HPV testing: a mixed-method approach to understand why women prefer self-collection in a middle-income country

BMC Public Health

Research Article

Liliana Orellana¹  Silvina Ramos²  Silvina Arrossi³  Laura Thouyaret⁴  Cecilia Straw⁵ 

[1] Biostatistics Unit, Faculty of Health, Deakin University, 3148, Geelong, VIC, Australia;Centro de Estudios de Estado y Sociedad (CEDES), Sánchez de Bustamante 27, C1173AAA, Buenos Aires, Argentina;Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas/(CEDES/CONICET), Sánchez de Bustamante 27, C1173AAA, Buenos Aires, Argentina;Instituto Nacional del Cáncer- Ministerio de Salud de la Nación (INC-MSAL), Av. Julio A. Roca 781, C1067ABP, Buenos Aires, Argentina;Universidad de Buenos Aires, Facultad de Ciencias Sociales (Buenos Aires, Argentina)/ Centro de Estudios de Estado y Sociedad (CEDES), Sánchez de Bustamante 27, C1173AAA, Buenos Aires, Argentina;

关键词: Argentina;    HPV testing;    Self-collection;    Acceptability;   

DOI  :  10.1186/s12889-016-3474-2

 received in 2015-12-03, accepted in 2016-08-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundHPV test self-collection has been shown to reduce barriers to cervical screening and increase uptake. However, little is known about women’s preferences when given the choice between self-collected and clinician-collected tests. This paper aims to describe experiences with HPV self-collection among women in Jujuy, the first Argentinean province to have introduced HPV testing as the primary screening method, provided free of cost in all public health centers.MethodsBetween July and December 2012, data on acceptability of HPV self-collection and several social variables including past screening were collected from 2616 self-collection accepters and 433 non-accepters, and were analyzed using multivariate regression. In addition, in-depth interviews (n = 30) and 2 focus groups were carried out and analyzed using thematic analysis.ResultsQuantitative findings indicate that main reasons for choosing self-collection are those reducing barriers related to women’s roles of responsibility for domestic work and work/family organization, and to health care services’ organization. No social variables were significantly associated with acceptability. Among those who preferred clinician-collection, the main reasons were trust in health professionals and fear of hurting themselves. Qualitative findings also showed that self-collection allows women to overcome barriers related to the health system (i.e. long wait times), without sacrificing time devoted to work/domestic responsibilities.ConclusionsFindings have implications for self-collection recommendations, as they show it is the preferred method when women are given the choice, even if they are not screening non-attenders. Findings also highlight the importance of incorporating women’s needs/preferences in HPV screening recommendations.

【 授权许可】

CC BY   
© The Author(s). 2016