Journal of Reproductive Health, Gender, and HIV in Africa | 07 June 2003
A Research Protocol to Assess the Effect of Integrated HPV Self-Sampling within Mobile HIV Testing Services on Cervical Cancer Screening Uptake Among Women in Blantyre, Malawi
K, i, m, b, e, r, l, e, y, L, e, e
Abstract
Cervical cancer is a leading cause of cancer mortality among women in Malawi, with low screening uptake a major contributor. Human papillomavirus (HPV) self-sampling can improve coverage, but its integration into established community health platforms like mobile HIV testing services remains inadequately evaluated. This protocol details a study to assess this integrated model in Blantyre, Malawi. The primary purpose is to assess the effect of integrating HPV self-sampling into routine mobile HIV testing on cervical cancer screening uptake among women aged 30-49. Specific objectives are: 1) To compare the proportion of women accepting cervical cancer screening in integrated versus standard mobile HIV testing services; 2) To identify facilitators and barriers to HPV self-sampling uptake within this model; and 3) To assess linkage to care for women with a positive HPV result. A pragmatic, cluster-randomised controlled trial will be conducted. Mobile HIV testing units will be randomised to an intervention arm (offering integrated HPV self-sampling and HIV testing) or a control arm (offering standard HIV testing with a referral for cervical screening). A mixed-methods approach will involve quantitative surveys to measure uptake and qualitative interviews with users and providers to explore experiences. The primary outcome is the proportion of eligible women who accept and complete HPV self-sampling during their visit. This is a study protocol; no empirical findings are available. Upon completion, results will present comparative screening uptake rates and qualitative themes. This protocol outlines a robust design to generate evidence on the effectiveness of integrating cervical cancer and HIV screening. The study will inform policy on scalable, client-centred screening strategies in high-burden, low-resource settings. Findings will be used to formulate recommendations for national policy on the integration of HPV self-sampling into community-based HIV services to improve cervical cancer prevention. cervical cancer screening, HPV self-sampling, HIV testing, integration, cluster-randomised trial, Malawi This study will contribute evidence on the operational effectiveness of a service-integration model aimed at reducing the dual burden of HIV and cervical cancer among women in sub-Saharan Africa.