Barriers and Opportunities for HPV Self-Sampling in Underserved Rural Communities: Insights from a Mixed Methods Study

Joyline Chepkorir (), Nancy Perrin, Lucy Kivuti-Bitok, Joseph J. Gallo, Deborah Gross, Jean Anderson, Nancy R. Reynolds, Susan Wyche, Hillary Kibet, Vincent Kipkuri, Anastasha Cherotich and Hae-Ra Han
Additional contact information
Joyline Chepkorir: School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
Nancy Perrin: School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
Lucy Kivuti-Bitok: Department of Nursing Sciences, University of Nairobi, Nairobi 00100, Kenya
Joseph J. Gallo: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
Deborah Gross: School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
Jean Anderson: Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Nancy R. Reynolds: School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
Susan Wyche: Department of Media and Information, Michigan State University, East Lansing, MI 48824, USA
Hillary Kibet: Department of Global Health, Masinde Muliro University of Science and Technology, Kakamega 50100, Kenya
Vincent Kipkuri: Department of Reproductive, Maternal, Newborn and Child Health, GoldStar Kenya, Nairobi 00208, Kenya
Anastasha Cherotich: Department of Public Health, Masinde Muliro University of Science and Technology, Kakamega 50100, Kenya
Hae-Ra Han: School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA

IJERPH, 2025, vol. 22, issue 5, 1-17

Abstract: Cervical cancer is the leading cause of cancer-related deaths among women in sub-Saharan Africa, especially in rural areas with limited access to screening. This study explored factors influencing rural Kenyan women’s willingness to self-collect samples for HPV-DNA testing. Data were drawn from a mixed methods study in two Kenyan rural counties, including surveys with 174 women and interviews with 21 participants. The mean age of the survey sample was 45.2 (SD = 13.2) years. Only 6.4% had ever been screened, yet 76.9% expressed willingness to self-collect samples for testing. Increased willingness was associated with cervical cancer awareness (OR = 3.49, 95% CI = 1.50–8.11), relying on health workers as primary sources of health information (OR = 1.88, CI = 1.23–2.86), or the news media (OR = 2.63, CI = 1.27–5.48). High cervical cancer stigma (OR = 0.71, CI = 0.57–0.88) and longer travel times of 30–120 min to a health facility (OR = 0.44, CI = 0.20–0.93) were linked to reduced willingness. Integration of the findings showed that comprehensive health promotion—through education, health worker endorsement, and mass media campaigns—may improve HPV self-sampling uptake and reduce the cervical cancer burden in rural Kenya.

Keywords: cervical cancer; screening; health information; sub-Saharan Africa; barriers; facilitators; HPV-DNA testing; self-sampling; willingness; rural (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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