{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:07:07Z","timestamp":1789614427964,"version":"build-2803163510"},"reference-count":43,"publisher":"BMJ","issue":"10","funder":[{"name":"The University of Michigan Department of Latin American and Caribbean Studies","award":["The Tinker Grant"],"award-info":[{"award-number":["The Tinker Grant"]}]},{"name":"The University of Michigan Center for the Education of Women"},{"name":"The University of British Columbia\u2019s School of Population and Public Health and Faculty of Medicine","award":["CIHR Foundation Scheme: Integrated Global Control"],"award-info":[{"award-number":["CIHR Foundation Scheme: Integrated Global Control"]}]},{"name":"The University of Michigan\u2019s School of Public Health Office of Global Public Health and Department of Epidemiology"},{"name":"The University of Michigan M-Cubed Program"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,9,2]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cervical cancer disproportionately burdens low-income and middle-income countries (LMICs) such as Guatemala. Self-collection testing for human papillomavirus (HPV) has been suggested as a form of cervical cancer screening to facilitate access in LMICs. This study assessed and compared the acceptability of self-collection HPV testing in two rural, indigenous and ethnically distinct communities in Guatemala: Santiago Atitl\u00e1n, Solol\u00e1 and Livingston, Izabal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All participants, women between the ages of 18 and 60, completed a questionnaire. Eligible participants were also asked to self-collect a vaginal sample and complete a questionnaire regarding comfort and acceptability. Self-collected samples were tested for high-risk HPV using the real-time PCR Hybribio kit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the indigenous community of Santiago Atitl\u00e1n, of 438 age-eligible participants, 94% completed self-collection. Of those, 81% found it comfortable and 98% were willing to use it as a form of screening. In the multiethnic (Afro-Caribbean, indigenous) community of Livingston, of 322 age-eligible participants, 53% chose to self-collect. Among those who took the test, 83% found it comfortable and 95% were willing to use it as a form of screening. In Livingston, literacy (can read and\/or write vs cannot read or write) was higher in women who chose to self-collect (prevalence ratio 2.25; 95% CI 1.38 to 3.68). Ethnicity, history of screening and reproductive history were not associated with willingness to self-collect in Livingston. Women in Santiago reported less prior use of healthcare than women in Livingston. Overall, 19% (106\/549) of samples tested positive for high-risk HPV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among women willing to self-collect in rural and indigenous communities in Guatemala, self-collection for HPV testing is highly acceptable. However, willingness to try self-collection might vary across communities and settings. Women from a community that used less healthcare were more likely to choose self-collection. Further research is necessary to determine what factors influence a woman\u2019s choice to self-collect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029158","type":"journal-article","created":{"date-parts":[[2019,10,29]],"date-time":"2019-10-29T06:51:13Z","timestamp":1572331873000},"page":"e029158","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":45,"title":["HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study"],"prefix":"10.1136","volume":"9","author":[{"given":"Audrey R.","family":"Murchland","sequence":"first","affiliation":[{"name":"Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gottschlich","sequence":"additional","affiliation":[{"name":"Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Bevilacqua","sequence":"additional","affiliation":[{"name":"Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Pineda","sequence":"additional","affiliation":[{"name":"Center for the Prevention of Chronic Diseases, Instituto de Nutricion de Centroamerica y Panama, Guatemala, Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berner Andr\u00e9e","family":"Sandoval-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Hospital Universitari Sant Joan, Reus, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian S","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina S","family":"Ogilvie","sequence":"additional","affiliation":[{"name":"Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery and Department of Pharmacology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Prince","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dean","sequence":"additional","affiliation":[{"name":"Laboratory of Translational Genomics, Division of Cancer, 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