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. 2025 May 14;5(5):e0004605.
doi: 10.1371/journal.pgph.0004605. eCollection 2025.

Acceptability of human papillomavirus self-sampling among women living with HIV in sub-Saharan Africa: A systematic review and meta-analysis

Olunike Rebecca Abodunrin  1   2 , Folahanmi Tomiwa Akinsolu  1   3 , Oluwabukola Mary Ola  1   3 , Mobolaji Timothy Olagunju  2 , Vivienne Ferife  4 , Akim Tafadzwa Lukwa  5 , Ishak Kayode Lawal  6 , George Uchenna Eleje  7   8 , Oliver Chukwujekwu Ezechi  1   3
Affiliations

Acceptability of human papillomavirus self-sampling among women living with HIV in sub-Saharan Africa: A systematic review and meta-analysis

Olunike Rebecca Abodunrin et al. PLOS Glob Public Health. .

Abstract

HPV self-sampling has the potential to improve early detection of cervical cancer among women living with HIV (WLHIV), but its acceptability varies, creating implementation challenges, especially in sub-Saharan Africa. This study aims to assess the acceptability of HPV self-sampling among WLHIV. We searched PubMed, Web of Science, CINAHL, Academic Medical Ultimate, Cochrane databases, and Google Scholar. The review protocol was registered with PROSPERO (CRD42022299781). Inclusion criteria were based on population, intervention, comparison, and outcome. Statistical analysis was done with R Studio version 4.3.2, and data abstraction was performed in Microsoft Excel. The analysis included 14 studies on the acceptability of HPV self-sampling among WLHIV. The overall acceptability rate was 73%. The pooled data showed that 94% felt comfortable with self-sampling, 72% found it easy to use, 10% reported pain, 14% felt embarrassed, and 41% felt confident about the process. The study found that a majority of WLHIV accepted HPV self-sampling, a higher rate than in the general female population. Many participants had concerns about the method's efficacy. This indicates that while WLHIV generally views self-sampling positively, additional education and support are needed to improve their confidence in its accuracy and reliability.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart.
Fig 2
Fig 2. Proportion of HPV self-sampling acceptability and across countries.
Fig 3
Fig 3. Agreement between HPV self-sampling and clinician sampling results.
Fig 4
Fig 4. Comfort.
Fig 5
Fig 5. Easy.
Fig 6
Fig 6. Pain.
Fig 7
Fig 7. Embarrassed.
Fig 8
Fig 8. Confident.
Fig 9
Fig 9. Baujat plot.
Fig 10
Fig 10. Externally studentized residuals results.
Fig 11
Fig 11. Leave-one-out forest plot.
Fig 12
Fig 12. Result of the influential study test.
Fig 13
Fig 13. Influential study diagnostics.
Fig 14
Fig 14. Baujat plot by countries.
Fig 15
Fig 15. Leave-one-out forest plot by countries.
Fig 16
Fig 16. Result of the influential study test by countries.
Fig 17
Fig 17. Influential study diagnostics by countries.
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