Barriers and Opportunities for HPV Self-Sampling in Underserved Rural Communities: Insights from a Mixed Methods Study

Cervical cancer is the leading cause of cancer-related deaths among women in Sub-Saharan Africa, especially in rural areas with limited access to screening. This study examined factors influencing rural Kenyan women's willingness to self-collect samples for HPV-DNA testing. Data were drawn from a mixed-methods study in two Kenyan rural Couties, including surveys with 174 women and interviews with 21 participants. The mean age of the survey sample was 45.2 (SD=13.2) years. Only 6.4% had ever been screened, yet 76.9% expressed willingness to self-collect samples for testing. Increased willingness was associated with cervical cancer awareness (OR=3.49, 95% CI=1.50–8.11), receiving health information from health workers (OR=1.88, CI=1.23–2.86) or the news media (OR=2.63, CI=1.27–5.48). High stigma (OR=0.71, CI=0.57–0.88) and travel time of 30–120 minutes to a health facility (OR=0.44, CI=0.20–0.93) were linked to reduced willingness. Integration of findings showed that a comprehensive health promotion—through educa-tion, health worker endorsement, and mass media campaigns—may im-prove HPV self-sampling uptake and reduce cervical cancer burden in rural Kenya.