The Cost of DIY: Correlates of Women’s Willingness to Pay for At-Home HPV Self-Sampling
Thompson, Erika PhD
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Objective: Cervical cancer is largely preventable through screening, including Pap testing and human papillomavirus (HPV) testing. Yet, most women who get cervical cancer are under-screened. At-home self-sampling for HPV, the causal virus for virtually all cervical cancers, offers a potential opportunity to reach more women. Users may need to pay when this service becomes available. Therefore, research is needed to inform strategies to promote uptake of HPV self-sampling among under-screened women. This study identified correlates of women’s willingness to pay for HPV self-sampling, particularly among women not compliant with cervical cancer screening guidelines. Methods: Women 30-65 years old who have never had a hysterectomy completed an online survey in June 2018 (n=812). The survey assessed correlates of willingness to pay for HPV self-sampling (Yes/No), including sociodemographic characteristics, perceived benefits (6-items), perceived risks (4-items), and trusting a healthcare provider. Descriptive statistics were assessed, and logistic regression modeled correlates of willingness to pay for self-sampling using SAS 9.4. The same method was followed for a subpopulation of women not compliant with cervical cancer screening guidelines (n=232). Results: Nearly one-third (36.0%) of participants were willing to pay for self-sampling. Women reported being willing to pay an average of $35.12 for testing. Significant correlates of willingness to pay for HPV self-sampling were age, salary, four of six perceived benefits (e.g. ease of use, comfort, autonomy, and not embarrassing), two of four perceived risks (e.g. pain and uncertainty test performed correctly), and trusting information from a healthcare provider. The perceived benefit, ease of use, was the strongest predictor for willingness to pay for HPV self-sampling (OR=3.91, 95%CI 1.80-8.59). Among women noncompliant with cervical cancer screening guidelines, trusting a healthcare provider was the only statistically significant correlate, with those who did not trust their provider at all being less likely to be willing to pay for self-sampling than those who trusted their provider a lot (OR=0.09, 95%CI 0.02-0.42). Conclusion: Perceived risks and benefits were correlates of willingness to pay for HPV self-sampling among women. Understanding the perspectives of potential end-users can inform future efforts to utilize innovative approaches for cervical cancer screening, especially among under-screened women.