Table 1.

Characteristics of studies assessing screening modality preference (n=23)

Study	Medically Underserved Population	Study Design	Sample Size	Findings	Factors Associated with Screening Modality Preference
Anhang 2005	Low-income populationsa	Cross-sectional Survey	172	32% preferred HPV self-test to Pap test “Which would increase screening likelihood…” Pap test (47%), HPV self-test (21%), HPV self-test + pelvic exam (19%), none (12%)	Those recruited at a STD clinic (versus a cancer screening clinic), non-Hispanics (versus Hispanics), and those with at least some college education (versus less than college education) were more likely to prefer the HPV self-test.
Barbee 2010	Racial/ethnic minorities	Cross-sectional Survey	189 (Haitian)	87% preferred HPV self-test to Pap test	--
Cina 2017	Racial/ethnic minorities	Cross-sectional Survey	93 (AI/AN)	63% preferred HPV self-test to Pap test	--
Crosby 2015b	Rural residents	Cross-sectional Survey	400 (Appalachian Kentucky)	89% preferred HPV self-test to Pap test	--
Crosby 2017	Racial/ethnic minorities	Cross-sectional Survey	88 (non-Hispanic Black Mississippians)	78% preferred HPV self-test to Pap test	No associations with preference for HPV self-test.
Hatcher 2011	Rural residents	Cross-sectional Survey	345 (Appalachian Kentucky)	66% preferred HPV self-test to Pap test	Rarely or never screened individuals (versus recently screened individuals) were more likely to prefer the HPV self-test.
Winer 2016	Racial/ethnic minorities	Cross-sectional Survey	306 (Hopi Tribe members)	62% preferred HPV self-test to Pap test	Those without a Pap test within the past 3 years and individuals not employed full-time were more likely to prefer the HPV self-test.
Ilangovan 2016	Racial/ethnic minorities	Cross-sectional Survey	121 (Haitian: 40 Hispanic: 81)	77% preferred HPV self-test, 20% had no preference, 2% preferred Pap test, 1% did not respond	Hispanics (versus Haitians) were more likely to prefer the HPV self-test.
Jones 2012	Racial/ethnic minorities	Cross-sectional Survey	197 (Hispanic: 166 Black: 25 Other: 6)	79% preferred HPV self-test, 14% reported no preference, 8% preferred Pap testc	Black individuals (versus Hispanic individuals) were more likely to prefer the HPV self-test.
Kilfoyle 2018	Low-income populationsd	Cross-sectional Survey	227	51% preferred HPV self-test, 27% had no preference,19% preferred Pap testc	Black women and other women of color (versus White women) were more likely to prefer the HPV self-test.
Levinson 2016	Women staying in domestic violence shelters	Cross-sectional Survey	142	10% preferred HPV self-test, 39% had no preference, 42% preferred Pap testc	Women not up-to-date on screening were more likely to prefer the HPV self-test.
Litton 2013	Racial/ethnic minorities	Cross-sectional Survey	516 (AA)	43% preferred HPV self-test, 25% preferred Pap test, 15% preferred HPV test at doctor’s office, 17% did not know	Women who had recently received a colposcopy or Pap test were more likely to prefer a Pap test.
Molokwu 2018	Racial/ethnic minorities	Randomized controlled trial	195 (Hispanic)	32% preferred HPV self-test, 45% had no preference, 23% preferred Pap test	--
Penaranda 2015	Racial/ethnic minorities	Cross-sectional Survey	110 (Hispanic)	30% preferred HPV self-test, 43% had no preference, 26% preferred Pap testc	--
Seay 2017	LGBTQ populations	Cross-sectional Survey	91 (transgender men)	57% preferred HPV self-test, 21% preferred Pap test, 14% had no preference, 7% would refuse both testsc	Individuals who reported avoiding preventive health care due to cost and/or discrimination were more likely to prefer the HPV self-test. Individuals with health insurance and a history of screening were less likely to prefer the HPV self-test.
Galbraith 2014	Low-income populationsd	Cross-sectional Survey	199	When asked which protects women’s health better… 75% had no preference, 19% preferred Pap test, 6% preferred HPV self-test	--
McDowell 2017	LGBTQ populations	Mixed Methods (Interviews + Surveys)	63 (transmasculine individualsf)	79% preferred HPV self-test to Pap test (across survey and interviews)	Self-test benefits: less invasive, more comfortable, less likely to provoke gender discordance, greater agency Pap test benefits: more thorough The degree of comfort participants felt with their providers influenced their willingness to have Pap test. (n=31, interviews only)
Pieters 2013	Homeless women	Qualitative (Interviews)	17	65% preferred HPV self-test, 29% preferred Pap test, 6% reported no preference	Self-test benefits: easy, comfortable, unintrusive Cytology still seen as necessary.
Katz 2017	Low-income populationsf	Qualitative (Focus Groups)	15	Majority preferred HPV self-tests	Self-test benefits: convenience, cost, no doctor’s office visit Self-test concerns: pain
Penaranda 2014	Racial/ethnic minorities	Qualitative (Focus Groups)	21 (Hispanicg)	No clear preference consensus	Participants value: choice, ease, accuracy, cost Self-test benefits: ease, convenience, practicality, less embarrassment, not needing child care Self-test concerns: performing test incorrectly
Reisner 2018	LGBTQ populations	Qualitative (Interviews)	131 (transmasculine individualsf)	>90% preferred HPV self-test to Pap test	Self-test benefits: ease, privacy, self-empowerment Self-test concerns: performing test incorrectly, distrust of accuracy, gender dysphoria triggered by interacting with genitals
Scarinci 2013	Racial/ethnic minorities	Qualitative (Focus Groups)	96 (AA)	Most women would be willing to perform HPV self-test	Self-test benefits: convenient, private Self-test concerns: performing test incorrectly, cost
Anhang 2004	Low-income populationsh & Racial/ethnic minorities	Qualitative (Focus Groups)	48 (Hispanic, AA, AI/AN, White)	Most women preferred physician- administered HPV test or preferred physician examination in addition to self-test	--

^aDefined as women attending inner-city publicly funded health clinics in New York City

^bPreference measured as which type of test participants would be more likely to complete on a regular basis

^cDue to rounding and/or missing data, percentages do not add up to 100%

^dDefined as individuals who had children in federal school lunch program, had Medicaid or Medicare Part B, were uninsured, or had income <200% of the federal poverty level

^eDefined as those assigned female at birth who identify with a gender other than female

^fIncome <$20,000 (87% of individuals had incomes less than $10,000)

^gResiding on the US-Mexico border, majority Hispanic

^hMajority had income <$15,000, not otherwise defined

Abbreviations: African American (AA); American Indian/Alaskan Native (AI/AN)