Barriers and Opportunities for HPV Self-Sampling in Underserved Rural Communities: Insights from a Mixed Methods...

Area of Science:

• Public Health
• Gynecologic Oncology
• Health Behavior

Background:

• Cervical cancer remains a leading cause of cancer deaths for women in sub-Saharan Africa, particularly in rural areas with limited screening access.
• Low screening rates highlight the need for innovative approaches to detect the disease early in underserved populations.

Purpose of the Study:

• To investigate factors influencing rural Kenyan women's willingness to self-collect samples for human papillomavirus (HPV) DNA testing.
• To identify facilitators and barriers to HPV self-sampling uptake in low-resource settings.

Main Methods:

• A mixed-methods study was conducted in two rural Kenyan counties.
• Data collection involved surveys with 174 women and in-depth interviews with 21 participants.
• Statistical analysis identified factors associated with willingness to self-collect samples.

Main Results:

• Despite low prior screening rates (6.4%), a high proportion of women (76.9%) expressed willingness for HPV self-sampling.
• Cervical cancer awareness, reliance on health workers or media for health information positively correlated with willingness.
• High levels of cervical cancer stigma and longer travel times to health facilities were associated with reduced willingness.

Conclusions:

• Comprehensive health promotion strategies, including education, health worker endorsement, and mass media campaigns, can enhance HPV self-sampling uptake.
• Addressing stigma and improving access to healthcare services are crucial for reducing the cervical cancer burden in rural Kenya.
• HPV self-sampling presents a promising strategy to improve cervical cancer screening coverage in resource-limited settings.