{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:06:08Z","timestamp":1790935568145,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Shoppers Foundation for Women\u2019s Health\u2014LOVE YOU by Shoppers Drug Mart\u2122 Community Grants Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Sex workers and formerly incarcerated people with a cervix face significant structural, interpersonal, and emotional barriers to cervical cancer screening, despite being at elevated risk for HPV infection. HPV self-sampling (HPV-SS) is a validated, user-directed method that has the potential to address these barriers, yet it remains excluded from Ontario\u2019s organized screening program. This qualitative study explored the lived experiences of structurally marginalized individuals with a cervix who were offered HPV-SS as part of a mixed-methods pilot in the Greater Toronto Area. Five virtual focus groups were conducted with 34 participants, including both those who used the HPV-SS kit and those who declined it. Using inductive thematic analysis, we identified barriers to traditional screening including fear, stigma, mistrust of healthcare providers, logistical constraints, and a lack of accessible information. HPV-SS was widely described as more acceptable, empowering, and emotionally manageable, offering participants autonomy, privacy, and control over their care. Concerns included swab design, uncertainty about correct use, and unclear follow-up after positive results. Participants offered concrete, community-informed recommendations to improve HPV-SS implementation, including opt-in distribution models, gender-affirming language, and trauma-informed educational materials. The findings highlight the urgent need to integrate HPV-SS into organized screening programs to advance equitable access to cervical cancer prevention for marginalized populations.<\/jats:p>","DOI":"10.3390\/curroncol32060327","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T03:57:18Z","timestamp":1748923038000},"page":"327","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Voices from the Margins: Barriers and Facilitators to HPV Self-Sampling Among Structurally Marginalized People with a Cervix in the Greater Toronto Area and Ontario"],"prefix":"10.3390","volume":"32","author":[{"given":"Mandana","family":"Vahabi","sequence":"first","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada"},{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, ON M5B 1W8, Canada"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada"},{"name":"Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6207-9699","authenticated-orcid":false,"given":"Natasha","family":"Kithulegoda","sequence":"additional","affiliation":[{"name":"Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoomeh","family":"Moosapoor","sequence":"additional","affiliation":[{"name":"Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7322-0894","authenticated-orcid":false,"given":"Aisha","family":"Lofters","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada"},{"name":"Peter Gilgan Centre for Women\u2019s Cancers, Women\u2019s College Hospital, Toronto, ON M5S 1B2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine Pui-Hing","family":"Wong","sequence":"additional","affiliation":[{"name":"Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada"},{"name":"Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7618-9477","authenticated-orcid":false,"given":"Abdolreza","family":"Akbarian","sequence":"additional","affiliation":[{"name":"Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Hynes","sequence":"additional","affiliation":[{"name":"Maggie\u2019s Toronto, Toronto, ON M3C 0C3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"366","DOI":"10.2105\/AJPH.2015.302863","article-title":"Barriers to cervical screening among sex workers in Vancouver","volume":"106","author":"Duff","year":"2016","journal-title":"Am. 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