Human Papillomavirus (HPV) self-testing among un- and under-screened Māori, Pasifika, and Asian women in Aotearoa New Zealand: a preference survey among responders and interviews with clinical-trial non-responders

Abstract

Aim: Maori, Pasifika, and Asian women are less likely to attend cervical screening and Maori and Pasifika women are more likely to be diagnosed with later-stage cervical cancer than other women in Aotearoa New Zealand. This study, with under-screened women taking part in a randomised controlled trial comparing self-testing and standard screening, explored the acceptability of an HPV self-test kit and the preferred method for receiving it. Methods: Maori, Pasifika, and Asian women (N=376) completed a postal questionnaire. Twenty-six women who had not accepted the trial invitation were interviewed to understand their reasons for non-participation. Results: Most women found the self-test kit easy and convenient to use and reported that they did not find it painful, uncomfortable, or embarrassing. This was reflected in the preference for a self-test over a future smear test on the same grounds. Most women preferred to receive the kit by mail and take the test themselves, rather than having it done by a doctor or nurse. There was a range of preferences relating to how to return the kit. Phone calls with non-responders revealed that, although most had received the test kit, the reasons for not choosing to be involved included not wanting to, being too busy, or forgetting. Conclusions: HPV self-testing was acceptable for Maori, Pasifika, and Asian women in Aotearoa New Zealand. HPV self-testing has considerable potential to reduce the inequities in the current screening programme and should be made available with appropriate delivery options as soon as possible.