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Cited by 51Cervical Cancer and HPV ResearchWomen's cancer prevention and managementReproductive tract infections research

HPV testing: a mixed-method approach to understand why women prefer self-collection in a middle-income country

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Arrossi, Silvina, Ramos, Silvina, Straw, Cecilia, Thouyaret, Laura, Orellana, Liliana·2016·BMC Public Health
DOI 10.1186/s12889-016-3474-2PMC PMC4990977
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Abstract

BACKGROUND: HPV test self-collection has been shown to reduce barriers to cervical screening and increase uptake. However, little is known about women's preferences when given the choice between self-collected and clinician-collected tests. This paper aims to describe experiences with HPV self-collection among women in Jujuy, the first Argentinean province to have introduced HPV testing as the primary screening method, provided free of cost in all public health centers. METHODS: Between July and December 2012, data on acceptability of HPV self-collection and several social variables including past screening were collected from 2616 self-collection accepters and 433 non-accepters, and were analyzed using multivariate regression. In addition, in-depth interviews (n = 30) and 2 focus groups were carried out and analyzed using thematic analysis. RESULTS: Quantitative findings indicate that main reasons for choosing self-collection are those reducing barriers related to women's roles of responsibility for domestic work and work/family organization, and to health care services' organization. No social variables were significantly associated with acceptability. Among those who preferred clinician-collection, the main reasons were trust in health professionals and fear of hurting themselves. Qualitative findings also showed that self-collection allows women to overcome barriers related to the health system (i.e. long wait times), without sacrificing time devoted to work/domestic responsibilities. CONCLUSIONS: Findings have implications for self-collection recommendations, as they show it is the preferred method when women are given the choice, even if they are not screening non-attenders. Findings also highlight the importance of incorporating women's needs/preferences in HPV screening recommendations.

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  • The finding on pelvic exam as a barrier to screening is consistent with other studies done in Africa and Asia which showed concerns around speculum use, embarrassment, and reluctance to have a male provider perform the exam.

    “The findings on pelvic exam as a barrier to screening is consistent with other studies done in Africa and Asia [18, 19, 33–35] which showed concerns around speculum use, embarrassment, and reluctance to have a male provider perform the exam [37–39].”

    From Perspectives of women participating in a cervical cancer screening campaign with community-based HPV self-sampling in rural western Kenya: a qualitative study (2019) · cites this paper as [38]

    The Results section reports that women valued self-collection because it avoided shame and embarrassment associated with Pap tests, particularly when the gynecologist was male. The paper studies women in Argentina; the cited passages do not establish findings from Africa or Asia or report a specific concern about speculum use. No page number is available in our copy. (LLM, conf=0.87)

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  • Health system factors such as access and proximity to care have also acted for other prevention programs as has been found in other studies.

    “as they have also acted for other prevention programs as has been found in other studies [37, 38, 40–43].”

    From Perspectives of women participating in a cervical cancer screening campaign with community-based HPV self-sampling in rural western Kenya: a qualitative study (2019) · cites this paper as [38]

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Authors
Arrossi, S., Ramos, S., Straw, C., Thouyaret, L., & Orellana, L.
Affiliations
  • Consejo Nacional de Investigaciones Científicas y Técnicas (AR)
  • Center for the Study of State and Society (AR)
  • Universidad de Buenos Aires (AR)
  • Ministerio de Salud (AR)
  • Deakin University (AU)
Corresponding author
Arrossi, Silvina
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2016-08-19
Volume
16
Issue
1
Pages
832-832
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-016-3474-2
PMC
PMC4990977
OpenAlex
W2510587290
Cited by
51
References
2
Citations by year
2026: 2 · 2025: 2 · 2024: 5 · 2023: 8 · 2022: 6 · 2021: 10 · 2020: 1 · 2019: 5 · 2018: 8 · 2017: 4
FWCI
5.32
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Americanae (AECID Library) (submittedVersion, cc-by-nc-sa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
Funders
Ministerio de Salud de la Nación (AR)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords
HPV self-collection, cervical cancer screening, women's preferences, barriers to screening, work-family balance, trust in healthcare providers, health system organization, screening uptake
MeSH terms
Adult, Aged, Uterine Cervical Neoplasms, Choice Behavior, Developing Countries, Female, Humans, Income, Mass Screening, Middle Aged, Motivation, Patient Acceptance of Health Care, Self Care, Specimen Handling, Papillomaviridae, Papillomavirus Infections

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