HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study
Introduction Cervical cancer disproportionately burdens low-income and middle-income countries (LMICs) such as Guatemala. Self-collection testing for human papillomavirus (HPV) has been suggested as a form of cervical cancer screening to facilitate access in LMICs. This study assessed and compared t...
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BMJ Publishing Group
2019-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/10/e029158.full |
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| author | Kristin Bevilacqua Audrey R. Murchland Anna Gottschlich Andres Pineda Berner Andrée Sandoval-Ramírez Christian S Alvarez Gina S Ogilvie Thomas E Carey Mark Prince Michael Dean Carlos Mendoza Montano Alvaro Rivera-Andrade Rafael Meza |
| author_facet | Kristin Bevilacqua Audrey R. Murchland Anna Gottschlich Andres Pineda Berner Andrée Sandoval-Ramírez Christian S Alvarez Gina S Ogilvie Thomas E Carey Mark Prince Michael Dean Carlos Mendoza Montano Alvaro Rivera-Andrade Rafael Meza |
| author_sort | Kristin Bevilacqua |
| collection | DOAJ |
| description | Introduction Cervical cancer disproportionately burdens low-income and middle-income countries (LMICs) such as Guatemala. Self-collection testing for human papillomavirus (HPV) has been suggested as a form of cervical cancer screening to facilitate access in LMICs. This study assessed and compared the acceptability of self-collection HPV testing in two rural, indigenous and ethnically distinct communities in Guatemala: Santiago Atitlán, Sololá and Livingston, Izabal.Methods All participants, women between the ages of 18 and 60, completed a questionnaire. Eligible participants were also asked to self-collect a vaginal sample and complete a questionnaire regarding comfort and acceptability. Self-collected samples were tested for high-risk HPV using the real-time PCR Hybribio kit.Results In the indigenous community of Santiago Atitlán, of 438 age-eligible participants, 94% completed self-collection. Of those, 81% found it comfortable and 98% were willing to use it as a form of screening. In the multiethnic (Afro-Caribbean, indigenous) community of Livingston, of 322 age-eligible participants, 53% chose to self-collect. Among those who took the test, 83% found it comfortable and 95% were willing to use it as a form of screening. In Livingston, literacy (can read and/or write vs cannot read or write) was higher in women who chose to self-collect (prevalence ratio 2.25; 95% CI 1.38 to 3.68). Ethnicity, history of screening and reproductive history were not associated with willingness to self-collect in Livingston. Women in Santiago reported less prior use of healthcare than women in Livingston. Overall, 19% (106/549) of samples tested positive for high-risk HPV.Conclusion Among women willing to self-collect in rural and indigenous communities in Guatemala, self-collection for HPV testing is highly acceptable. However, willingness to try self-collection might vary across communities and settings. Women from a community that used less healthcare were more likely to choose self-collection. Further research is necessary to determine what factors influence a woman’s choice to self-collect. |
| format | Article |
| id | doaj-art-9ae511f47f394472bb21ee609df8c9ea |
| institution | OA Journals |
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| language | English |
| publishDate | 2019-10-01 |
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| series | BMJ Open |
| spelling | doaj-art-9ae511f47f394472bb21ee609df8c9ea2025-08-20T02:38:48ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-029158HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional studyKristin Bevilacqua0Audrey R. Murchland1Anna Gottschlich2Andres Pineda3Berner Andrée Sandoval-Ramírez4Christian S Alvarez5Gina S Ogilvie6Thomas E Carey7Mark Prince8Michael Dean9Carlos Mendoza Montano10Alvaro Rivera-Andrade11Rafael Meza123 Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, New York, USA1 Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA1 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA2 Center for the Prevention of Chronic Diseases, Instituto de Nutricion de Centroamerica y Panama, Guatemala, Guatemala3 Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Hospital Universitari Sant Joan, Reus, SpainDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USAWomen`s Health Research Institute, BC Women`s Hospital and Health Centre, Vancouver, British Columbia, CanadaDepartment of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA6 Department of Otolaryngology Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA7 Laboratory of Translational Genomics, Division of Cancer, Epidemiology and Genetics, National Cancer Institute, Gaithersburg, Maryland, USACentro de Investigación para la Prevención de las Enfermedades Crónicas, Instituto deNutrición de Centro América y Panamá, Guatemala City, Guatemala2 Center for the Prevention of Chronic Diseases, Instituto de Nutricion de Centroamerica y Panama, Guatemala, Guatemala8 Cancer Epidemiology and Prevention Program, University of Michigan Rogel Cancer Center, Ann Arbor, United StatesIntroduction Cervical cancer disproportionately burdens low-income and middle-income countries (LMICs) such as Guatemala. Self-collection testing for human papillomavirus (HPV) has been suggested as a form of cervical cancer screening to facilitate access in LMICs. This study assessed and compared the acceptability of self-collection HPV testing in two rural, indigenous and ethnically distinct communities in Guatemala: Santiago Atitlán, Sololá and Livingston, Izabal.Methods All participants, women between the ages of 18 and 60, completed a questionnaire. Eligible participants were also asked to self-collect a vaginal sample and complete a questionnaire regarding comfort and acceptability. Self-collected samples were tested for high-risk HPV using the real-time PCR Hybribio kit.Results In the indigenous community of Santiago Atitlán, of 438 age-eligible participants, 94% completed self-collection. Of those, 81% found it comfortable and 98% were willing to use it as a form of screening. In the multiethnic (Afro-Caribbean, indigenous) community of Livingston, of 322 age-eligible participants, 53% chose to self-collect. Among those who took the test, 83% found it comfortable and 95% were willing to use it as a form of screening. In Livingston, literacy (can read and/or write vs cannot read or write) was higher in women who chose to self-collect (prevalence ratio 2.25; 95% CI 1.38 to 3.68). Ethnicity, history of screening and reproductive history were not associated with willingness to self-collect in Livingston. Women in Santiago reported less prior use of healthcare than women in Livingston. Overall, 19% (106/549) of samples tested positive for high-risk HPV.Conclusion Among women willing to self-collect in rural and indigenous communities in Guatemala, self-collection for HPV testing is highly acceptable. However, willingness to try self-collection might vary across communities and settings. Women from a community that used less healthcare were more likely to choose self-collection. Further research is necessary to determine what factors influence a woman’s choice to self-collect.https://bmjopen.bmj.com/content/9/10/e029158.full |
| spellingShingle | Kristin Bevilacqua Audrey R. Murchland Anna Gottschlich Andres Pineda Berner Andrée Sandoval-Ramírez Christian S Alvarez Gina S Ogilvie Thomas E Carey Mark Prince Michael Dean Carlos Mendoza Montano Alvaro Rivera-Andrade Rafael Meza HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study BMJ Open |
| title | HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study |
| title_full | HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study |
| title_fullStr | HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study |
| title_full_unstemmed | HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study |
| title_short | HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study |
| title_sort | hpv self sampling acceptability in rural and indigenous communities in guatemala a cross sectional study |
| url | https://bmjopen.bmj.com/content/9/10/e029158.full |
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