Acceptability and validity of HPV self‐sampling for cervical cancer screening among women living in different ecological settings in India
AbstractIndia records one fifth of global cervical cancer burden. Unlike human papillomavirus (HPV) self‐sampling, other screening methods may cause discomfort and embarrassment. This study aimed to investigate attitudes, acceptability, barriers, predictors, effective modality of instructions, and validity of HPV self‐sampling among Indian women residing in varied settings and different literacy levels. This is community‐based interventional study among Indian women 30–55 years, residing in urban slums (500), urban non‐slums (500), and rural (600) settings with varied washroom facilities and privacy, to collect self‐samples. Each group was subdivided into two arms; in one women received education with pamphlets and other with health education program (HEP). Study involved enlisting eligibles, obtaining informed consents and conducting personal interviews to collect baseline data. Self‐samplers were distributed with instructions (pictorial pamphlets in one group and HEP in other) regarding usage, storage and return. Willingness to use self‐samplers, refusals, experiences, and so forth were captured. Post‐intervention knowledge, attitudes, practices was recorded. HPV reports were distributed. Women with positive result on either test were offered further management. Acceptance rate of self‐sampling was 99.2%, 97%, and 98.8% and HPV positivity was 7%, 7.8%, and 8.5%, respectively among urban non‐slum, urban slum and rural women. Agreement rate between health personnel collected and self‐collected samples was 96.5% in pamphlet and 93.2% in HEP arm. Major barriers of self‐sampling were lack of confidence about performing self‐test correctly, fear that test would be painful and anxiety about test results. HPV self‐sampling has good acceptability among Indian women and good agreement with health personnel collected samples.
