it up there [in the consultation]. At least not when you're together [with a partner] at the consultation… but these are also things that are shameful for us to talk about. It's taboo to discuss.” (ID18)
	27	“Well, what can I say … as a woman, it's a very vulnerable area [the genital area], and having to lie in these stirrups is, of course, not a pleasant feeling. But they [nurses and doctors] were skilled, and I received really good information throughout the entire examination.” (ID3)
	28	“… then I'm told to lie down on the examination table, and then they insert this camera into my genital area. It's quite a special experience … it's never comfortable to lie there with your legs up for this kind of procedure. It felt quite invasive that all of a sudden, I had a camera between my legs.” (ID18)

3. RESULTS

Twenty‐one women with a median age of 42.5 years (range: 32–55 years) participated in semi‐structured interviews. Participant characteristics are shown in Table 3. Three women had completed their medical evaluation at the outpatient clinic and were scheduled for follow‐up in 6 months at the time of their interviews. Thirteen were still waiting for their cervical biopsy test result, four were awaiting a LLETZ, and one had already undergone a LLETZ.

TABLE 3.

Characteristics of Study Participants.

Characteristics	Total (N = 21)
Age
32 to 40	8
41 to 55	13
Mean age (years)	42.5
Educational level 1
Low	9
Middle	7
High	5
Civil status
Living with partner	12
Single	5
Dating	4
Ethnicity
Danish	21
Other ethnic background	0
HPV vaccination status
Vaccinated	9
Not vaccinated	12
Parity
Para 0	3
Para≥1	18

Note: All data are self‐reported.

¹ Using the International Standard Classification of Education (ISCED) from Statistics Denmark, educational level was grouped into three categories; low (1 to 10 years), medium (11 to 14 years), and high (>15 years).

We identified three main themes: (1) Women's initial experiences of receiving a hrHPV test result, (2) Recognizing the impact of HPV as an STI on women and their partners, and (3) A Complex Meeting: Barriers to Addressing the Sexual Nature of HPV. The themes are illustrated in Figure 1.

FIGURE 1.

Themes and Subthemes as Experienced over Time after HPV Diagnosis This figure illustrates the main themes and subthemes identified through qualitative analysis of women's experiences after receiving an HPV diagnosis, highlighting how these evolve over time.

3.1. Women's initial experiences of receiving a high‐risk HPV test result

The women articulated two different emotional responses upon receiving an email informing them that hrHPV was detected: (1) limited emotional impact, and (2) anxiety and fear.

3.1.1. Limited emotional impact of a high‐risk HPV diagnosis

Some women described feeling quite calm and “not particularly” affected when receiving the hrHPV diagnosis. They understood HPV as a common infection and that HPV is not cancer (Table 2, #1). Some of these women had previously had HPV detected and drew on this experience as part of their coping strategy, as they were already more familiar with the diagnosis, its prognosis, and the recommended follow‐up. They acknowledged that some worries or concerns about the development of HPV and cervical precancer could linger in the back of their minds (Table 2, #2). However, they felt reassured by the cervical cancer screening program that cervical precancer would be detected in the early stage and treated.

3.1.2. Anxiety and fear in response to a high‐risk HPV diagnosis: Focus on cancer risk

Other women reported how the term “high‐risk HPV” gave them the impression that they had advanced cancer and likely had “one foot in the grave.” Initially, their concern was primarily focused on the risk of cancer and worrying about whether they were seriously ill. Participants used the words fear, anxiety, panic, and shock, and several women noted that their anxiety significantly impacted their overall mood (Table 2, #3). Some vaccinated women also expressed confusion about how they could test HPV‐positive despite having received the HPV vaccine.

Receiving the hrHPV result by email left many women feeling unsupported and uncertain about the diagnosis and its implications. The lack of accompanying information contributed to emotional distress, including anxiety, intrusive thoughts, and fears of incurable cancer. For some, the psychological impact disrupted daily life, making it difficult to cope at work or causing physical symptoms such as nausea (Table 2, #4, #5). A few broke down emotionally and had to leave work.

Women raising their children alone experienced existential thoughts about their children's future and fearing what might happen if they, as mothers, became seriously ill or did not survive (Table 2, #6).

The GP was perceived as a source of reassurance, but was not always easily accessible (Table 2, #7). The women searched for information online, including from official sources like the Health Authority as well as influencers. A few sought out the gynecological outpatient clinic for advice and support or read research articles, as described by this woman:

”The term high‐risk HPV became a focal point for me, so I started reading both English and Swedish publications to understand which HPV types were the most concerning and needed monitoring. Was it type 16 or 19, or something like that? But I still couldn't fully wrap my head around it. I was terrified, filled with anxiety. I was so scared, I just couldn't process it… and I'm usually pretty calm, I'd say.” (Id16)

3.2. The impact of recognizing HPV as an STI on women and their partners

The women described how the sexual nature of HPV gave rise to moral emotions such as guilt and shame, shaped their embodied experiences of the virus, and challenged their sense of intimacy and self‐perception within relationships. However, not all women experienced negative relational consequences. Some described being able to discuss the diagnosis openly with their partners and experienced support and reassurance within their relationships.

3.2.1. Subtheme 2.1: Navigating moral emotions, intimacy, and embodiment

Some women linked HPV to promiscuity, feeling morally affected by the fact that an early sexual debut and having multiple sexual partners are known to increase the risk of infection. This left them feeling guilty and ashamed, with the added fear that others would judge them negatively because of their HPV diagnosis (Table 2, #8). The diagnosis triggered reflections on whether it could have been prevented, for example, by using condoms (Table 2, #9). Deeper, culturally and generationally embedded feelings of shame related to sexuality were reactivated:

“I'm from a generation that grew up feeling guilt and shame about having a sex life, and I have to admit, with some shame, that it still lingers with me, … the HPV diagnosis is definitely tied to a sense of shame.” (Id11)

The HPV diagnosis altered women's perception and relationship with their bodies. Feelings of contamination were experienced, with descriptions such as “unclean,” “gross,” and “infected” used to characterize themselves (Table 2, #10). This led to behavioral changes, including increased washing of the genital area in an attempt to regain a sense of cleanliness (Table 2, #11). The absence of symptoms created uncertainty, making it difficult to come to terms with the diagnosis (Table 2, #12). This uncertainty could result in heightened bodily awareness, with women regularly checking for signs and interpreting normal sensations as potential symptoms of disease.

3.2.2. Subtheme 2.2: The impact of HPV diagnosis on Women's intimate relationships with partners

Women shared how their HPV diagnosis impacted their emotional and sexual intimacy with others. This included a diminished desire for physical intimacy with a partner, concerns about infidelity, and worries about transmission (Table 2, #13, #14, #15). Disclosure in new relationships was particularly difficult (Table 2, #16). Fear of rejection or stigma led some to avoid dating altogether, either to prevent potential transmission or to escape the anticipated humiliation of disclosing an STI (Table 2, #17, #18, #19).

For a few, the HPV diagnosis not only introduced new challenges but also compounded pre‐existing sexual trauma, making physical closeness even more fraught and emotionally complex.

3.3. A complex meeting: Barriers to addressing the sexual nature of HPV

This theme captures the complexity surrounding the consultation at the gynecological outpatient clinic and highlights the barriers to discussing the sexual nature of HPV, as experienced by the participants referred for colposcopy and biopsy following an HPV diagnosis as part of routine cervical cancer screening.

Although all 21 women described the consultation at the gynecological outpatient clinic as informative, reassuring, and human‐centered, many also experienced it as complex due to the combination of receiving information about the potential risk of having cervical precancer or cancer, managing anxiety, undergoing a gynecological examination, and navigating the personal and intimate implications of an HPV diagnosis. It was suggested that there simply was not enough space, neither in terms of time nor in terms of emotional capacity, to adequately address all questions and concerns (Table 2, #20). As a result, some women left the consultation with unanswered questions and unresolved negative and difficult emotions.

The clinical encounter was, for some, characterized by stress and anxiety both before and during the appointment, while others described feeling unprepared for the clinical setting (Table 2, #21, #22). During the consultation, several focused their efforts on maintaining composure and suppressing tears (Table 2, #23, #24). They attributed their vulnerability to uncertainty about the colposcopy and biopsy, as well as a fear of being confronted with “bad news,” specifically a cancer diagnosis. Additionally, some women felt intimidated by the situation, feeling the need to simply “comply,” which prevented them from addressing questions about the sexual nature of HPV (Table 2, #25).

For certain couples, discussing the sexual implications of an HPV diagnosis was experienced as shameful and taboo. As a result, addressing concerns about their sex life during the consultation felt impossible (Table 2, #26). For example, a woman had issues related to her sex life that she wanted to clarify with the doctor during the consultation. The conversation, however, became complicated and too personal, and the woman left without clarification. She explained:

“The Doctor told me, ‘You can tell him at home it's not because you've been with someone else. You might have been exposed to this virus as far back as 20 years ago’ … And I just couldn't bring myself to say, ‘Well, I'm single.’ It felt way too personal for me. I thought, I shouldn't start crying or anything. I feel like I can't be seen dating anyone, and I actually feel, … not disgusting, but ashamed of it [HPV diagnosis] … But I just couldn't bring myself to say it to the doctor, because the doctor had the assumption that I lived with a man, and I just thought it would seem… It's not that I'm embarrassed about being single, but it just felt… because it kind of exposed my sex life, or lack of it. It was just way too personal.” (Id16)

Although the gynecological examination, including colposcopy and biopsy, was described as uncomfortable, the women felt well‐guided and cared for by the staff. However, because the examination required significant attention and provoked anxiety and vulnerability, it reduced some women's capacity to engage in discussions about the more personal and sexual aspects of HPV (Table 2, #27, #28).

4. DISCUSSION

In this study we explored women's psychosexual experiences of receiving a hrHPV diagnosis and the factors shaping their responses and coping strategies within the Danish cervical cancer screening program. While some women perceived the hrHPV diagnosis as manageable and trusted the screening program's ability to enable early detection of cervical cell changes, others experienced significant emotional distress, often linked to uncertainty about the meaning and consequences of testing HPV‐positive. For some, the sexually transmitted nature of HPV evoked feelings of guilt and shame and affected intimate relationships and bodily self‐perception. The findings further suggest that emotional and structural barriers within clinical encounters may limit opportunities to address women's psychosocial and existential concerns related to high‐risk HPV.

Importantly, not all women experienced the hrHPV diagnosis as emotionally distressing. Some appeared reassured by their trust in the screening program and their understanding of HPV as a common and manageable condition. At the same time, variations in emotional impact were not consistently reflected in women's experiences of intimacy, partner communication, or relational concerns. Some women who experienced significant emotional distress nevertheless described open and supportive communication with partners. While no clear demographic pattern was identifiable in our data, these findings highlight the heterogeneous nature of women's responses to hrHPV screening results.

Our findings suggest that receiving a letter indicating the detection of hrHPV can trigger worry and anxiety about the possibility of having cancer. As this emotional reaction may be disproportionate to the actual risk, particularly given that, most HPV infections are transient and do not lead to cervical cancer and precursors, it highlights the need to reconsider how screening results are delivered to ensure patients are informed of their status in an emotionally balanced way. Other research has similarly shown that women may experience emotional distress and anxiety related to HPV infection and the risk of cervical cancer and its precursors, ¹⁰ , ¹¹ , ¹² although these reactions may vary according to factors such as HPV‐related knowledge, perceived stigma, relational context, and general psychological resilience, ²² , ²³ , ²⁴ and may be particularly pronounced in the short term. ⁷ , ²⁵

Several women in this study described feelings of guilt and shame in response to the sexually transmitted nature of the HPV diagnosis and its associated cultural meanings. This finding is supported by previous research, which shows that HPV diagnoses can evoke moralized understandings of sexuality, where women internalize blame or feel “tainted” by their infection. ¹¹ , ¹² Such responses can be understood through Erving Goffman's concept of stigma, ²⁶ which arises when an individual possesses an attribute that is deeply discrediting within a given social context. In the case of HPV, the diagnosis may be perceived by women as a marker of sexual “riskiness” or moral failure, despite the virus being highly prevalent and asymptomatic. Shame and guilt in this context are not simply individual reactions, but emerge within a wider cultural framework that links women's bodies, sexuality, and responsibility.

Our findings, supported by previous qualitative research, ⁸ , ¹² , ¹³ show that the sexually transmitted nature of HPV can negatively affect women's body perception and image, intimate relationships, and sexual behavior. Women may experience feelings of shame, fear of infidelity, reduced sexual desire, and difficulty disclosing their diagnosis due to stigma and uncertainty about their partner's reaction. ¹³ , ¹⁴ These findings resonate with feminist and phenomenological perspectives that view the body not merely as a biological entity, but as a site of social meaning and emotional experience. ²⁷ Following an HPV diagnosis, women may experience a profound shift in embodied self‐awareness. As Carel notes, ²⁸ the body, once an unnoticed part of everyday life, becomes a source of uncertainty and potential pathology. This transformation introduces a sense of alienation, as women now inhabit bodies marked by risk. In this way, the diagnosis elicits existential concerns. The HPV diagnosis thus has both relational and embodied consequences, reinforcing the need to consider how medical labeling intersects with gendered moral discourses around female sexuality.

This study highlights a gap between women's appreciation of respectful clinical communication and their unmet need to discuss personal and intimate concerns. Women also described the follow‐up examination, including colposcopy and biopsy, as emotionally challenging and closely linked to their experience and receiving a positive hrHPV result. Some vaccinated women furthermore expressed confusion about testing HPV‐positive despite having received the HPV vaccine, reflecting uncertainty about the protection offered by vaccination. Taken together, our findings illustrate how women's experiences of hrHPV extend beyond the clinical encounter and are shaped by emotional, relational, and socio‐cultural meanings attached to the diagnosis. This underlines the importance of a more holistic approach to HPV‐based cervical cancer screening, where clinicians are supported in addressing women's emotional and informational needs through open, nonjudgmental communication, while broader public health efforts actively work to reduce stigma and improve understanding of HPV as a common virus. ²⁹

The study is theoretically grounded in practice theory, which offers a robust analytical framework for understanding how embodied, social, and material practices shape women's experiences of health‐related events. This theoretical lens enabled us to situate women's experiences within broader socio‐cultural and moral contexts, thereby deepening the interpretive potential of the findings.

At the same time, certain limitations should be noted. Although participants represented a broad age range within the population eligible for HPV‐based cervical cancer screening in Denmark, the study focused on women referred to a colposcopy clinic, excluding those managed in primary care or without follow‐up, which may limit representation of the broader spectrum of HPV management. Furthermore, interviews were conducted 1–3 weeks after treatment, which may not capture how concerns and meanings evolve over time, particularly in the context of repeated testing or changing life circumstances.

These insights highlight the need for a more holistic approach to care, where women receive clear medical information while stigma is actively counteracted through open and nonjudgmental communication. At the same time, broader public health efforts are necessary to reduce stigma and raise awareness about the actual risks of HPV as a common virus.

5. CONCLUSION

Based on a practice theoretical framework, this study shows that women's experiences following an hrHPV diagnosis in the context of cervical screening are not merely individual responses to medical information but should be understood within a broader psychological, social, and cultural context that shapes how women process and cope with the diagnosis.

AUTHOR CONTRIBUTIONS

AH, VR, JEM, BF, AK, ASK, and JH conceived the study. JH drafted the study protocol with input from all Danish co‐authors. JH was responsible for data collection. JH analyzed and interpreted the data in collaboration with BM and BF and with additional input from the entire author group. JH wrote the manuscript in collaboration with BM and AH. All authors reviewed and commented on the manuscript and approved the final version.

FUNDING INFORMATION

This study was supported by a grant from the Health Research Foundation of Central Denmark Region (e‐fond ID = 63). (Region Midtjylland's Sundhedsvidenskabelige Forskningsfond). The funding body had no involvement in any aspect of the research or writing of the manuscript.

CONFLICT OF INTEREST STATEMENT

AH has received an honorarium from Exeltis, outside the submitted work. The remaining authors report no conflicts of interest.

ETHICS STATEMENT

The study was registered on September 21, 2024, to the record of processing activities for research projects in Central Denmark Region (J. number. 1‐16‐02‐357‐24). According to Danish legislation, ethical approval is not required for qualitative research.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.