Researchers with UNC School of Medicine, Gillings School of Global Health, and Lineberger Comprehensive Cancer Center collaborated on a new study that highlights a simple but effective way to improve women’s health screenings for women who are often missed by traditional programs.
Researchers with UNC School of Medicine, Gillings School of Global Health, and Lineberger Comprehensive Cancer Center collaborated on a new study that highlights a simple but effective way to improve women’s health screenings for women who are often missed by traditional programs.
The study “Streamlined Self Collection Screening for Sexually Transmitted Infections and Human Papillomavirus” focused on 327 low-income women in 22 counties across North Carolina who were overdue for cervical cancer screening. Participants received mailed self-collection kits to collect samples for the testing of human papillomavirus (HPV) and other sexually transmitted infections (STIs), including chlamydia, gonorrhea and trichomoniasis.
Nearly one in six participants tested positive for another STI, the same rate as HPV. Two percent of participants tested positive for both infections. The study also identified several factors linked with a higher risk of STIs. Women who identified as non-Hispanic Black, reported two or more sexual partners in the past year, were single, or currently smoked, were more likely to test positive.
“The findings from this study highlight the power of putting testing in the hands of women historically marginalized from our healthcare system, said UNC School of Medicine’s Anisha Ganguly, MD, MPH, assistant professor of medicine, Department of Medicine. “By mailing women self-collection screening kits, we can identify STIs and HPV infection among women who face barriers to traditional clinic-based screening, expediting detection and treatment. By testing for multiple preventive care needs at once, we can maximize outreach to populations that are hard to reach, which will ultimately help reduce disparities in STIs and cervical cancer.”
Among participants who tested positive, about two-thirds received follow-up care, showing both the promise and the challenge of connecting women to treatment after at-home testing.
Researchers say the findings suggest that combining screenings for HPV and other STIs in a single self-collection kit could fill critical gaps in preventive care to reach women who face barriers to clinic-based screening. Women who are under-screened for cervical cancer often face similar barriers to STI testing, including limited access to clinics, time constraints and discomfort with in-person exams.
Participants responded positively to receiving self-collection kits by mail, with more than 80% indicating they would prefer future tests to screen for both HPV and other STIs at the same time.
“These results support a streamlined approach for screening both cervical cancer and STIs at the same time,” said Jennifer S. Smith, PhD, professor in the Department of Epidemiology at the Gillings School and UNC Lineberger Comprehensive Cancer Center member. “We’ve previously found that mailing self-collection kits to under-screened women doubles cervical cancer screening, and these findings show that combining cervical cancer and STI testing is not only feasible, but also acceptable. This points toward a future as a combined testing platform – one and done for women.”
The study underscores the potential of home-based, self-collection testing to improve health outcomes for women from marginalized communities.
By streamlining screening for multiple conditions in a single kit, the approach can help identify infections earlier, connect more women to care, and reduce disparities in women’s health outcomes.
The UNC research team included Peyton K. Pretsch, MPH; Noel T. Brewer, PhD; Michael G. Hudgens, PhD; Busola Sanusi; Stephanie B. Wheeler, PhD; and Jennifer S. Smith, PhD, Anisha P. Ganguly, MD, MPH Lisa P. Spees, PhD; and Lynn Barclay from the American Sexual Health Association; and Alicia Carter, MD from LabCorp.