Pairing community health workers with HPV self-sampling for cervical cancer prevention in rural Haiti

Int J Gynaecol Obstet. 2015 Mar;128(3):206-10. doi: 10.1016/j.ijgo.2014.09.016. Epub 2014 Nov 11.


Objective: To assess a program in which community health workers (CHWs) provided women with self-sampling devices to detect high-risk human papillomavirus (HPV).

Methods: In a cross-sectional study, 13 CHWs visited homes in a rural area in Haiti's Central Plateau to recruit premenopausal women aged 30-50 years between July 2009 and April 2010. Eligible women had not undergone a cervical smear in the previous 3 years. Participants learned about cervical cancer and self-sampling for HPV testing before using a self-sampler in private. They then completed a questionnaire. CHWs later returned to provide results and advice about follow-up care.

Results: CHWs enrolled 493 women. Among the 485 women for whom questionnaires were received, 468 (96.5%) were comfortable using the self-sampler and 484 (99.8%) stated they would recommend it to others. Among 426 analyzed samples, 54 (12.7%) were positive for high-risk HPV, of whom 46 (85.2%) received follow-up care and 17 (31.5%) had precursor lesions and were treated.

Conclusion: Using a CHW-led intervention, women at high risk for developing cervical cancer were identified and navigated to preventive care. Therefore, pairing CHWs with HPV self-sampling is a promising strategy to combat cervical cancer in rural Haiti and similar settings.

Keywords: Cervical cancer; Community health workers; Human papillomavirus (HPV); Screening; Self-sampling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Community Health Workers / organization & administration*
  • Cross-Sectional Studies
  • Female
  • Haiti
  • Humans
  • Mass Screening / methods
  • Middle Aged
  • Papillomavirus Infections / complications
  • Papillomavirus Infections / diagnosis*
  • Patient Acceptance of Health Care
  • Rural Population
  • Self Care / methods*
  • Specimen Handling / methods
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / prevention & control*
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears