Feasibility and acceptability of telehealth and contactless delivery of human papillomavirus (HPV) self-testing for cervical screening with Māori and Pacific women in a COVID-19 outbreak in Aotearoa New Zealand

N Z Med J. 2022 Nov 11;135(1565):83-94.

Abstract

Aim: To determine the feasibility and acceptability of a telehealth offer and contactless delivery of human papillomavirus (HPV) cervical screening self-test during the 2021 COVID-19 Level 4 lockdown in Auckland, New Zealand.

Methods: A small proof-of-concept study was undertaken to test telehealth approaches in never-screened, due or overdue Māori and Pacific women enrolled in a local Primary Health Organisation (PHO). Study invitation, active follow-up, nurse-led discussions, result notification and a post-test questionnaire were all delivered through telehealth.

Results: A sample of 197 eligible Māori and Pacific women were invited to take part, of which 86 women were successfully contacted. Sixty-six agreed to take part. Overall uptake was 61 samples returned (31.8%) and uptake of all contactable women was 70.9%. Six of the 61 HPV self-tests (9.8%) were positive, all for non 16/18 types, and were referred for cytology. Three had negative cytology results, and three with positive cytology results were referred for colposcopy.

Conclusion: The offer of HPV self-testing during COVID-19 lockdown was both feasible and highly acceptable for Māori and Pacific women. Importantly, HPV self-testing via telehealth and mail-out, alongside other options, offers a potential pro-equity approach for addressing the impact of deferred screens due to COVID-19 and other longstanding coverage issues.

MeSH terms

  • Alphapapillomavirus*
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • Colposcopy
  • Communicable Disease Control
  • Disease Outbreaks
  • Early Detection of Cancer / methods
  • Feasibility Studies
  • Female
  • Humans
  • Mass Screening
  • Native Hawaiian or Other Pacific Islander
  • New Zealand / epidemiology
  • Papillomaviridae
  • Papillomavirus Infections* / diagnosis
  • Papillomavirus Infections* / epidemiology
  • Papillomavirus Infections* / prevention & control
  • Pregnancy
  • Self-Testing
  • Telemedicine*
  • Uterine Cervical Neoplasms* / diagnosis
  • Uterine Cervical Neoplasms* / epidemiology
  • Uterine Cervical Neoplasms* / prevention & control
  • Vaginal Smears