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HPV Self-sampling to Improve Access to Cervical Cancer Screening for Persons With HIV and/or Underserved Individuals

Not Applicable
Conditions
Cervical Cancer
Interventions
Device: Flocked swab paired with Roche Cobas 4800
Registration Number
NCT05528237
Lead Sponsor
University of Washington
Brief Summary

The objective of this study is to evaluate self-collection of vaginal samples for HPV testing as an alternative cervical cancer screening strategy for persons with HIV and/or limited access to care. Self-collection kits will be offered to persons who refuse a Pap smear or are overdue (\>=6 months) for cervical cancer screening, with screening uptake recorded as a primary outcome. Kits will be offered in-clinic to individuals who refuse a Pap smear, and individuals overdue for screening will have the option to receive and return kits in the mail. The investigators will additionally administer a phone-based survey to evaluate knowledge about HPV and cervical cancer, barriers and facilitators to screening, and attitudes towards screening. Data from medical records will be abstracted to describe the clinical characteristics of the sample and measure receipt of follow-up procedures. Focus groups will be conducted with clinic administrators, staff, and HIV and women's health experts to evaluate clinic and provider barriers and facilitators to cervical cancer screening. The investigators hypothesize that HPV self-sampling will result in favorable patient-centered outcomes and could reduce disparities in access to screening.

Detailed Description

Not available

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
Female
Target Recruitment
50
Inclusion Criteria
  • Age >=25 and <65 (individuals without diagnosed HIV) or >=30 years (individuals with diagnosed HIV)
  • Female sex at birth
  • Proficient in English or Spanish
  • Refused a Pap smear or are >=6 months overdue for cervical cancer screening
Read More
Exclusion Criteria
  • Current pregnancy
  • Complete hysterectomy
  • History of cervical cancer
  • Unable to provide informed consent
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
HPV self-samplingFlocked swab paired with Roche Cobas 4800Participants will be offered self-collection kits for HPV-based cervical cancer screening.
Primary Outcome Measures
NameTimeMethod
Proportion of eligible individuals who accept self-sampling kitsBaseline (during clinical and/or study recruitment encounter)

the proportion of eligible individuals due or overdue for screening who agree to collect a vaginal sample for HPV testing.

Confidence with self-collectionWithin 2 weeks of sample collection

Participants will use a 5-point Likert scale (strongly agree, agree, neutral, disagree, strongly disagree) to respond to the statement, "I am sure I got a good sample using the swab."

Ease of returning home kitsWithin 2 weeks of sample collection

Participants who collected a sample at home will use a 5-point Likert scale (strongly agree, agree, neutral, disagree, strongly disagree) to respond to the statement, "It was easy to return my sample (by mail or to the clinic)."

Proportion of eligible individuals who submit self-sampled specimens3 weeks from enrollment

the proportion of individuals who agree to self-collection who return samples

Satisfaction with self-collectionWithin 2 weeks of sample collection

Participants will use a 5-point Likert scale (strongly agree, agree, neutral, disagree, strongly disagree) to respond to the statement, "I was satisfied with the self-collection experience."

Recommendation of self-collectionWithin 2 weeks of sample collection

Participants will use a 5-point Likert scale (strongly agree, agree, neutral, disagree, strongly disagree) to respond to the statement, "I would recommend self-collection to a friend."

Secondary Outcome Measures
NameTimeMethod
Proportion of eligible individuals who return samples with adequate specimens3 weeks from enrollment

the proportion of returned samples that have valid specimens for HPV testing

Perceived risk of cervical cancerBaseline

a survey to measure participant's perceived risk of cervical cancer

Provider and/or clinic barriers and facilitators to cervical cancer screening surveyDuring study year 1

focus group discussions with clinic administrators, staff and other HIV and women's health experts. These discussions will cover: barriers to clinician-administered screening (i.e., Pap screening and clinician-collected HPV samples); perceived patient barriers to clinician-administered screening and follow-up procedures; perceived facilitators to cervical cancer screening and follow-up; and feasibility of offering HPV self-sampling kits as a potential primary screening strategy.

Knowledge about HPV and cervical cancer screeningBaseline

a survey to measure participant's knowledge about HPV and cervical cancer screening

Reflex cytology results checklistUp to 6 months after self-sampling

the results of cytology tests following positive self-sampled HPV results

HPV prevalence checklistBaseline

the distribution of HPV results from all individuals who return a self-sampled specimen

Attitudes and preferences for screeningBaseline

a survey to measure participant's attitudes and preferences for cervical cancer screening

Colposcopy results checklistUp to 6 months after self-sampling

the results of colposcopy tests following positive self-sampled HPV results.

Receipt of follow-up careUp to 6 months after self-sampling

Among participants who screen positive for hrHPV, measure the proportion who receive indicated follow-up care (cytology and/or colposcopy)

Trial Locations

Locations (3)

MAX Clinic

🇺🇸

Seattle, Washington, United States

SHE Clinic

🇺🇸

Seattle, Washington, United States

Madison Clinic

🇺🇸

Seattle, Washington, United States

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