Acceptability of human papillomavirus self testing in female adolescents

Abstract

Objectives: To develop scales assessing acceptability of human papillomavirus (HPV) testing in adolescents, to compare acceptability of self to clinician testing, and to identify adolescent characteristics associated with acceptability. Methods: Female adolescents 14-21 years of age attending a hospital based teen health centre self collected vaginal samples and a clinician, using a speculum, collected cervicovaginal samples for HPV DNA. Acceptability of and preferences for self and clinician testing were assessed at baseline and 2 week visits. Results: The mean age of the 121 participants was 17.8 years and 82% were black. The acceptability scales demonstrated good internal consistency, reliability, test-retest reliability, and factorial validity. Scores were significantly lower for self testing than clinician testing on the acceptability scale and three subscales measuring trust of the test result, confidence in one's ability to collect a specimen, and perceived effects of testing (p,0.01). Of those who reported a preference, 73% preferred clinician to self testing. Acceptability scores for both self and clinician testing increased significantly pre-examination to postexamination (p,0.01). Multivariable analyses demonstrated that race was independently associated with pre-examination and post-examination acceptability of self testing, and that sexual behaviours and gynaecological experiences were associated with specific acceptability subscales. Conclusions: This sample of adolescents found clinician testing for HPV to be more acceptable than self testing and preferred clinician to self testing. If self testing for HPV is offered in the future, clinicians should not assume that adolescent patients will prefer self testing. Instead, they should educate adolescents about available testing options and discuss any concerns regarding self collection technique or accuracy of test results.

Determinants of women¿s likelihood of vaginal self-sampling for human papillomavirus to screen for cervical cancer in Taiwan: a cross-sectional study

“…This result is not surprising, given that most women know and accept the Pap smear as an effective method for cervical screening despite the side effects of discomfort and embarrassment [3,6,27]. In this respect, selfsampling for HPV is a less painful and embarrassing procedure than the Pap test.…”

Self-Sampling for Human Papillomavirus in a Community Setting: Feasibility in Hispanic Women

“…High satisfaction with self-sampling in supervised settings has also been reported by most of the previous studies (10,18,33,39). Yet, some report preference for physician collection of samples (16,19) and, in a study done in China, rural women preferred to do selfsampling at the clinic rather than at home (28). Further study is required to identify factors affecting satisfaction with home or unsupervised self-sampling for HPV and to identify populations more likely to benefit from this sampling method.…”

“…Previous reports indicate that self-sampling under optimal conditions in clinical or supervised settings is both accurate (8)(9)(10)(11)(12)(13)(14)(15) and preferred by patients (16)(17)(18)(19). In a recent systematic review, the sensitivity and specificity of self-sampling for identifying high-risk HPV were 74% and 88% compared with physician sampling (12).…”

Ease and Comfort of Cervical and Vaginal Sampling for Chlamydia trachomatis and Trichomonas vaginalis with a New Aptima Specimen Collection and Transportation Kit

“…Other studies have reported that self-collection of vaginal samples was not preferred over collection by health care workers (7-10) but was acceptable. The reasons for not preferring self-collection of vaginal samples have included concerns about collecting an inadequate sample (10-13) and that self-collection was not as comfortable as collection by health care workers (12).…”