HPV Self-Collection to Increase Cervical Cancer Screening in People without Stable Housing, HOPE Trial
This clinical trial compares the effect of oral instructions to oral instructions with an educational brochure on standard of care human papillomavirus (HPV) self-collection in people without stable housing who are due for cervical cancer screening. Cervical cancer affects people without stable housing at higher rates than the general population and the national rates of homelessness have increased. Early stage and treatable cervical cancer can be detected by Papanicolaou (Pap) testing or HPV deoxyribonucleic testing, but many unhoused people don't get regular screening. HPV self-collection testing results have been shown to be as accurate as those collected by providers and HPV self-collection in the clinic setting has been approved as a standard of care testing method. Self-collection provides a convenient, cost-effective and life-saving option to improve access to screening. There are ongoing clinical trials for mailed self-collection testing, however, many homeless lack long-term addresses and may not benefit from this method. A mobile health-unit (MHU), vans or clinics on wheels, may be an effective option to provide screening services to those without a stable home or address. Oral Instructions include tailored education about the importance of cervical cancer screening, directions on how to perform HPV self-collection and follow-up care as needed. Oral instructions may also include written educational material. This study may help understand whether oral instruction or oral instruction with a written educational brochure is more effective in increasing MHU-based HPV self-collection screening in patients without stable housing.