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Acceptability of self‐taken vaginal HPV sample for cervical screening among an under‐screened Indigenous population
Author(s) -
Adcock Anna,
Cram Fiona,
Lawton Beverley,
Geller Stacie,
Hibma Merilyn,
Sykes Peter,
MacDonald E Jane,
DallasKatoa Wendy,
Rendle Bronwyn,
Cornell Tracey,
Mataki Tania,
Rangiwhetu Tania,
Gifkins Naieta,
Hart Selah
Publication year - 2019
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12933
Subject(s) - medicine , embarrassment , cervical screening , cervical cancer , family medicine , focus group , shyness , pap test , indigenous , population , cervical cancer screening , gynecology , psychology , anxiety , cancer , psychiatry , environmental health , social psychology , ecology , marketing , business , biology
Background Human 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 Māori women who suffer a greater burden of cervical disease than New Zealand European women. Aims This 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+) Māori women by Kaupapa Māori (by, with and for Māori) mixed methods, involving hui (focus groups/interviews) and survey. Materials and Methods Community‐based researchers ran hui with women in four regions ( N = 106) and supported hui participants to collect survey data ( N = 397). Healthcare providers ( HCP s) 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. Results Most 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 whakamā (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 HCP s in the hui emphasised the importance of health literacy, cultural competence and empathetic support. Conclusion The findings indicate that with a culturally competent introduction of HPV self‐testing, many currently never/under‐screened Māori women would be willing to be screened and followed up if necessary. HPV self‐testing has the potential to save lives.