Abstract B160: Willingness to perform HPV self-sampling among women living with HIV in Puerto Rico: Findings from the 2023–2024 Medical Monitoring Project

Abstract

Women living with HIV (WLWH) are at increased risk of persistent high-risk HPV infection and cervical cancer (CC) compared with women without HIV. Despite recommendations for routine CC screening, participation remains suboptimal because of systemic, financial, and psychosocial barriers. HPV self-sampling has emerged as a promising strategy to address these barriers by increasing privacy, autonomy, and convenience. However, willingness to use this screening approach among WLWH has not been well characterized. This study assessed willingness to perform HPV self-sampling and associated factors among Hispanic WLWH in Puerto Rico (PR). We conducted a cross-sectional secondary data analysis of 85 WLWH participating in the 2023-2024 cycles of the Medical Monitoring Project (MMP) in PR who completed the local survey. Willingness to perform HPV self-sampling was self-reported and categorized as willing (probably or willing) versus not willing (not sure, probably not, or definitely not). Prevalence estimates for HPV self-sampling willingness were calculated as weighted percentages with 95% confidence intervals (CI) by sociodemographic, social determinants of health, and lifestyle behaviors. Log-binomial regression models estimated adjusted prevalence ratios (aPRs) and 95% CIs using Stata 19.0 survey procedures. Generative artificial intelligence was used solely to improve grammar and language. Participants had a mean age of 54.8±14.3 years, and 73.1% reported a cervical Pap test within the past 3 years. Overall, 32.6% of WLWH were willing to perform HPV self-sampling. In unadjusted analyses, higher annual income and health literacy were significantly associated with greater willingness to perform HPV self-sampling; however, these associations were attenuated after adjustment. WLWH with annual income ≥ $20,000 (aPR=1.89, 95% CI: 0.99-3.58) and greater confidence completing health forms (aPR=2.11, 95% CI: 0.91-4.90) were more likely to report willingness to perform HPV self-sampling than their counterparts. Additionally, women covered by Medicaid, another public insurance program, or the Ryan White HIV/AIDS Program (aPR=0.66,95% CI: 0.33-1.34), as well as those covered by Medicare (aPR=0.37, 95% CI: 0.10-1.38), were less likely to report willingness to perform HPV self-sampling than women with private insurance. The prevalence of willingness did not differ by education or alcohol use. Approximately one-third of WLWH in PR reported willingness to perform HPV self-sampling. Although willingness appeared to vary by socioeconomic factors, larger studies are needed to confirm these associations. As the first study to assess willingness to perform HPV self-sampling among WLWH in PR, these findings provide baseline evidence to inform future implementation studies evaluating HPV self-sampling as a strategy to increase CC screening participation among WLWH in PR. Maria del mar Conde, Lorena González-Sepúlveda, Maritza Cruz, Gilbert Encarnación, Ana Ortiz, Vivian Colón, Josefina Romaguera, Jane Montealegre, Marievelisse Soto. Willingness to perform HPV self-sampling among women living with HIV in Puerto Rico: Findings from the 2023–2024 Medical Monitoring Project [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B160.