1.Introduction of Provider Initiated Testing & Counseling (PITC) to HIV testing for Pregnant Women in Cambodia
Kazuhiro KAKIMOTO ; Koum KANAL ; Sathiarany VONG ; Yuri SASAKI ; Chushi KUROIWA
Journal of International Health 2008;23(3):199-206
Objective
Provider initiated testing and counseling (PITC) for HIV testing, which is not a mandatory HIV testing policy, to pregnant women was being introducing in many countries. The aim of this study was to assess impact and issues raised by the PITC approach for prevention of mother-to-child transmission (PMTCT) of HIV services at an antenatal clinic (ANC) in the capital of Cambodia.
Method
Impact of the PITC approach on the acceptance of PMTCT services was determined by comparing quantitative data indicating the uptakes of PMTCT services during the first one year of PITC with the prior one year.
Results
The acceptance rate of HIV testing dramatically increased from 35.9% (3,033/8,459) to 95.3% (7,780/8,162) (p<0.001), however the acceptance rate of post-test counseling after tested declined from 92.1% (2,793/3,033) to 73.9% (5,753/7,780) (p<0.001). The return rates of pregnant women tested with partners and without partners to post-test counseling were, respectively, 85.5% (1,913/2,237) and 69.7% (3,840/5,507) in PITC approach (p<0.001) although this difference was not significant in VCT approach.
Conclusions
Although it can be agreed that the PITC approach was an effective strategy to increase the uptake of HIV testing, the remarkable declines of the post-test counseling acceptance lead concern about unexpected needs of counselors and the possibility of negative response to the HIV testing by their partners since the women tested without partners in PITC approach are less likely to return to post-test counseling compared to VCT approach. Further investigation on the reasons why some tested women didn’t receive post-test counseling is needed to find out strategies to keep or increase the acceptance of post-test counseling safely in the PITC approach. It was suggested that we still need to take into account the roles of counseling and partners’ involvement in careful consideration of women’s personal safety even in the implementation of PITC approach.
2.Feasibility, accuracy and acceptability of self-sampled human papillomavirus testing using careHPV in Cambodia:a cross-sectional study
Sovanara HANG ; Rei HARUYAMA ; Kyna UY ; Noriko FUJITA ; Tadashi KIMURA ; Kanal KOUM ; Kei KAWANA
Journal of Gynecologic Oncology 2024;35(1):e6-
Objective:
Self-sampled human papillomavirus (HPV) testing is a potential option for cervical cancer screening, but research is scarce in Cambodia. We evaluated the feasibility, accuracy, and acceptability of self-sampled HPV testing using careHPV.
Methods:
A cross-sectional study including women aged 20–49 years attending 2 national hospitals in the capital city was conducted. Women underwent both self-sampling and clinician-sampling of specimens, and were then asked to complete an acceptability questionnaire. The paired samples were analyzed for high-risk HPV by careHPV and genotyped by polymerase chain reaction (PCR).
Results:
A total of 375 women were eligible for inclusion. Based on PCR, 78.9% were negative for HPV in both self and clinician-samples, 9.9% had a complete HPV type match, and 6.1% had all HPV types in clinician-samples also detected in self-samples. In 5.1%, one or more HPV types identified in the clinician-samples were missed in self-samples. When using careHPV, the overall agreement between the 2 sampling methods was 95.7% (95% confidence interval [CI]=95.8–95.6) with good concordance (κ=0.66, 95% CI=0.56–0.76). Nearly 90% of the women preferred clinician-sampling over self-sampling, citing greater comfort, ease, and speed.
Conclusion
Self-sampled HPV testing using careHPV could be an option for cervical cancer screening in Cambodia; however, it requires periodic quality control of handling procedures.In addition, women’s health education regarding the accuracy of self-sampled HPV testing and the importance of follow-up in cases of positive results is needed.
3.Feasibility, accuracy and acceptability of self-sampled human papillomavirus testing using careHPV in Cambodia:a cross-sectional study
Sovanara HANG ; Rei HARUYAMA ; Kyna UY ; Noriko FUJITA ; Tadashi KIMURA ; Kanal KOUM ; Kei KAWANA
Journal of Gynecologic Oncology 2024;35(1):e6-
Objective:
Self-sampled human papillomavirus (HPV) testing is a potential option for cervical cancer screening, but research is scarce in Cambodia. We evaluated the feasibility, accuracy, and acceptability of self-sampled HPV testing using careHPV.
Methods:
A cross-sectional study including women aged 20–49 years attending 2 national hospitals in the capital city was conducted. Women underwent both self-sampling and clinician-sampling of specimens, and were then asked to complete an acceptability questionnaire. The paired samples were analyzed for high-risk HPV by careHPV and genotyped by polymerase chain reaction (PCR).
Results:
A total of 375 women were eligible for inclusion. Based on PCR, 78.9% were negative for HPV in both self and clinician-samples, 9.9% had a complete HPV type match, and 6.1% had all HPV types in clinician-samples also detected in self-samples. In 5.1%, one or more HPV types identified in the clinician-samples were missed in self-samples. When using careHPV, the overall agreement between the 2 sampling methods was 95.7% (95% confidence interval [CI]=95.8–95.6) with good concordance (κ=0.66, 95% CI=0.56–0.76). Nearly 90% of the women preferred clinician-sampling over self-sampling, citing greater comfort, ease, and speed.
Conclusion
Self-sampled HPV testing using careHPV could be an option for cervical cancer screening in Cambodia; however, it requires periodic quality control of handling procedures.In addition, women’s health education regarding the accuracy of self-sampled HPV testing and the importance of follow-up in cases of positive results is needed.
4.Feasibility, accuracy and acceptability of self-sampled human papillomavirus testing using careHPV in Cambodia:a cross-sectional study
Sovanara HANG ; Rei HARUYAMA ; Kyna UY ; Noriko FUJITA ; Tadashi KIMURA ; Kanal KOUM ; Kei KAWANA
Journal of Gynecologic Oncology 2024;35(1):e6-
Objective:
Self-sampled human papillomavirus (HPV) testing is a potential option for cervical cancer screening, but research is scarce in Cambodia. We evaluated the feasibility, accuracy, and acceptability of self-sampled HPV testing using careHPV.
Methods:
A cross-sectional study including women aged 20–49 years attending 2 national hospitals in the capital city was conducted. Women underwent both self-sampling and clinician-sampling of specimens, and were then asked to complete an acceptability questionnaire. The paired samples were analyzed for high-risk HPV by careHPV and genotyped by polymerase chain reaction (PCR).
Results:
A total of 375 women were eligible for inclusion. Based on PCR, 78.9% were negative for HPV in both self and clinician-samples, 9.9% had a complete HPV type match, and 6.1% had all HPV types in clinician-samples also detected in self-samples. In 5.1%, one or more HPV types identified in the clinician-samples were missed in self-samples. When using careHPV, the overall agreement between the 2 sampling methods was 95.7% (95% confidence interval [CI]=95.8–95.6) with good concordance (κ=0.66, 95% CI=0.56–0.76). Nearly 90% of the women preferred clinician-sampling over self-sampling, citing greater comfort, ease, and speed.
Conclusion
Self-sampled HPV testing using careHPV could be an option for cervical cancer screening in Cambodia; however, it requires periodic quality control of handling procedures.In addition, women’s health education regarding the accuracy of self-sampled HPV testing and the importance of follow-up in cases of positive results is needed.