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HOPE: "Human Papillomavirus screening to improve women's life"


Project Status

Start date of study (mm/yy) 10/2014
Launching of
Self- Sampling (mm/yy)
Completion Date
of Study (mm/yy)


Study Description

Study TypeImplementation research (Proof of concept)
Funding AgencyGrand Challenges Canada
LocationDistrict: Ventanilla
Province: Callao
Country: Peru
Number of women screened with HPV self-sampling2,090
Follow up of HPV-positive womenYes
Percentage of HPV-positive women with completed treatment97.7%


Brief Sumary

Cervical Cancer (CC) is a serious puclic health issue and primary cause of death due to cancer in Peruvian women. Although there are national guidelines for free cytology (Pap) for CC, only 40% of women have screening due to lack of knowledge, fear to the examination, or poor availability of screening services. We evaluated the feasibility of a new model for the detection of CC based on four issues:
1. Use of molecular testing to detect HPV
2. HPV self-sampling, which empower women to care for herself and offers an opportunity t improve screening covverage.
3. Women could teach other women about CC and how to do the self-sampling
4. Use cell phones to send through SMSs results, appointments and reminders.
The HOPE pogram was implemented in the district of Ventanilla (Callao) a periurban area, 30 minutes from the airport. To identify potential female leaders, we placed posters and approached women at markets, streets, community centers and schools. These community women received training about cervical cancer, collection of sample, recording of data and effective communication. After the 3-day intensive training 59 women were certified as «HOPE ladies». They were not paid for the activities they conducted.  The “HOPE ladies” received a package for their home visits which included a bag which could be used also to teach women about their reproductive system and how to self-collect samples; a brochure with information about HPV, cervical cancer and the test in very simple words; and an envelope with a barcoding, a tube with the collection media for the test and a small cytobrush.
The “HOPE ladies” offered the testing to women 30 to 59 yo, testing was done in the comfort of their homes and the samples were left in a collection box open 24/7 located near their living area.  The envelope with barcoding had a space to record name and cellular number. Tests were processed at a central lab and the results were sent by mobile phones SMS messages when they were HPV negative.  If the results were positive women received a message inviting her to come to the center and gave them an appointment. Women also received remainders of appointments and follow ups.
+ | 2090  women were screened, less than 25% ever had a Pap before.
+ | The prevalence of HPV positivity was 12.8%. 
+ | 97.7% of the positive women received treatment.
In a evaluation performed after the study, 86.5% of women reported being satisfied or very satisfied receiving results by SMS in their cellular phones and 96.9% said she would participate again and 99% would recommend the program to relatives or friends. 


Lessons Learned

1. Women love self-sampling and getting results by SMS messages
2. Community women are incredible powerful to reach other women (and families) that otherwise may not show to a health center.
3. The process has empowered women (the “HOPE ladies”) to become “champions”, they were volunteers but a model for sustainability is needed.


Contact Us

Principal InvestigatorPatricia J. García
Contact Informationpatricia.garcia@upch.pe

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