Experience of HPV primary screening: a cross-sectional survey of 'Let's test for HPV' study participants in Aotearoa New Zealand.

Abstract

Introduction In 2022-2023, a multi-region implementation study ('Let's test for HPV') was undertaken in New Zealand primary care to inform the National Cervical Screening Programme shift to human papillomavirus (HPV) primary screening in September 2023. Aim This study aimed to describe 'Let's test for HPV study participants' experiences with HPV primary screening. Method Implementation study participants were invited to complete an anonymous online survey in September 2023. Survey data were summarised using descriptive statistics. Free text comments were analysed using inductive thematic analysis. Results Forty-two percent of those invited began a survey (969/2302) and 921 were included in analyses. Respondents were aged 24-71, represented each of the three regions of New Zealand and different ethnic groups and included never and under-screened participants. Most people chose to self-test for comfort, convenience and privacy. Gaps were identified in participant understanding about HPV, how HPV testing differs from cervical cytology and the implications of HPV test results. Key topics requiring further explanation were identified by participants. Around 8% did not find self-testing easy or comfortable. Intent to screen again was high (92.4%), with greater preference for self-testing at home (48.2%) over the GP practice (33.5%). Discussion HPV primary screening incorporating the option to self-test was highly acceptable to primary care-based study participants. Despite having participated in the new pathway, knowledge gaps were evident. Clear communication from screen-takers will be key to support participant knowledge, understanding and confidence in the efficacy of HPV primary screening. Ongoing programme evaluation, including patients' perspectives, will be essential in the pursuit of equity and progress towards cervical cancer elimination.