Acceptability of self-collection sampling for HPV-DNA testing in low-resource settings: a mixed methods approach

Area of Science:

• Gynecology
• Public Health
• Infectious Disease

Background:

• Vaginal self-sampling with HPV-DNA tests offers a promising primary screening approach for cervical cancer.
• Understanding women's experiences and concerns is crucial for implementing these tests in low-resource settings.

Purpose of the Study:

• To evaluate women's and healthcare providers' experiences with vaginal self-sampling for HPV-DNA testing.
• To assess women's opinions on home-based self-sampling and identify future needs in low-resource settings.

Main Methods:

• A mixed-method study involving surveys (N=3,863), qualitative interviews (N=72), and focus groups (N=30) was conducted in India, Nicaragua, and Uganda.
• Data collection focused on women's and providers' experiences, preferences for self-sampling, and home-based versus clinic-based screening.

Main Results:

• 90% of women provided a self-collected sample, with 75% finding it easy, though initial concerns about self-harm and sample adequacy were noted.
• Most women preferred self-sampling (78%) but also preferred provider-collected samples and clinic-based screening for comprehensive care.
• Provider education, allowing examination of the collection brush, and in-person presence enhanced self-sampling acceptability.

Conclusions:

• Vaginal self-sampling is widely acceptable among women in low-resource settings.
• Healthcare providers play a key role in educating and preparing women, improving the acceptance of self-sampling methods.
• Flexibility in accommodating women's preferences for self-sampling is essential for successful implementation.