Online Program

Perceptions related to HPV self-testing: Disparities by race and income among under-screened women

Monday, November 4, 2013 : 11:15 a.m. - 11:30 a.m.

Kayoll Galbraith, BSN, RN, School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Melissa Gilkey, PhD, Population Medicine, Harvard Medical School, Boston, MA
Jennifer S. Smith, PhD, Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC
Noel T. Brewer, PhD, Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, NC
Alice Richman, PhD, MPH, Department of Health Education and Promotion, ECU College of Health and Human Performance, Greenville, NC
Lynn Barclay, BA, American Sexual Health Association, Research Triangle Park, NC
Purpose. The ability of human papillomavirus (HPV) self-testing to expand access to cervical cancer screening rests on the test's acceptability to higher-risk women. We sought to assess perceptions related to HPV self-testing in a sample of low-income, under-screened women. Methods. We conducted a telephone survey of at-risk women in North Carolina (n=213) who received HPV self-test kits by mail. Eligibility criteria included not having had a Pap test in over 3 years and reporting at least 1 of 4 indicators of economic hardship, such as being uninsured or Medicaid-eligible. Results. Most respondents were non-Hispanic black (54%) or white (33%), and a majority (86%) reported an annual household income of $20,000 or less. Overall trust in HPV self-testing was high, and most women (98%) agreed the test was safe. A few women (6%) preferred self-testing to Pap testing, but most (75%) had no preference. Trust in or preference for the self-test did not vary by race or income. However, compared to white women, black women had lower HPV-related knowledge (OR=0.47, 95% CI, 2.24-0.91) and perceived lower cervical cancer risk (OR=0.42, 95% CI, 0.22-0.81). On these measures, we found a similar pattern of disparities for women with very low (<$0,000) versus higher incomes. Conclusions. Our findings suggest that, across racial and economic subgroups, HPV self-testing is highly acceptable to low-income, under-screened women. To be successful, programs for HPV self-testing must seek to overcome disparities in knowledge and perceptions related to the test.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Public health or related nursing
Public health or related research
Social and behavioral sciences

Learning Objectives:
Assess the acceptability of the HPV self-test among women at higher risk for cervical cancer. Describe psychosocial factors that may discourage low-income and African American women from getting cervical cancer screening. Discuss the HPV self-test as an additional cervical cancer screening tool for under-screened women.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Registered Nurse and a second year Doctoral Student in Nursing with a research interest in cancer health disparities in minority women. I have taken coursework in cancer prevention and control content areas and advanced statistical methods. This project was conducted under the guidance and supervision of faculty members with extensive work in cancer prevention, screening tools, infectious diseases and intervention development.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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