Feasibility of First-Void Urinary and Vaginal Self-Sampling for High-Risk Human Papillomavirus Testing Among Women...

In Guinea-Bissau, cervical cancer (CC) screening is unimplemented and data on high-risk human papillomavirus (hr-HPV) prevalence among women living with HIV (WLWH) are limited. This study assessed the acceptability of first-void urine (FVU) and vaginal self-sampling for HPV testing and the HPV prevalence and among WLWH in Guinea-Bissau. This multicenter cross-sectional study included a total of 498 WLWH aged 18-64 years. At nine HIV-clinics, women self-collected paired FVU and vaginal samples (VS), using the Colli-Pee and Evalyn Brush device, respectively. The Allplex HPV-HR assay was used for HPV DNA testing. Acceptability and preferences were assessed using questionnaires and hr-HPV genotype concordance was analyzed using Cohen's kappa (κ). Overall, 78% (n = 389/498) tested hr-HPV positive (FVU and/or VS). Good hr-HPV genotype concordance was observed (range 0.64-0.78) between sample types. HPV52 and HPV58 were the most prevalent genotypes (both 21%) followed by HPV66 and HPV16 (both 18%). Both modalities were well-accepted regarding comfort and ease of use, however, the urine device was preferred. Clinic-based FVU and VS self-sampling was feasible and well-accepted by WLWH, with urine sampling as the most preferred modality. The high hr-HPV prevalence underscores the urgency of integrating HPV-based CC screening and treatment into HIV care. Trial Registration: NCT05783167 (clinicaltrials.gov).