The role of community pharmacies in the provision of human papillomavirus (HPV) self-testing: A range of delivery models and proof-of-concept study

Cervical cancer persists in Aotearoa New Zealand, mainly due to under-screening. Longstanding disparities in screening and cancer rates remain for Māori, Pacific and people not regularly screened. Community pharmacies are an important and accessible part of primary care. To outline and provide potential models of pharmacy involvement in the provision of HPV self-testing. Of the three potential models identified, our proof-of-concept study trialled two models: the 1) promotion of human papillomavirus (HPV) self-testing by pharmacy staff, with mailed test kits from the study team (a centralised co-ordination function), and 2) on-site provision of at-home self-test kits by study nurses, both with telehealth support and results follow-up from the study team to expand self-test access. Six Auckland community pharmacies with high proportions of female Māori and Pacific customers (based on dispensing data) participated in the study for 6 weeks from May to July 2024. All pharmacies participated in the promotion model and one participated in the on-site provision model. Although our numbers were small ( n = 45 participants), our sample return uptake was 69%, showing that pharmacy involvement can engage people with HPV self-testing. Self-tested participants ( n = 31) included 29% who were Māori (19%) or Pacific (10%), and 32% who were overdue for screening by ≥2 years. All surveyed pharmacy staff ( n = 16) supported pharmacy involvement in providing HPV self-tests. Community pharmacies, supported by a centralised co-ordination team, appropriate infrastructure and resources, may be an additional setting for further research to increase access to HPV self-testing for Māori, Pacific, under-screened people, and those not enrolled with a primary care provider. • Community pharmacies may be a new setting to increase access to HPV self-testing. • This setting could engage under-screened groups who do not regularly access general practice; in Aotearoa New Zealand, these groups include Indigenous Māori and Pacific. • We identified three, and tested two, models of pharmacy involvement to inform future research. • With support by a centralised co-ordination team, appropriate infrastructure and resources, pharmacies may be an additional setting for future research to increase access to HPV self-testing for Māori, Pacific, under-screened people, and those not enrolled with a primary care provider.