The aim of this study was to compare the acceptability of self-collected vs clinician-collected human papillomavirus (HPV) tests. Utilising a cross-sectional approach, 250 non-pregnant, 25-60-year-old women from Leon, Nicaragua self-collected vaginal swabs and brushes for HPV and received a pelvic examination for liquid-based cytology and reflex HPV. Subjects underwent colposcopy, with biopsy if indicated, and completed questionnaires comparing their perceptions of HPV testing methods. Acceptability indices were significantly higher for self-collected brushes (M = 18.40, SD = 2.73) and swabs (M = 18.48, SD = 2.41) than clinician-collection (M = 17.56, SD = 2.92), p < 0.001. Multiple regression analyses revealed that age, education, and reproductive history were not significant predictors of acceptability. A total of 81.1% of subjects reported they would self-collect in the future. Self-collected HPV tests are highly acceptable in terms of pain, comfort, privacy and embarrassment, and are thus a viable method of screening in low-resource areas.

The aim of the study was to compare the sensitivity of self-collected with clinician-collected human papillomavirus (HPV) tests and cytology for cervical cancer. A total of 250 non-pregnant, 25 -60-year-old women from Leon, Nicaragua, self-collected vaginal specimens for HPV and received a pelvic examination for cytology and refl ex HPV. All participants underwent colposcopy and completed questionnaires regarding demographic and medical information. The sensitivities of self-collected brushes, self-collected swabs and cliniciancollected HPV tests were 25%, 16.7%, and 16.7%, respectively, with colposcopy as the gold standard and 30%, 22.2% and 40% when cytology was the gold standard. Agreement between self-collection methods was signifi cant ( k ‫؍‬ 0.84, p < 0.001). Although utilisation of colposcopy in every participant resulted in lower sensitivities, the self-collected tests surpassed cytology and signifi cantly agreed with the clinician-collected results. Further clarifi cation of the sensitivity will be required to employ self-collection for cervical cancer screening in low resource areas like rural Nicaragua.

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