• Anna Adcock, Fiona Cram, Beverley Lawton, Stacie Geller, Merilyn Hibma, Peter Sykes, MacDonaldE JaneEJ0000-0002-9307-2323Centre for Women's Health Research, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand., Wendy Dallas-Katoa, Bronwyn Rendle, Tracey Cornell, Tania Mataki, Tania Rangiwhetu, Naieta Gifkins, and Selah Hart.
• Centre for Women's Health Research, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.
• Aust N Z J Obstet Gynaecol. 2019 Apr 1; 59 (2): 301-307.

BackgroundHuman papillomavirus (HPV), the causative agent of cervical cancer, can be screened for using self-collected vaginal samples (self-testing). This may overcome barriers to screening for Māori women who suffer a greater burden of cervical disease than New Zealand European women.AimsThis study aimed to explore the potential acceptability of HPV self-testing for never/under-screened (self-reported no cervical screen in 4+ years, aged 25+) Māori women by Kaupapa Māori (by, with and for Māori) mixed methods, involving hui (focus groups/interviews) and survey.Materials And MethodsCommunity-based researchers ran hui with women in four regions (N = 106) and supported hui participants to collect survey data (N = 397). Healthcare providers (HCPs) were also interviewed (N = 17). Hui data were thematically analysed. Survey data were analysed by age group, rural/urban, primary health organisation (PHO) enrolment, and time since last cervical screen.ResultsMost survey participants were PHO-enrolled (87.15%) and attended regularly (71.79%), but did not attend regular cervical screening. A desire for bodily autonomy, including whakamā (embarrassment/shyness/reticence), was the most frequently cited barrier. Three in four women reported being likely/very likely to do an HPV self-test. Nine in ten women reported being likely/very likely to attend follow up if they receive a positive HPV test result. Women and HCPs in the hui emphasised the importance of health literacy, cultural competence and empathetic support.ConclusionThe findings indicate that with a culturally competent introduction of HPV self-testing, many currently never/under-screened Māori women would be willing to be screened and followed up if necessary. HPV self-testing has the potential to save lives.© 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

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