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Cited by 29Cervical Cancer and HPV ResearchWomen's cancer prevention and managementReproductive tract infections research

Effectiveness of family-centred sexual health education and HPV self-sampling in promoting cervical cancer screening among hard-to-reach indian women in rural and tribal areas: a community-based pilot study

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Vahabi, Mandana, Mishra, Gauravi, Pimple, Sharmila, Wong, Josephine Pui-Hing, Khan, Momina, Prakash, Vijayshree, Anand, Kavita, Narushima, Miya +1 more·2023·BMC Public Health
DOI 10.1186/s12889-023-15602-1PMC PMC10088194

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Abstract

Background: While cervical cancer deaths have declined steeply in high-income countries due to the widespread use of the Papanicolaou test (Pap test), the same trend has not emerged in low or middle-income countries (LMICs). Access to screening in LMICs like India is limited due to barriers such as limited healthcare infrastructures, lack of sexual health education, and stigma demarcating sexually transmitted infections (STIs). HPV self-sampling (HPV-SS), a woman–centered and at-home method for screening, can be utilized as a unique screening tool to overcome some of these barriers. Our study examined the effectiveness of HPV-SS, supported by family-centred arts-based sexual health literacy on the uptake of cervical cancer screening among hard-to-reach women in rural and remote areas in India. Methods: Our community-based mixed methods pilot study recruited 240 participants (120 women and 120 male partners or family members) through female Accredited Social Health Activists (ASHA) across 3 Indian villages of Shirgoan, Khodala, and Jamsar in Palghar district. Inclusion criteria included women ages 30–69 who were under or never screened (UNS) and their male partners/family members aged 18 or over. Knowledge and attitudes about cervical cancer and screening and their perceived stigma surrounding STI were assessed using validated scales prior to and after attending a 2-hour arts-based sexual health education (SHE). In addition, participants’ uptake of cervical cancer screening was assessed after attendance in SHE. Findings: Results revealed significant improvement in knowledge and attitudes about cervical cancer and screening, and a reduction in the STI stigma after participation in SHE sessions (overall mean difference in Knowledge: z = 6.1 ± 2.4, P < 0.001; attitudes about Pap-test and VIA: z = 2.2 ± 8.4, P < 0.001 and z = 2.9 ± 8.2, P < 0.001; STI stigma: z = 2.8 ± 12.4, P < 0.001). 118 out of 120 female participants chose to be screened and 115 opted for HPV-SS. Conclusions: The implementation of HPV-SS coupled with family-centered arts-based and culturally appropriate SHE is highly promising in promoting cervical cancer screening among hard-to-reach women. Evidence from our study can be used to advance public health policies and inform the scale-up of similar initiatives in other villages and states across rural India and other LMICs.

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  • A recent study in rural India piloted a family-centered sexual health education intervention to improve uptake of HPV testing for women, providing story-based audio-visual education to both women and a male family member; the intervention demonstrated improved attitudes and knowledge regarding cervical cancer screening and reduced STI-related stigma.

    “A recent study in rural India piloted a family-centered sexual health education intervention to improve uptake of HPV testing for women, providing story-based audio-visual education to both women and a male family member; the intervention demonstrated improved attitudes and knowledge regarding cervical cancer screening and reduced STI-related stigma [53].”

    From Acceptability of HPV vaccination for cervical cancer prevention amongst emerging adult women in rural Mysore, India: a mixed-methods study (2024) · cites this paper as [53]

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Authors
Vahabi, M., Mishra, G., Pimple, S., Wong, J. P.-H., Khan, M., Prakash, V., Anand, K., Narushima, M., & Lofters, A. K.
Affiliations
  • Institute for Clinical Evaluative Sciences (CA)
  • Homi Bhabha National Institute (IN)
  • University of Toronto (CA)
  • Toronto Metropolitan University (CA)
  • Brock University (CA)
Corresponding author
Vahabi, Mandana
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2023-04-11
Volume
23
Issue
1
Pages
671-671
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-023-15602-1
PMC
PMC10088194
OpenAlex
W4364354843
Cited by
29
References
2
Citations by year
2026: 10 · 2025: 12 · 2024: 5 · 2023: 2
FWCI
5.79
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Global Affairs Canada
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
cervical cancer screening, HPV self-sampling, sexual health literacy, rural women, tribal communities, Pap smear, visual inspection with acetic acid, Palghar district, India, community health workers, screening uptake, culturally appropriate health promotion, male partner involvement
MeSH terms
Uterine Cervical Neoplasms, China, Ethnicity, Female, Humans, Male, Pilot Projects, Sex Education, Papillomavirus Infections, Early Detection of Cancer

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