Table 2.

Summary of the fifteen included articles.

Country	Authors, Year	Study design	Women, n	Population characteristics	Intervention	Setting	Acceptability	Experience
Argentina, Jujuy (Urban and rural area)	Arrossi et al., 2016 [22]	Cross-sectional/Mixed method	3049	Inclusion criteria: Age: 30 years + Living in a home visited by community health workers Exclusion criteria: Have a previous HPV DNA test History of hysterectomy History of treatment for premalignant or malignant disease Pregnancy Have a mental disability	Self-sampling Offered by: Community Health Workers (CHWs) Specimen collection instructions: offered but not described Device: cervical sampler kit (Qiagen, Gaithersburg, MD, USA), brush. Quantitative component Questionnaire: 7-item closed-ended questions regarding education level, health insurance, cervical cancer screening history, and reasons for screening method choice. Qualitative component Two focus groups (n = 30) Interview for HPV knowledge, reasons for accepting or rejecting self-sampling tests. Experience, satisfaction, and circumstances surrounding the test. The possibility of changing their minds in the future to accept self-collection.	Home	85.8% for self-sampling	Majority accepted for being comfortable, easy, fast, painless, voluntary, and free.
Bolivia, Cochabamba (Urban, peri-urban, and rural area)	Surriabre et al., 2017 [23]	Cross-sectional	222	Inclusion criteria: Age: 25 -59 years old Living in urban, peri-urban, and rural areas of Cochabamba.	Self-sampling and clinician-sampling. Offered by: a health professional Specimen collection instructions: written and visual (video) Device: cotton swab and vaginal tampon Questionnaire: evaluate the experience with self-sampling and the preference for a specific device	Health center	64% for self-sampling	Comparing the two self-sampling devices: Cotton swab is 77% easier to use, and 80% more comfortable to use than a vaginal tampon.
Bolivia, Cochabamba and Chapare (Urban, peri-urban, and rural area)	Allende et al., 2019 [24]	Cross-sectional	221	Inclusion criteria: Age: 25 -64 years old Living in urban, peri-urban areas of Cochabamba and rural Chapare Signed informed consent Exclusion criteria: Pregnant women over 20 weeks History of hysterectomy	Vaginal self-sampling and physician-sampling Offered by: a health professional Specimen collection instructions: offered but not described Device: cotton swab Questionnaire: 8-item closed-ended questions after self-sampling and physician-sampling	Health center	High acceptance of self-sampling	89.7% easy to use 81.7% comfortable 67.2.% painless
Brazil, São Paulo (Urban area)	Lorenzi et al., 2019 [25]	Cross-sectional	116	Inclusion criteria: Age: 21 years + Were referred for colposcopy due to an abnormal Pap smear. Exclusion criteria: Women under 21 years of age Pregnant women Women unwilling to participate in the research protocol	Vaginal self-sampling Offered by: a health professional Specimen collection instructions: verbal and visual (illustrations) Device: Evalyn Brush® (Rovers®, Oss, the Netherlands). Questionnaire: 7-item regarding ease of understanding of the method's use, ease of the use the self-collection brush, discomfort or pain, embarrassment or shame, fear of hurting oneself, preference between self-sampling vs. health professional collection. Reason to choose self-sampling (less pain or discomfort, less shame or embarrassment, practicality, Self-sampling at home/Basic Health Facility/ Laboratory; afraid of not collecting it correctly, the health professional can do it better)	Health center	76.70% for self- sampling (95% CI, 68.40–83.70) vs. 12.9% for health professional sampling (95% CI, 7.8–19.9%) vs. 10.3% for both tests acceptable (95% CI, 5.8–16.9%)	Easy to understand how to use and use it. Practicality, minor embarrassment, Discomfort or pain perception decreased as the age increased (p = 0.080).
Chile, Santiago (Urban area)	Léniz et al., 2013 [26]	Cross-sectional	1085	Inclusion criteria: Age: 30–64 years Residents of the geographic area covered by the Alejandro del Río health center in the Puente Alto County Have not attended Pap screening in the previous three years. Exclusion criteria: History of hysterectomy Pregnant women	Vaginal self-sampling Offered by: Community Health monitor Specimen collection instructions: verbal Device: HC2 Collection Device (brush) Questionnaire: regarding socio-educational characteristics, reproductive history, Pap test history, smoking, sexual habits, satisfaction with the procedure, and future test preference	Home	High acceptability for self-sampling	93.4% slightly or not at all uncomfortable 91.6% considered vaginal self-sampling less uncomfortable than Pap testing
Colombia, Bucaramanga (Urban area)	Torrado-Garcia et al. 2020 [27]	Cross-sectional	423	Inclusion criteria: Age: 35–65 years Living in the northern part of Bucaramanga Have a moderate to high risk of developing cervical cancer Exclusion criteria: History of hysterectomy Pregnant women	Cervico-vaginal self-sampling and physician-sampling Offered by: a health professional Specimen collection instructions: visual and verbal Device: brush Questionnaire: 10 questions regarding experience, comfort, the safety of the procedure, preference between the self-sampling method and conventional cytology, and the reasons why they had chosen one of the two methods	Health center	88.5% for self-collected sampling vs. 4% for conventional cytology vs. 7.3% no preference over any method	40.1% Privacy 29.7% comfortability 14% easier to use 29.7% painless 12.4% reliability
El Salvador, San Pedro Perulapan, San Rafael Cedros, Apastepeque and San Sebastian (Rural area)	Rosenbaum et al., 2014 [28]	Cross-sectional	518	Inclusion criteria: Age: 30–49 years Under-screening women in the last 3 years Women capable of providing informed consent Exclusion criteria: Pregnant women History of hysterectomy, cryotherapy, or loop electrosurgical excision procedure	Provider-collected sampling and cervicovaginal self-sampling Specimen collection instructions: verbal Offered by: Health provider Device: careHPV QIAGEN Gaithersburg, Gaithersburg, MD, USA) Questionnaire: regarding demographic information (age, education, marital status, household size, and the number of children), sexual history (age of first intercourse, lifetime sexual partners, and current birth control method), smoking history, cervical cancer screening history, and knowledge of HPV and cervical cancer. Open-ended question regarding the preference between self-sampling or provider-collected sampling, preferred method and during a future screening visit, the preferred screening location (home vs. clinic).	Health center	38.8% for self-collection; (95% CI, 34.6–43.2) vs. 31.9% for provider-collected sampling (95% CI, 27.9–36.1) vs. 29.3% no preference over any method. (95% CI, 29.3–33.5)	29.9% Privacy/embarrassment 19.9% ease 18.9% pain 14.9% comfort 8.5% time/convenience
El Salvador, San Pedro Perulapan, San Sebastian, Apastepeque, San Rafael Cedros, Candelaria, San Vicente, Tecoluca, and Suchitoto (Rural area)	Laskow et al., 2017 [29]	Cross-sectional	60	Inclusion criteria: Age: 30–59 years Non-attenders women to scheduled appointments for cervical cancer screening of the CAPE program Women capable of providing informed consent Exclusion criteria: Pregnant women Women screened within the past 2 years history of hysterectomy, cryotherapy, or loop electrosurgical excision procedure.	Vaginal self-sampling Specimen collection instructions: visual and verbal Offered by: Health researchers Device: Digene Hc2 DNA test, Gaithersburg, MD, USA) (Brush) Questionnaire: regarding sociodemographic characteristics (age, education, marital status, household size, and number of children), sexual history (age at first intercourse, number of lifetime sexual partners, and birth control method), smoking history, previous cervical cancer screening, knowledge and risk perception of HPV and cervical cancer, and reasons for non-attendance, and reasons for agreeing to self-sampling	Home	68% for self-sampling	90% easy process, could be performed at home, save time, little discomfort. and less embarrassment.
El Salvador, San Vicente, La Paz, Cabañas, and Cuscatlán (Rural area)	Maza et al., 2018 [30]	Cross-sectional	1869	Inclusion criteria: Age: 30–59 years Underscreening women (No cytology screening in the last three years, HPV screening within the last five years or had never been screened) Exclusion criteria: History of hysterectomy, cryotherapy, cold knife conization History of cervical cancer	Vaginal self-sampling Specimen collection instructions: visual and verbal Offered by: Community Health promoter and research assistant. Device: CareHPV test (QIAGEN, Gaithersburg, MD, USA) Questionnaire: collected sociodemographic information, health, sexual history, previous screening history, cervical cancer and HPV risk perception, and reasons for non-participation in previous screening programs. Finally, separate sets of questions were administered to women who accepted and those who declined self-sampling to explore the underlying reasons.	Home	99.8% for self-sampling	Most women agreed with statements highlighting positive aspects of the test (e.g., it is easy to perform, can be performed at home, and is more comfortable to do the exam oneself).
Guatemala, Santiago Atitlán, (Rural and rural area)	Gottschlich et al., 2017 [31]	Cross-sectional	178	Inclusion criteria: Age: 25–54 years Exclusion criteria: Pregnant women Women currently menstruating	Cervical self-sampling Specimen collection instructions: visual and verbal Offered by: Community Health Workers (CHWs): Tz’utujil language Device: Eve Medical HerSwab self-collection HPV kits Questionnaire: 143 questions regarding demographics, preventive health care practices, HPV and cervical cancer knowledge, and risk factors. Finally, questions assessing the acceptability and feelings toward HPV self-collection.	Home	High acceptability for self-sampling	78.7% comfortable to use 91% easy to use 80% screening at home
Guatemala, Santiago Atitlán, and Livingston (Rural area)	Murchland et al., 2019 [32]	Cross-sectional	760	Inclusion criteria: Age: 25–54 years Exclusion criteria: History of hysterectomy, History of previous cervical cancer Pregnant women Women currently menstruating Women who had never been sexually active.	Cervical self-sampling Specimen collection instructions: visual and verbal Offered by: Community Health Workers (CHWs) (bilingual: Spanish and Tz’utujil or Q’eqchi, Karif language) Device: HerSwab kits (brush) Questionnaire: 153 questions regarding demographics, risk factors for cervical cancer and HPV, self-reported attitudes towards screening, health care service use, and knowledge of cervical cancer and HPV. Finally, a post-sample survey of 3 questions regarding ease, comfort, and acceptability of the sampling method:	Home	High acceptability for self-sampling	82.3% comfortable 84% easy to use 96.7% willing to use it as a form of cervical cancer screening
Mexico, Morelos (Unspecified area)	Dzuba et al., 2002 [33]	Cross-sectional	1061	Inclusion criteria: Age: 20 years + Use of the Mexican Institute of Social Security services in Morelos Are registered in the parent study [50]	Vaginal self-sampling and health professional sampling Specimen collection instructions: visual, written, and verbal Offered by: Female nurses (self-sampling and pelvic examination) Device: Cotton-tipped sterile Dacron swab Questionnaire: 65 questions regarding socioeconomic and demographic status; sexual, reproductive, and Pap histories; and the acceptability (discomfort, pain, embarrassment, and privacy) perceived during the self-sampling and Pap test procedure.	Health center	65.6% for self-sampling vs. 11.3% for Pap test vs. 23% for both procedures Overall self-sampling acceptability score was 21.7 (p < 0.001) for a maximum total score of 25.	71% more comfortable 55.3% less embarrassing
Nicaragua, Leon (Unspecified area)	Quincy et al., 2012 [34]	Cross-sectional	245	Inclusion criteria: Age: 25–60 years Women living in Leon, Nicaragua Women with intact uteri Exclusion criteria Pregnant women	Vaginal self-sampling and clinician-collected specimen Specimen collection instructions: none reported Offered by: a health professional Device: vaginal swab and brush Questionnaire: questions regarding demographic information, past medical and reproductive history, and perceptions of experiences with self-collection and the clinician examinations. The questionnaire included items about the comfort, pain, privacy, and level of embarrassment associated with the self-collection and pelvic examination. There were also questions about the preference of testing method, the reason for the preference and willingness to self-collect in the future.	Health center	High acceptance of self-sampling Self-collected brush acceptability Score index for a maximum total score of 20 Self-collected brush (M = 18.40, SD = 2.73) Self-collected swab (M = 18.48, SD = 2.41), t(238) = 4.27, p < 0.01. Clinician-collection (M = 17.56, SD = 2.92), t (235) = 3.81, p < 0.01	76.3% no pain with self-sampling using the swab 73.1% no pain with self-sampling using the brush 76.3% very comfortable with self-sampling using the swab 73.1% very comfortable with self-sampling using the brush 90.2% no embarrassment with self-sampling using the swab 88.2% no embarrassment with self-sampling using the brush 90% high privacy for all methods self-sampling using brush and swab were statistically significantly high than those for the clinician-collection
Peru, Ventanilla (Unspecified area)	Morán et al., 2017 [35]	Cross-sectional / Mixed method	97	Inclusion criteria: Age: 25–59 years Have performed a previous vaginal self-sampling test at the HOPE program (Women who help women to fight cervical cancer)	Previous vaginal self-sampling Offered by: Community Health Workers (CHWs) Device:CareHPV (QIAGEN, Gaithersburg, MD, USA) Questionnaire: 29 questions regarding sociodemographic information and variables of preferences regarding self-administration of the test.	Home	68% for self-sampling	It requires less time, privacy. very few women reporting pain or discomfort.
Puerto Rico, San Juan (Urban area)	Ortiz et al., 2012 [36]	Cross-sectional	100	Inclusion criteria: Age: 18–34 years Women undergoing routine Pap smears in the University of Puerto Rico Gynecology Clinic. Women with an intact uterus, No history of cervical cancer No recent cervical procedures Exclusion criteria: HIV-positive Cognitively or physically impaired	Cervicovaginal clinician-collected specimens and cervicovaginal self-sampling Specimen collection instructions: written and verbal Offered by: physician Device: Sterile collection kit - Dacron swab and Cytobrush® (Cooper Surgical, Inc; Connecticut, USA) Questionnaire: 16-item questions regarding demographic, lifestyle, and reproductive characteristics. Sexual practices and acceptability (comfort, pain, privacy, and embarrassment) and the reasons for this preference for the self-sampling for HPV testing	Health center	50% for self-sampling. vs. 22% for clinician-collection vs. 28% for both sampling methods (MD = −0.71, p<0.05). MD: mean difference	Less embarrassment (MD − 0.36) Less pain (MD − 0.23) Women felt that the techniques were equally acceptable in terms of pain (58%), embarrassment (71%), discomfort (47%), and privacy (94%).