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Results of a Pilot Study of a Mail-Based HPV Self-Testing Program for Underscreened Women from Appalachian Ohio.

Reiter, Paul L; Shoben, Abigail B; McDonough, Deborah; Ruffin, Mack T; Steinau, Martin; Unger, Elizabeth R; Paskett, Electra D; Katz, Mira L.
Sex Transm Dis; 2018 Nov 19.
Artigo em Inglês | MEDLINE | Nov 2018 | ID: mdl-30461597
Resumo: BACKGROUND: Human papillomavirus (HPV) self-testing is an emerging cervical cancer screening strategy, yet few mail-based HPV self-testing programs have been implemented in the United States. We report the results of a pilot study of a mail-based program, the Health Outcomes through Motivation and Education (HOME) Project. METHODS: In 2015-2016, we recruited 103 women from Appalachian Ohio who were ages 30-65 and had not received a Pap test in at least three years. Women were mailed an HPV self-test and randomized to receive either: a) self-test instructions developed by the device manufacturer and a standard information brochure about cervical cancer (control group); or b) self-test instructions developed by the HOME Project and a photo story information brochure about cervical cancer (intervention group). Logistic regression compared study arms on HPV self-test return and receipt of a Pap test. RESULTS: Overall, 80 (78%) women returned their HPV self-test. Return was similar among the intervention and control groups (78% vs. 77%; OR=1.09, 95% CI: 0.43-2.76). Among returners, 26% had an oncogenic HPV type detected in their sample. Women who returned their self-test reported high levels of satisfaction and positive experiences with the self-testing process. Few women overall received a Pap test (11%), and Pap testing was similar among the intervention and control groups (14% vs. 8%; OR=1.91, 95% CI: 0.52-6.97). CONCLUSIONS: Mail-based HPV self-testing programs are a potentially promising strategy for reaching underscreened women in Appalachia. Efforts are needed to better understand how to optimize the success of such programs.