Adcock Anna, Cram Fiona, Lawton Beverley, Geller Stacie, Hibma Merilyn, Sykes Peter, MacDonald E Jane, Dallas-Katoa Wendy, Rendle Bronwyn, Cornell Tracey, Mataki Tania, Rangiwhetu Tania, Gifkins Naieta, Hart Selah
Centre for Women's Health Research, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.
Katoa Ltd, Auckland, New Zealand.
Aust N Z J Obstet Gynaecol. 2019 Apr;59(2):301-307. doi: 10.1111/ajo.12933. Epub 2019 Jan 7.
Human papillomavirus (HPV), the causative agent of cervical cancer, can be screened for using self-collected vaginal samples (self-testing). This may overcome barriers to screening for Māori women who suffer a greater burden of cervical disease than New Zealand European women.
This study aimed to explore the potential acceptability of HPV self-testing for never/under-screened (self-reported no cervical screen in 4+ years, aged 25+) Māori women by Kaupapa Māori (by, with and for Māori) mixed methods, involving hui (focus groups/interviews) and survey.
Community-based researchers ran hui with women in four regions (N = 106) and supported hui participants to collect survey data (N = 397). Healthcare providers (HCPs) were also interviewed (N = 17). Hui data were thematically analysed. Survey data were analysed by age group, rural/urban, primary health organisation (PHO) enrolment, and time since last cervical screen.
Most survey participants were PHO-enrolled (87.15%) and attended regularly (71.79%), but did not attend regular cervical screening. A desire for bodily autonomy, including whakamā (embarrassment/shyness/reticence), was the most frequently cited barrier. Three in four women reported being likely/very likely to do an HPV self-test. Nine in ten women reported being likely/very likely to attend follow up if they receive a positive HPV test result. Women and HCPs in the hui emphasised the importance of health literacy, cultural competence and empathetic support.
The findings indicate that with a culturally competent introduction of HPV self-testing, many currently never/under-screened Māori women would be willing to be screened and followed up if necessary. HPV self-testing has the potential to save lives.
人乳头瘤病毒（HPV）是宫颈癌的病原体，可以通过自我采集阴道样本（自我检测）进行筛查。这可能会克服毛利女性筛查的障碍，因为她们患宫颈疾病的负担比新西兰欧洲女性更重。
本研究旨在通过毛利人主导（由毛利人进行、与毛利人合作并为毛利人开展）的混合方法，即通过hui（焦点小组/访谈）和调查，探索HPV自我检测对于从未接受过筛查/筛查不足（自我报告4年以上未进行宫颈筛查，年龄在25岁以上）的毛利女性的潜在可接受性。
基于社区的研究人员在四个地区与女性进行了hui（N = 106），并支持hui参与者收集调查数据（N = 397）。还对医疗保健提供者（HCPs）进行了访谈（N = 17）。对hui数据进行了主题分析。调查数据按年龄组、农村/城市、初级卫生组织（PHO）注册情况以及上次宫颈筛查后的时间进行分析。
大多数调查参与者注册了PHO（87.15%）且定期就诊（71.79%），但未定期进行宫颈筛查。对身体自主权的渴望，包括whakamā（尴尬/害羞/沉默寡言），是最常被提及的障碍。四分之三的女性表示可能/非常可能进行HPV自我检测。十分之九的女性表示如果HPV检测结果呈阳性，可能/非常可能接受后续检查。hui中的女性和HCPs强调了健康素养、文化能力和同理心支持的重要性。
研究结果表明，通过在文化上具备胜任能力地引入HPV自我检测，许多目前从未接受过筛查/筛查不足的毛利女性愿意在必要时接受筛查和后续检查。HPV自我检测有可能挽救生命。
