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. 2024 Dec 2;22(1):569.
doi: 10.1186/s12916-024-03788-z.

Differences in intention to receive clinician-collected and self-collected samples for HPV DNA testing and its determinants between heterosexual males and females in Hong Kong, China: findings of a territory-wide household survey

Zixin Wang  1 , Siyu Chen  1 , Ngai Sze Wong  2   3 , Annie Wai-Ling Cheung  4 , Zoe Pui-Yee Tam  4 , Sze Long Chung  2   3 , Denise Pui-Chung Chan  2   3 , Phoenix K H Mo  1 , Eliza Lai-Yi Wong  5
Affiliations

Differences in intention to receive clinician-collected and self-collected samples for HPV DNA testing and its determinants between heterosexual males and females in Hong Kong, China: findings of a territory-wide household survey

Zixin Wang et al. BMC Med. .

Abstract

Background: Human papillomavirus (HPV) infection is prevalent among people who are sexually active. This study aimed to compare the levels of behavioral intention to receive free clinician-collected and self-collected samples for HPV DNA testing and its determinants between heterosexual males and females in Hong Kong, China.

Methods: This is a secondary analysis of a territory-wide survey conducted in Hong Kong between May 2021 and March 2022. Participants were sexually active adult Hong Kong residents who were able to communicate in English or Chinese. Invitation letters were mailed to residential addresses that were geographically randomly selected. All sexually active adult household members were invited to complete a self-administered online survey. Multivariate logistic regression analyses were fitted.

Results: Out of 45,394 invitations, 1265 surveys were collected, and 487 heterosexual males and 741 females were included in the analysis. More females than heterosexual males intended to take up free clinician-collected samples for HPV DNA testing (76.7% versus 62.2%, p < 0.001). Similar proportion of heterosexual males and females intended to receive free self-collected samples for HPV DNA testing (67.8% versus 72.6%, p = 0.20). Perceived existing treatment could control sexually transmitted infections (STI) (treatment control), more concerned about STI (concern), perceived more benefits, cue to action (suggested by significant others), and self-efficacy related to HPV testing were associated with higher intention to receive clinician-collected samples for HPV testing in both groups. Heterosexual males who perceived more severe symptoms if contracted STI (identity), longer duration of STI (timeline), more negative effects of STI on their lives (consequences), more understanding of STI (coherence), and stronger negative emotions if contracted STI (emotions) also had higher behavioral intention to take up clinician-collected samples for HPV testing. In addition, perceived more benefits, cue to action, and self-efficacy related to self-collected samples for HPV DNA testing were associated with behavioral intention to take up such testing in both groups.

Conclusions: HPV DNA testing was under-utilized in Hong Kong. Free self-collected samples for HPV testing were highly acceptable by both heterosexual males and females. Illness representation of STI and the Health Belief Model could explain intentions to take up HPV DNA testing.

Keywords: Behavioral intention; China; Clinician-collected samples for HPV DNA testing; Females; Health Belief Model; Heterosexual males; Illness representation of sexually transmitted infections; Self-collected samples for HPV DNA testing.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Before starting the online survey, the participants read a statement that participation was voluntary, refusal to participate would have no effect on them, and the data would be kept strictly confidential and would only be used for research purposes. Online informed consent was sought. Ethical approval was obtained from the Joint Chinese University of Hong Kong – New Territories East Cluster Clinical Research Ethics Committee (reference number: CREC 2020.436). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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