Abstract
Introduction: In 2023, Aotearoa New Zealand's National Cervical Screening Programme introduced human papillomavirus (HPV) primary screening with the universal option to self-test. This change was informed by a primary care implementation study involving 3308 people due or overdue for cervical screening.
Methods: A cross-sectional survey conducted in 2023 sought implementation study participants' perspectives on their experience of HPV primary screening, with separate analysis of responses from indigenous Māori participants - a group historically underserved by the screening programme. Data collection included: information provision, choice of test, receipt of results, screening experience, understanding of HPV testing, future preferences and suggested improvements. Survey data were analysed using descriptive statistics and inductive thematic analysis.
Results: In total, 176 of 921 survey respondents self-identified as Māori ethnicity (aged 24-70 years) so were included in analyses. Most chose to self-test (94%) for comfort, privacy and convenience and because it supports mana motuhake (self-determination). Good communication and support from the health professional had a positive impact on screening experience. Many felt well informed, but key facts about HPV primary screening were later incorrectly recalled. A minority of participants experienced issues related to implementation, including inadequate education, information or instructions. Future screening intent was high (91.8%), with nearly half (48.2%) wanting to self-test at home.
Conclusion: HPV self-testing was an acceptable screening method for Māori survey participants. Findings highlight the need for clear, repeated communication and education to improve awareness and understanding of HPV screening. Reducing current inequities in screening and related outcomes will require providers to effectively engage, educate and support Māori into screening.