Chepkorir Joyline, Perrin Nancy, Kivuti-Bitok Lucy, Gallo Joseph J, Gross Deborah, Anderson Jean, Reynolds Nancy R, Wyche Susan, Kibet Hillary, Kipkuri Vincent, Cherotich Anastasha, Han Hae-Ra
School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA.
Department of Nursing Sciences, University of Nairobi, Nairobi 00100, Kenya.
Int J Environ Res Public Health. 2025 May 15;22(5):783. doi: 10.3390/ijerph22050783.
Cervical cancer is the leading cause of cancer-related deaths among women in sub-Saharan Africa, especially in rural areas with limited access to screening. This study explored factors influencing rural Kenyan women's willingness to self-collect samples for HPV-DNA testing. Data were drawn from a mixed methods study in two Kenyan rural counties, including surveys with 174 women and interviews with 21 participants. The mean age of the survey sample was 45.2 (SD = 13.2) years. Only 6.4% had ever been screened, yet 76.9% expressed willingness to self-collect samples for testing. Increased willingness was associated with cervical cancer awareness (OR = 3.49, 95% CI = 1.50-8.11), relying on health workers as primary sources of health information (OR = 1.88, CI = 1.23-2.86), or the news media (OR = 2.63, CI = 1.27-5.48). High cervical cancer stigma (OR = 0.71, CI = 0.57-0.88) and longer travel times of 30-120 min to a health facility (OR = 0.44, CI = 0.20-0.93) were linked to reduced willingness. Integration of the findings showed that comprehensive health promotion-through education, health worker endorsement, and mass media campaigns-may improve HPV self-sampling uptake and reduce the cervical cancer burden in rural Kenya.
宫颈癌是撒哈拉以南非洲地区女性癌症相关死亡的主要原因，尤其是在筛查机会有限的农村地区。本研究探讨了影响肯尼亚农村妇女自行采集样本进行HPV-DNA检测意愿的因素。数据来自肯尼亚两个农村县的一项混合方法研究，包括对174名妇女的调查和对21名参与者的访谈。调查样本的平均年龄为45.2岁（标准差=13.2）。只有6.4%的人曾接受过筛查，但76.9%的人表示愿意自行采集样本进行检测。意愿增加与宫颈癌认知度提高（比值比=3.49，95%置信区间=1.50-8.11）、将卫生工作者作为主要健康信息来源（比值比=1.88，置信区间=1.23-2.86）或新闻媒体（比值比=2.63，置信区间=1.27-5.48）有关。高度的宫颈癌污名化（比值比=0.71，置信区间=0.57-0.88）以及前往医疗机构需要30至120分钟的较长行程时间（比值比=0.44，置信区间=0.20-0.93）与意愿降低有关。综合研究结果表明，通过教育、卫生工作者支持和大众媒体宣传活动进行全面的健康促进，可能会提高肯尼亚农村地区HPV自我采样的接受度，并减轻宫颈癌负担。
