For Human Papillomavirus Self-Sampling, Stated Willingness Does Not Correspond With Subsequent Uptake by Rural Malawian Women. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Hood, Robert B.; Turner, Abigail Norris; Huber-Krum, Sarah; Lancaster, Kathryn E.; Mwapasa, Victor; Poindexter, Tiara; Nampandeni, Patrick; Esber, Allahna; Norris, Alison H.
• Is Part Of: Sexually transmitted diseases. Volume 47:Issue 4(2020)
• Publication Date: 2020-04
• Subjects: Sexually transmitted diseases -- Periodicals; Sexual health -- Periodicals; 616.951005
• DOI: 10.1097/OLQ.0000000000001119
• Languages: English
• ISSNs: 0148-5717

Abstract

Abstract : Background: Human papilloma virus (HPV), the causative agent for cervical cancer, can be tested for using self-collected vaginal samples. Self-collection is promising for HPV screening in hard-to-reach populations. To assess the relationship between willingness to self-collect and subsequent uptake of self-collection, we conducted a longitudinal study of reproductive-age women in rural Malawi. Methods: At baseline, we asked women if they would be willing to self-collect a vaginal sample for HPV testing. At follow-up (12–18 months later), we offered the same women the opportunity to self-collect a sample for HPV testing. We examined unadjusted and adjusted associations between baseline willingness to self-collect a sample for HPV testing and uptake of self-collection at follow-up using log-binomial models. Results: Among 122 women who, at baseline, indicated willingness to self-collect, n = 65 (53%) agreed to self-collect a sample at follow-up. Of 64 women who stated unwillingness at baseline to self-collect, n = 30 (47%) self-collected a sample for testing at follow-up. We observed no association between women's willingness at baseline and their observed self-collection decision at follow-up (unadjusted prevalence ratio, 1.14; 95% confidence interval, 0.83–1.55). The association remained null after adjustment for age, awareness of cervical cancer, and perceived behavioral control. Conclusions: Our results suggest that evaluation of acceptability of self-collection should go beyond simply asking women if they would be willing to self-collect a vaginal sample. Given that half of this study's participants agreed to self-collect a sample when the opportunity was offered, regardless of their previously stated preferences, self-collection should be offered to everyone. Abstract : Rural Malawian women's stated willingness to self-collect vaginal samples for human papilloma virus testing was not associated with their subsequent uptake of testing when offered 1 year later.