Implementation of Self-Sampling-Based Human Papillomavirus Screening in HIV-Infected Women in Mali

PURPOSE This study aimed to assess the implementation of self-sampling (SS)-based HPV screening among high-risk HIV-infected women in an HIV Care Center in Bamako, Mali. METHODS Participants received self-sampling kits after receiving explanations and answering questions regarding their preferences. The Cepheid Xpert HPV test, which detects the 14 most common HPV subtypes, was utilized. High-risk (hr)-HPV+ participants underwent visual inspection tests and histology if cancerous lesions were detected, followed by treatment. RESULTS Among the 100 enrolled HIV-infected women, 92% opted to conduct self-sampling on-site, while 8% preferred home sampling. Only four out of the eight women who chose home sampling returned their samples, whereas all participants who opted for on-site sampling provided their samples. The concept of self-sampling was well-received, with 40.6% of women testing positive for high-risk HPV, predominantly HPV18/45 (45%) and the P3 group (HPV31, 35, 33, 52, 58) (33%). Co-infections were common, and all positive cases agreed to undergo further testing and treatment as necessary. CONCLUSION The majority of women (92%) preferred on-site self-sampling. This self-sampling strategy for HPV screening appears to be acceptable among HIV-infected women in Mali and holds potential for widespread implementation to decrease cervical cancer incidence in resource-limited settings.