Acceptability of Human Papillomavirus Self-Sampling among Women Living With Human Immunodeficiency Syndrome in Africa: A Systematic Review
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Date
2022-12
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Lead City University
Abstract
Human Papillomavirus self-sampling is a process in which a woman who wants to know if she has an HPV infection collects a cervicovaginal sample herself with a kit and sends it to a laboratory for analysis. Self-sampling has the potential to increase the uptake of cervical cancer screening among women living with HIV in Africa. Immunosuppression and low CD4 counts caused by HIV infection predispose women living with HIV infection to an increased risk for cervical cancer and the development of intraepithelial lesions. Although the majority of HPV infections are asymptomatic and cure on their own, chronic HPV infection can lead to illness. In women, persistent infection with specific HPV types (most often HPV-16 and HPV-18) can cause precancerous lesions that can proceed to cervical cancer if left untreated. The causal relation between HPV and cervical cancer has enabled self-sampling to be envisaged as a possible screening method in low-resource settings. Also, in Africa, research conducted on the acceptability of the self-sampling of HPV among HIV patients is few. The purpose of this study was to evaluate the acceptability of HPV self-testing among women living with HIV, the uptake of cervical cancer screening services, the frequency of cervical cancer screening, the clinical treatment provided for cervical lesions/HPV positive and the social harm/adverse effects of self- sampling. PubMed, Cochrane Central Register of Controlled Trials and Google Scholar were used to search for articles on HPV self-sampling among women living with HIV in Africa published as of 1 September 2020. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2020 guidelines were followed to design and report the results. A total of 1074 records were identified through electronic searches. After applying the screening criteria, 7 studies were eligible for inclusion in the review and were analysed. Five articles reported the acceptability of self-sampled tests, five studies stated the participants that tested positive, only two reported follow-up, two studies reported social harm/adverse effects of self-clinician sampled test and no study reported the frequency of cervical cancer screening. HPV self-sampling is an effective and achievable substitute for clinician sampling in Africa. It could improve the uptake of cervical cancer screening and reduce the mortality rate of cervical cancer in Africa.
Keywords: Human papillomavirus, Self-sampling, women living with HIV/AIDS, Africa
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