Feasibility and acceptability of self-sampling for Human Papillomavirus (HPV) screening in a rural community in Western Kenya

Abstract

<title>Abstract</title> <bold>Introduction</bold> Cervical cancer (CC) is the leading cause of female related cancer deaths and the second most common cancer affecting women in Africa. Furthermore, over 3000 mortalities are linked to low screening uptake and Kenya currently reports a CC screening rate of 16%. We sought to determine the feasibility and acceptability of “self-collection” for human papillomavirus (HPV testing) in Webuye Sub County, Western Kenya as a method to overcome low CC screening rates to decrease CC mortality. <bold>Methods</bold> A qualitative descriptive study design was used to collect data from 20 women who attended a rural village <italic>“chama”</italic> (meeting for health promotion) on importance of CC screening. Of the 20 women who participated in this study, 15 women completed the self-collection kit when offered at the <italic>chama</italic>, and 5 women declined self-collection. Data were collected using in-depth interviews. Investigators used a deductive approach, or <italic>a priori</italic>, analysis of the data by applying predetermined codes derived from the Health Belief Model. <bold>Results</bold> Overall, women who accepted screening indicated that knowledge about CC motivated them to take and use the Evalyn® Brush self-collection kit. Additionally, women who acknowledged the greatest risk for CC were those who had multiple sexual partners. Women who declined self-collection discussed fear of adverse physical effects, fear of receiving a positive diagnosis, stigma and loss of privacy as the main barriers to CC screening. Fear voiced by women included pain, bruising, and bleeding from the self-collection device, which in this case was an Evalyn® Brush. Perceived benefits included autonomy in conducting self-collection. Peer support at <italic>chama</italic> reinforced acceptance of self-collection. <bold>Conclusions</bold> Self-collection may promote autonomy and uptake of HPV screening in low resourced settings.