Perceptions and Experiences of Cervical Cancer and PoC Self-Collected HPV-DNA Cervical Screening

Explore the preliminary results of a study on perceptions and experiences of cervical cancer and point-of-care self-collected HPV-DNA cervical screening. The study highlights the need for improved screening services, introduces WHO GeneXpert PoC HPV-DNA technology, and advocates for global cervical cancer elimination. Themes such as pre-intervention versus intervention and feelings of shame among women are discussed in the findings.

• Cervical cancer
• HPV-DNA screening
• Womens health
• Global health
• Medical research

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1. Perceptions and experience of cervical cancer and PoC self- collected HPV-DNA cervical screening in PNG (Preliminary Results) Hawa Camara| November 17th, 2018

2. Experiences of PoC HPV-DNA cervical screening in PNG Facts about Cervical cancer in PNG Most common Cancer 1,500 deaths annually Pap Smear program cancelled in 2015 2

3. Experiences of PoC HPV-DNA cervical screening in PNG Need for improved screening services WHO GeneXpert PoC HPV-DNA technology was introduced 2018 Call for the elimination of cervical cancer globally recommendation for screen-and- treat approach 3

4. Experiences of PoC HPV-DNA cervical screening in PNG Purpose of Study 4

5. Experiences of PoC HPV-DNA cervical screening in PNG Purpose of Study Pre- Perceptions and experience of previous screening Intervention Experience of PoC self- collected HPV testing Intervention 5

6. Experiences of PoC HPV-DNA cervical screening in PNG Methods 13 9 pre- intervention interviews Data analysis intervention interviews Tok Pisin (Pidgin English) Recorded Transcribed verbatim Translated into English 6

7. Experiences of PoC HPV-DNA cervical screening in PNG Themes: Pre-intervention vs Intervention Pre- Intervention intervention 7

8. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention vs Intervention Pre- Intervention intervention 8

9. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention Feeling of shame Women felt ashamed and uncomfortable during the examination I was embarrassed to show myself to them. That is the only thing that I felt ashamed of. We are all women but I didn t like it. 9

10. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention vs Intervention Pre- Intervention intervention 10

11. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention Negative patient-provider interaction experience Disregard for women s circumstances (transport, financial burden, unavailability of providers ) I was upset and worried when they told me to go back and come again another time. I was very depressed that I was going to go and come back another time 11

12. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention vs Intervention Pre- Intervention intervention 12

13. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention Lack of knowledge of cervical cancer Most women didn t know the symptoms/causes or treatment The way [of getting cancer] is not washing ourselves properly. Going straight to bed after a day s work, that is when [we get cancer] 13

14. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention vs Intervention Pre- Intervention intervention 14

15. Experiences of PoC HPV-DNA cervical screening in PNG Intervention Positive experience using self-sampling More comfortable and preferable to clinician-collected In the past, the workers (HCW) use to examine us... I feel ashamed looking into their faces. However today we collect our own dirt (specimen) is a bit good rather than them (HCW) checking us. Might increase testing when [the women feel that] they would be able to collect it (specimen) themselves [ ] then they would be happy to come. 15

16. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention vs Intervention Pre- Intervention intervention 16

17. Experiences of PoC HPV-DNA cervical screening in PNG Intervention Positive patient-provider interaction experience Felt cared for/welcomed When I went in, I was ashamed but when the nurses smiled at me, greeted me, I felt at ease and happy Better health education/counseling improved patient knowledge then the woman (health workers) who explained everything [ ] and they understood everything mothers felt good and it was alright. 17

18. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention vs Intervention Pre- Intervention intervention 18

19. Experiences of PoC HPV-DNA cervical screening in PNG Intervention Improved service Quicker results/more convenient Better service experience overall The service (provided) was nice, easy, and fast and fee free without any cost. Having received our feedback quickly we about to leave for home which I feel is good. 19

20. Experiences of PoC HPV-DNA cervical screening in PNG Pre-intervention vs Intervention Pre- Intervention intervention 20

21. Experiences of PoC HPV-DNA cervical screening in PNG Intervention Feeling empowered Increased knowledge EMPOWERED Increased awareness 21

22. Experiences of PoC HPV-DNA cervical screening in PNG Intervention Feeling empowered I will go back and tell this to women who have similar problem so that lives will be saved. 22

23. Experiences of PoC HPV-DNA cervical screening in PNG Conclusion Conclusion Ongoing projects - emerging themes Better experience Next steps Piece of larger study that explores acceptability and implementation feasibility Interviews with HCW and key stakeholders 23

24. Experiences of PoC HPV-DNA cervical screening in PNG Acknowledgement Supervisory and study team Angela Kelly-Hanku (PNG IMR/KI UNSW) Andrew Vallely (PNG IMR/KI UNSW) Rebecca Guy (KI UNSW) Somu Nosi (PNG IMR) Support System Family and UNSW/Kirby HDR students (based in Sydney and Cairns) Mentors (local and global) Scott Barnhart Emily deRiel Brianna Clifford 24

25. Experiences of PoC HPV-DNA cervical screening in PNG Tenkyu tru!