Acceptability of, and preference for, HPV self-sampling for physically Disabled women: a cross-sectional survey

Introduction: Physically Disabled women face multiple barriers to cervical screening, contributing to lower uptake and increased health inequalities. Human papillomavirus (HPV) self-sampling has been shown to increase screening participation in under-screened populations, but little is known about its acceptability for Disabled women. Methods We conducted a cross-sectional online survey with 1,493 UK-based participants who identified as having a physical disability, impairment, condition, or difference that makes cervical screening difficult or impossible. Participants completed questions on the acceptability of HPV self-sampling, their attitudes and beliefs relating to self-sampling, and future screening preferences. Descriptive statistics and multinomial logistic regression were used to analyse responses. Results A majority of participants (63.3%) reported that they would be able to carry out self-sampling themselves and (59.1%) would be willing for a healthcare professional to use a self-sampling kit on their behalf. Many (70.5%) had concerns about not performing the test correctly. Around half (53.0%) would prefer self-sampling at home if offered a screening choice. Women who had never attended screening, or who had delayed/missed appointments, were significantly more likely to prefer self-sampling (odds ratios 13.11 and 5.25, respectively) than women who had always attended. Approximately a fifth of participants (18.7%) would prefer a non-speculum clinician-taken test. Conclusion HPV self-sampling was acceptable to many physically Disabled women and was preferred over conventional screening, particularly among those who had delayed or missed screening or never attended. Implementation should include tailored accessible instructions to support HPV self-sampling, disability-informed clinical support, and consideration of non-speculum clinician-taken samples to ensure equitable access and reduce inequalities in cervical screening.