Acceptability of Self-Taken Vaginal HPV Sample for Cervical Screening among an Under-Screened Indigenous Population

BackgroundHuman papillomavirus (HPV), the causative agent of cervical cancer, can be screened for using self-collected vaginal samples (self-testing). This may overcome barriers to screening for Mori women who suffer a greater burden of cervical disease than New Zealand European women. AimsThis study aimed to explore the potential acceptability of HPV self-testing for never/under-screened (self-reported no cervical screen in 4+ years, aged 25+) Mori women by Kaupapa Mori (by, with and for Mori) mixed methods, involving hui (focus groups/interviews) and survey. Materials and MethodsCommunity-based researchers ran hui with women in four regions (N=106) and supported hui participants to collect survey data (N=397). Healthcare providers (HCPs) were also interviewed (N=17). Hui data were thematically analysed. Survey data were analysed by age group, rural/urban, primary health organisation (PHO) enrolment, and time since last cervical screen. ResultsMost survey participants were PHO-enrolled (87.15%) and attended regularly (71.79%), but did not attend regular cervical screening. A desire for bodily autonomy, including whakam (embarrassment/shyness/reticence), was the most frequently cited barrier. Three in four women reported being likely/very likely to do an HPV self-test. Nine in ten women reported being likely/very likely to attend follow up if they receive a positive HPV test result. Women and HCPs in the hui emphasised the importance of health literacy, cultural competence and empathetic support. ConclusionThe findings indicate that with a culturally competent introduction of HPV self-testing, many currently never/under-screened Mori women would be willing to be screened and followed up if necessary. HPV self-testing has the potential to save lives.