Saidu, R.Kuhn, L.Tergas, A.Boa, R.Moodley, J.Svanholm-Barrie, C.Persing, D.Campbell, STsai, W-YWright, T.CDenny, L2024-06-072024-06-072021-01-01Saidu R, Kuhn L, Tergas A, Boa R, Moodley J, Svanholm-Barrie C, Persing D, Campbell S, Tsai WY, Wright TC, Denny L. Performance of Xpert HPV on Self-collected Vaginal Samples for Cervical Cancer Screening Among Women in South Africa. J Low Genit Tract Dis. 2021 Jan 1;25(1):15-21. doi: 10.1097/LGT.0000000000000575.10.1097/LGT.000000000000057510.1097/LGT.0000000000000575https://pubmed.ncbi.nlm.nih.gov/33105451/https://hdl.handle.net/11288/596222Objectives: Self-sampling may increase access to cervical cancer screening in low-resource settings. Using Xpert HPV, we compared test performance of self- and clinician-collected samples in HIV-positive and HIV-negative women in South Africa. Materials and methods: Three hundred thirty HIV-positive and 375 HIV-negative women in the screening group and 202 HIV-negative and 200 HIV-positive women in the referral group, aged 30-65 years, participated in the study. All women self-collected a vaginal sample, and then, a cervical sample was collected by a clinician (both tested using Xpert HPV), followed by colposcopic examination and collection of histologic specimens. Results: There was good agreement between self- and clinician-collected samples for detection of any high-risk human papillomavirus (HPV, κ = 0.72 [95% CI = 0.669-0.771]). Prevalence of HPV and sensitivity of the test to detect cervical intraepithelial neoplasia 2+ was similar in self- and clinician-collected samples. Specificity was lower in self-collected than in clinician-collected samples in both HIV-negative (self: 77.5% [95% CI = 72.8-81.8] vs clinician: 86.9% [95% CI = 82.9-90.2]) and HIV-positive (self: 44.0% [95% CI = 38.0-50.1] vs clinician: 59.7% [95% CI = 53.6-65.6]) women. Restricting the definition of screen-positive to 3 of 5 channels on HPV Xpert improved specificity in both HIV-negative (self: 83.2% [95% CI = 78.8-87.0] vs clinician: 89.7% [95% CI = 86.1-92.7]) and HIV-positive (self: 54.2% [95% CI = 48.1-60.2] vs clinician: 67.4% [95% CI = 61.5-72.9]) women. Conclusions: The self-collected sample had good agreement with the clinician-collected sample for the detection of HPV, and restricting the HPV types may improve the specificity in HIV-positive women.enAttribution 3.0 United Stateshttp://creativecommons.org/licenses/by/3.0/us/Self-collected vaginal samplesCervical cancer screeningWomenSouth AfricaArticleJournal Lower Genital Tract Disease