Abstract:
INTRODUCTION: Cervical cancer is the most common cancer among women in Sub-Saharan Africa. Cervical cancer is treatable if detected timeously,
yet only 20% of South African women have ever been for a Pap smear in their lifetime due to limited access to screening, transport or child care
responsibilities. OBJECTIVE: To evaluate the acceptability of self-collection for cervical cancer screening. We aimed to identify which self-collection
device women prefer and if they would consider using them for routine cervical cancer screening. METHODS: HIV-positive women (>18 years) from
urban and rural HIV clinics were interviewed following an education session on HIV, human papillomavirus (HPV) and cervical cancer. Participants
were shown three self-collection devices; (i) an Evalyn cervical brush, (ii) a Delphilavager and (iii) a tampon-like plastic wand before completing a
short questionnaire. RESULTS: A total of 106 women from the urban (n=52) and rural (n=54) clinic were interviewed. Overall 51% of women
preferred the cervical brush, while fewer women preferred the tampon-like plastic wand (31%) or lavage sampler (18%). More than 75% of
women from the rural site preferred the cervical brush, compared to 22% from the urban site (p<0.001). Women from the urban clinic preferred
the tampon-like plastic wand (45%) and then the lavage sampler (33%), as compared to women from the rural clinic (19% and 4%, respectively).
CONCLUSION: Women from urban or rural settings had different preferences for the various self-collection devices. Patient self-collection with HPV
testing may be an acceptable way to improve coverage to cervical cancer screening in high risk HIV-seropositive women.
