Awareness and preference for HPV self-collection among Aboriginal and Torres Strait Islander women and people with a cervix

This study evaluated awareness and preference for Human Papillomavirus (HPV) self-collection for cervical screening among Aboriginal and Torres Strait Islander screen-eligible participants. A whole-of-population online survey was conducted between December 2023 and April 2024, with responses from 555 Aboriginal and Torres Strait Islander women and people with a cervix. Around 80% of survey participants had heard of self-collection, with healthcare providers the most mentioned source of this knowledge. Never-screened participants were less likely to have heard of self-collection and more likely to report traditional (n=18, 23%) and social media (n=12, 15%) as sources of knowledge of self-collection compared to their healthcare provider (n=13, 16%). Most never-screened participants said self-collection would make them more likely to have a cervical screening test (n=59, 75%). Overall, 275 participants indicated a clear preference for self-collection (50%). Screening history was significantly associated with a preference for self-collection, with Aboriginal and Torres Strait Islander women and people with a cervix who did not screen regularly (adjusted odds ratio [adjOR]=1.9, 95% confidence interval [95%CI]=1.2-3.0, p<0.01), who had never screened (adjOR=3.5, 95%CI=1.8-6.9, p<0.001), or who lived in regional or remote areas (ajdOR=1.6, 95%CI=1.0-2.5, p=0.03) significantly more likely to prefer self-collection. Age, educational attainment and sexuality did not influence preference in the model. These findings indicate a clear preference for self-collection among under- and never-screened Aboriginal and Torres Strait Islander women and people with a cervix. Despite this, never-screened participants were less likely to have heard of this option. There is an opportunity to reach clients who have never screened or are overdue for cervical screening by raising awareness of self-collection. Other than remoteness, sociodemographic characteristics were not associated with a preference for self-collection, reinforcing the need to offer all eligible clients the choice of collection methods.