Scoping review on the perceptions and attitude of women on methods for collecting cervicovaginal samples for Human Papillomavirus testing in Sub-Saharan Africa

The burden of cervical cancer (CC) continues to rise in Sub-Saharan Africa (SSA) while some high-income countries are approaching elimination targets. Self-sampling for Human Papillomavirus (HPV) test for CC screening is increasingly used globally to accelerate wide coverage but some have reported barriers against its use. This scoping review explored published literature on the perception and attitude of women on the methods for collecting cervicovaginal samples for HPV testing for CC in SSA. This involves a review of electronic databases including Pubmed, Cochrane, Google Scholar, and African Journal Online. The review was limited to published English articles between 2013-2023 using the Arksey and O'Malley framework. Included studies were articles that used perception, attitude, perspective, or acceptability as primary or secondary outcome variables. Of the 137 articles, 131 articles were excluded due to duplicates and ineligibility. Six studies reported that women perceived self-sampling to provide better privacy and comfort, five studies reported that self-sampling was an easier procedure, five studies reported self-sampling was less painful, four reported that self-samples caused lesser embarrassment, three studies reported that women were willing to self-sample, and five studies reported it to be associated with better confidentiality than clinician sampling. Six studies reported that women perceived that the biological samples collected by the clinicians were more reliable compared to self-collected samples. Three studies showed that women preferred self-sampling in a private place in the hospital because they can seek reassurance from clinicians, and reduce the risk of financial burden associated with multiple visitations to the hospital. This shows that self-sampling is preferred relative to clinician-initiated collection of samples for HPV-based CC screening. It is important to emphasize increased sensitization on the reliability of self-sampling before asking the women to self-collect cervicovaginal samples.