Abstract 82: Women’s Experiences with and Acceptability of Intravaginal, Self-Administered Artesunate Pessaries of Cervical Precancer Treatment in Kenya

Abstract Purpose: The World Health Organization’s 90/70/90 cervical cancer elimination targets aim for 90% access to precancer treatment globally by 2030. In LMICs where the burden of cervical cancer is highest, access to precancer screening and treatment is severely limited. Self-administered topical therapies can help close this gap. In an ongoing Phase 1 trial (ClinicalTrials.gov NCT06165614) we sought to assess the acceptability and experiences of women using intravaginal Artesunate as a treatment for cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3), the premalignant lesion most likely to progress to cervical cancer. Methods: 17 of 18 participants from the Phase 1 trial have completed structured questionnaires and in-depth interviews (IDIs) in their preferred language, focusing on their experiences with Artesunate pessary self-administration, challenges faced, and impact on sexual life. Women consented to participation in the IDIs at screening and IDIs were conducted after women had completed Artesunate treatment. Thematic analysis was used and each transcript was coded by two individuals. Consensus was reached via discussion. NVivo software was used for coding transcripts. Results: A majority of interviews (15/17, 88.2%) were conducted in Luo, and 2/17 were conducted in Swahili. The mean age of participants was 39.9 (SD 6.82), and 11/17 (64.7%) had completed primary education or less. 14/17 (82%) participants earned less than 500 KSH ($5) per day, and 10/17 (58.8%) were married. Less than half, 7/17 (41.2%), had electricity at home. In terms of acceptability of the Artesunate pessaries, women experienced challenges with the initial applicator used for self- administration but found it comfortable to self-administer the drug at home. Important themes that emerged in the analysis included the impact on participants’ dynamics with partners and their ability to navigate their responsibility to care for their health vs. responsibility to partners. Women also expressed hope for complete healing and trust in medical providers. Some participants took action to advocate for themselves and educate their community. Conclusion: Women in the study found self-administered intravaginal Artesunate pessaries acceptable. Further studies should investigate the impact of intravaginal treatments on sexual quality of life. Studies should also explore the role of peer networks in navigating treatment for cervical pre-cancer in the community. Citation Format: Annum Sadana, Anagha Guliam, Erum Agha, Elizabeth Opiyo, Felix Adundo, Katherine Sorgi, Chemtai Mungo. Women’s Experiences with and Acceptability of Intravaginal, Self-Administered Artesunate Pessaries of Cervical Precancer Treatment in Kenya [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 82.