Te Waka Wahine Hauora, The Woman's Health Bus, University of Otago, 362 Leith Street Dunedin 9016, New Zealand.
Te Tātai Hauora o Hine, National Centre for Women's Health Research Aotearoa, Faculty of Health, Victoria University of Wellington, 14 Kelburn Parade, Wellington 6012, New Zealand.
N Z Med J. 2024 Jun 7;137(1596):43-51. doi: 10.26635/6965.6267.
Cervical cancer is now preventable with human papillomavirus (HPV) vaccination and HPV screening. However, structural health system barriers in rural areas can inhibit screening access. Inequitable access for rural Māori is exacerbated by social determinants and racism. Pro-equity tools, such as self-taken swabs point of care (POC) testing, now exist. This study aimed to investigate whether POC HPV testing and immediate offer of colposcopy by a mobile colposcopy service is possible at a rural community event.
This case study was a collaboration between a research centre, a women's health bus, a molecular diagnostics company, a Māori health provider and a community charity, and took place prior to the new cervical screening programme introduction at a 2-day community event-a shearathon. Eligible participants were offered a self-taken swab for HPV, which was analysed by POC testing. If high-risk HPV was detected, they were offered an immediate colposcopy. The Māori-centred qualitative component explored women's experiences of the process.
Fourteen women undertook a self-test for HPV. High-risk HPV was detected in six women and all were offered immediate colposcopy. Six women were interviewed. All were supportive of the service. Culturally safe staff taking time to put women at ease contributed to acceptability and positive experiences.
This case study shows that provision of POC HPV testing and colposcopy at a rural community event setting is possible through cross-sector collaboration. This service was acceptable to rural transient workers who face barriers to healthcare in a high-income country.
宫颈癌现在可以通过人乳头瘤病毒（HPV）疫苗接种和 HPV 筛查来预防。然而，农村地区的结构性卫生系统障碍可能会阻碍筛查的获得。农村毛利人的不平等获得机会因社会决定因素和种族主义而加剧。现在有公平工具，例如自我采集拭子即时护理（POC）检测。本研究旨在调查在农村社区活动中，是否可以通过移动阴道镜服务进行 POC HPV 检测和立即提供阴道镜检查。
这是一项研究中心、妇女健康巴士、分子诊断公司、毛利人健康提供者和社区慈善机构之间的合作研究，在新的宫颈癌筛查计划在为期两天的社区活动——剪羊毛大赛之前进行。合格的参与者被提供用于 HPV 的自我采集拭子，该拭子由 POC 检测进行分析。如果检测到高危 HPV，则提供立即进行阴道镜检查。以毛利人为中心的定性部分探讨了女性对该过程的体验。
14 名女性进行了 HPV 自我检测。6 名女性检测出高危 HPV，均被提供立即进行阴道镜检查。对 6 名女性进行了采访。她们都支持该服务。文化安全的工作人员花时间让女性安心，有助于提高可接受性和积极的体验。
本案例研究表明，通过跨部门合作，在农村社区活动场所提供 POC HPV 检测和阴道镜检查是可行的。这种服务对在高收入国家面临医疗保健障碍的农村流动人口是可接受的。
