Table 4.

Provider and women’s focus groups: Barriers to self-testing.

HPV self-tests: Barriers—Worry about correctly completing self-test
Provider: “… obviously if I mess it up the first time I may try it again….”	Woman: “They see that big long stick in there and they’re like um … How far do I go?” Woman: “That would be my only concern, that I would do it wrong.”
HPV self-tests: Barriers—Potential harm/discomfort from device
Provider: “I’m totally against that one. I just fear that that Q-tip is going to break off in somebody. I just know it.” This same concern was raised by several women; “The instructions are easy to follow, but I would be afraid that the little white brush that you take off, that it would like come off [inside of the woman].”	Woman: “The idea of pushing … Once you have something inside of you and it’s already resisting and you’ve got to push, uh no.” Woman: “I know but it’s more like a Q-tip and that plastic in it because even like a Q-tip in your ear, that can be uncomfortable, and just thinking a Q-tip down there and I know they use a Q-tip in the Pap smear, and that makes it uncomfortable.”
HPV self-tests: Barriers—Women’s physical limitations
Provider: “… if you’re not real dexterous, you know. How am I going to navigate to get where I need to be and push the plunger. It can cause problems.”  Provider: “I mean, if you have back problems, I mean, sometimes it’s not as easy … if you had short arms it would be difficult….”	Woman: “It’s just, will it hurt someone if you’re built small?”
HPV self-tests: Barriers—Potential contamination of device
Provider:” “If they touch it the wrong way they might contaminate it….”	Woman: “… but what if it touches something before you put it in there?”
HPV self-tests: Barriers—Negative associations with HPV infection
Provider: “… so that might be a barrier because if they think, well if I test for this and I test positive, then that means that I have been unfaithful or I’ve done something wrong in my past or so, just a thought.”  Provider: “Again, that goes back to the HPV. This is not, I’m not looking for genital warts, you know. I’m not saying that you’re promiscuous, I mean, because once they say that, then all of the sudden they’re thinking well now you’re saying I’m …”	Woman: “HPV, first thing I thought was ‘Okay well this is just another name for a type of cancer.’
HPV self-tests: Barriers—self-test instructions
Provider: “The pictures are great but there is so much underneath it. And here, number five, ‘Spread your labia.’ They don’t know …”	Woman: “Yeah, what is a labia? I’ve never heard it called a labia before….”
Provider: “I mean, it seems like it’s too much reading…. The pictures aren’t very clear…. The font’s too small….”	Woman: “I don’t much like the instructions. I can’t see nothing on this, the pictures or the words….”