Optimizing Human Papillomavirus (HPV) self-testing for high risk women

Purpose: Human papillomavirus (HPV) is the main cause of cervical cancer. Allowing women to use a HPV self-test, which can be used at home and mailed in, is one approach that may increase cervical cancer screening. The purpose of this study was to identify which self-test device women prefer and why.

Methods: We conducted four qualitative focus groups with 30 high-risk women in two rural and two urban counties in North Carolina. Women were shown three self-test devices: a lavage (releases liquid into vagina and re-collects fluid), a brush (inserted into vagina and is manually rotated to collect cells), and a tampon-like plastic wand (with an ejectable tip, which is manually rotated around to collect cells).

Results: Women most preferred the brush. The majority reported that they would use the brush (70%), followed by the wand (67%), and the lavage (43%). Women from urban areas preferred the brush, while women from rural areas endorsed the wand. Women reported liking the lavage because it seemed easy to use; they liked the wand because of its inviting color (green), and liked the brush because of its small size and familiarity. Generally, women disliked the lavage because the liquid seemed messy and unsanitary, disliked the wand due to the 15-20 turns required, and disliked the brush because it was short and the tip seemed abrasive.

Conclusions: No one device was perfect although suggestions for an optimal self-test most resembled the brush. These findings can be used to develop an optimal self-test for women.