Grant: Team Grant: GACD Primary and Secondary Prevention of Cancer - General

With appropriate screening cervical cancer is highly preventable. However, some vulnerable groups of women in India, like those living in rural or impoverished urban areas, continue to be victims of premature deaths. Presently, cervical cancer screening is performed via the Pap test, which requires a visit to a clinician's office. Self-sampling for HPV, the virus that causes cervical cancer, is an innovative and useful method of screening that allows a woman to test in a space and at a time of her choosing and could overcome many of the barriers to the Pap test like transportation, child care, and cultural modesty. Our goals are to provide sexual health education and to determine the acceptability, uptake and impact of HPV self-sampling on women's health. We will recruit 600 never/under screened women age 25-69 in rural and low income urban areas. We will provide sexual health education sessions to both women and their male partners. The cultural sensitivity and appropriateness of the content of educational materials will be determined through extensive consultation and collaboration with the local communities. To overcome issues related to low literacy we will rely heavily on audiovisual, info graphs, story boards and locally developed plays and videos. We will use a combination of surveys, focus group and interviews to assess the feasibility and impact of the HPV self-sampling and explore barriers and facilitators to cervical cancer screening uptake. The implementation of this proposed novel strategy of HPV self-sampling has the potential to lead to a new screening standard for hard-to-reach women by removing known barriers and offering it as a primary screening test for subsequent Pap testing. Furthermore, HPV self-sampling can be adapted and scaled up to other regions in India and other low- and middle- income countries to advance cancer prevention, community health literacy, public health policies, and enable women to make healthful and personalized decisions.