Retrospective survey of colposcopy experience for wahine Maori across two time periods (2016 and 2021) in Waitemata and Auckland districts, New Zealand.

AIMS: To examine wahine Maori experiences of colposcopy services in New Zealand based on surveys conducted in 2016 and 2021. METHODS: The surveys included a total of 201 wahine Maori who had attended one of the three colposcopy clinics in the Waitemata and Auckland districts. Participants were retrospectively surveyed about their experience via telephone using a pre-tested questionnaire. Pre-defined responses were analysed quantitatively, and narrative comments were analysed thematically. RESULTS: Response rates were 27.6% in 2016 and 34.2% in 2021. Prior to their appointment, most women reported receiving the information leaflet and a reminder. At the clinic visit, overall interaction with staff, comfort, listening and explanation of the procedure all scored highly, with maintenance or improvements from 2016 to 2021. Wahine reported feeling culturally safe. Areas for improvement included content of information, access to Maori community liaison, appointment waiting time and delivery of colposcopy results. CONCLUSIONS: The findings indicated that wahine Maori had overall excellent experiences of colposcopy services, maintained over a five-year period with some suggested improvements to context of information and communication. This provides reassurance for wahine Maori in the diagnostic and treatment part of the cervical screening pathway ahead of the upcoming change to HPV primary screening.

Acceptability of self-taken vaginal HPV sample for cervical screening among an under-screened Indigenous population.

BACKGROUND: Human papillomavirus (HPV), the causative agent of cervical cancer, can be screened for using self-collected vaginal samples (self-testing). This may overcome barriers to screening for Maori women who suffer a greater burden of cervical disease than New Zealand European women. AIMS: This study aimed to explore the potential acceptability of HPV self-testing for never/under-screened (self-reported no cervical screen in 4+ years, aged 25+) Maori women by Kaupapa Maori (by, with and for Maori) mixed methods, involving hui (focus groups/interviews) and survey. MATERIALS AND METHODS: Community-based researchers ran hui with women in four regions (N = 106) and supported hui participants to collect survey data (N = 397). Healthcare providers (HCPs) were also interviewed (N = 17). Hui data were thematically analysed. Survey data were analysed by age group, rural/urban, primary health organisation (PHO) enrolment, and time since last cervical screen. RESULTS: Most survey participants were PHO-enrolled (87.15%) and attended regularly (71.79%), but did not attend regular cervical screening. A desire for bodily autonomy, including whakama (embarrassment/shyness/reticence), was the most frequently cited barrier. Three in four women reported being likely/very likely to do an HPV self-test. Nine in ten women reported being likely/very likely to attend follow up if they receive a positive HPV test result. Women and HCPs in the hui emphasised the importance of health literacy, cultural competence and empathetic support. CONCLUSION: The findings indicate that with a culturally competent introduction of HPV self-testing, many currently never/under-screened Maori women would be willing to be screened and followed up if necessary. HPV self-testing has the potential to save lives.