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Pan Afr Med J. 2014 Mar 11;17:189. doi: 10.11604/pamj.2014.17.189.3454. eCollection 2014.

Human papillomavirus (HPV) testing on self-collected specimens: perceptions among HIV positive women attending rural and urban clinics in South Africa.

Author information

1
Right to Care, Johannesburg, South Africa.
2
Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
3
Department of Medical Virology, University of Pretoria, National Health Laboratory Service, Pretoria, South Africa.
4
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, United States of America.
5
Right to Care, Johannesburg, South Africa ; Clinical HIV Research Unit, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

INTRODUCTION:

Cervical cancer is the most common cancer among women in Sub-Saharan Africa. Cervical cancer is treatable if detected timeously, yet only 20% of South African women have ever been for a Pap smear in their lifetime due to limited access to screening, transport or child care responsibilities.

OBJECTIVE:

To evaluate the acceptability of self-collection for cervical cancer screening. We aimed to identify which self-collection device women prefer and if they would consider using them for routine cervical cancer screening.

METHODS:

HIV-positive women (>18 years) from urban and rural HIV clinics were interviewed following an education session on HIV, human papillomavirus (HPV) and cervical cancer. Participants were shown three self-collection devices; (i) an Evalyn cervical brush, (ii) a Delphilavager and (iii) a tampon-like plastic wand before completing a short questionnaire.

RESULTS:

A total of 106 women from the urban (n = 52) and rural (n = 54) clinic were interviewed. Overall 51% of women preferred the cervical brush, while fewer women preferred the tampon-like plastic wand (31%) or lavage sampler (18%). More than 75% of women from the rural site preferred the cervical brush, compared to 22% from the urban site (p < 0.001). Women from the urban clinic preferred the tampon-like plastic wand (45%) and then the lavage sampler (33%), as compared to women from the rural clinic (19% and 4%, respectively).

CONCLUSION:

Women from urban or rural settings had different preferences for the various self-collection devices. Patient self-collection with HPV testing may be an acceptable way to improve coverage to cervical cancer screening in high risk HIV-seropositive women.

KEYWORDS:

HIV-positive women; South Africa; acceptability; cervical cancer; human papillomavirus; resource-limited setting; self-collection

PMID:
25396015
PMCID:
PMC4228994
DOI:
10.11604/pamj.2014.17.189.3454
[Indexed for MEDLINE]
Free PMC Article

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