Acceptability of self-collected for HPV testing among African American women in the Mississippi Delta

We examined the sociocultural factors associated with acceptability of self-collection (at home) for human papillomavirus (HPV) testing, and preference between this method vs. Pap Smear among 87 African-American women (AAW) 30 years of age and older in the Mississippi Delta from a theoretical (PEN-3 and Health Belief Model) and culturally relevant perspective. A total of 8 focus groups were conducted. Participants reported that AAW are susceptible to cervical cancer (CC) primarily due to: lack of knowledge, limited financial resources, not engaging in screening for fear of results, and fatalism. Most women acknowledged the CC severity, but were unaware of the HPV-CC link. Barriers to participation Pap screening included: lack of health insurance, limited financial resources, lack of transportation, embarrassment, the test being uncomfortable, and fear of results. Most women were receptive to self-collected sampling, but they were divided regarding preference. The ones preferring a Pap stated that they would rather have a doctor or nurse doing it and that they would not feel comfortable doing it themselves for fear of “not doing it right” or hurting themselves. The ones preferring self-collected sampling indicated privacy and not having to wait at the clinic for a long period of time, as the main reasons. Overall, participants indicated that given detailed instructions and demonstration at the clinic, they would be willing to try self-collected sampling at home. There were concerns regarding cost, confidentiality (e.g., sampling getting lost in the mail), getting results mixed up with another patient, and fear of hurting themselves.