# West Africa Self-Sampling HPV Based Cervical Cancer Control Program (WA-SS-HCCP) for WLWHA: Barriers, challenges, and needs

> **NIH NIH U01** · NORTHWESTERN UNIVERSITY · 2024 · $623,418

## Abstract

PROJECT SUMMARY/ABSTRACT
Worldwide, 70% of new HIV infections every year occur in Sub-Saharan Africa (SSA), home to 74% of people
living with HIV/AIDS (PLWHA), of whom over 50% are women. Furthermore, the highest rates of cervical
cancer (CC) incidence and related death also occur in SSA, where approximately 60% of all CC cases are in
women living with HIV/AIDS (WLWHA). Human Papillomavirus (HPV), amajor cause of CC, is the most
common sexually transmitted infection in SSA and nearly all WLWHA worldwide who develop CC are co-
infected with HPV. CC is largely preventable by HPV vaccination and cervical screening for early detection and
treatment. In high income countries (HICs), these strategies have led to a steep decline in CC; however they
remain largely inaccessible to women in low- and middle-income countries (LMICs). Self-sampling-based HPV
(SS-HPV) tests have been shown to be a cost-effective and feasible approach to identifying women infected
with high-risk HPV strains (hr-HPV) who need more advanced diagnostic tests and treatment. However, SS-
HPV testing has not been widely implemented in most LMICs, including SSA despite high HIV prevalence.
Leveraging our decade-long, extensive, and successful training partnership and research collaborations in Mali
and Nigeria, we propose to implement a novel West African Self-Sampling HPV-Based Cervical Cancer
Control Program (WA-SS-HCCP). The project capitalizes on existing strengths and resources including the
HIV systems of care with Community Health Workers (CHWs) who have established relationships with
WLWHA and can provide HPV and CC education/counseling and SS specimen collection guidance, rapid
transportation of specimens to hospital laboratories, personalized delivery of test results directly to the women,
and facilitation of clinic referrals for women with hr-HPV for advanced diagnostics and treatment. The study will
conduct in-depth assessment of barriers, challenges, and needs to contextually adapt, implement, and
evaluate the effectiveness and success of WA-SS-HCCP. The specific aims are to (1) Assess barriers and
needs for contextual adaptations of WA-SS-HCCP among WLWHA in Mali and Nigeria, using qualitative risk
assessment and observation methods; (2) Contextually adapt, using a learning collaborative approach (e.g.,
monthly webinars, rapid-cycle small tests of change) and an implementation framework (e.g., training to
competency of CHWs, data coordination across settings, implementation dashboard) to optimize the WA-SS-
HCCP across all four sites; and (3) Conduct a dual evaluation of the effectiveness (e.g., % WLWHA fully
screened and % change in) and implementation (e.g., reach, adoption, implementation fidelity, and
maintenance or sustainability) and develop a “WA-SS-HCCP Scale-Up Toolkit” for wide dissemination of this
“detect-to-treat” program that can be expanded to HIV- women and across LMICs.

## Key facts

- **NIH application ID:** 10906797
- **Project number:** 5U01CA275129-03
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** JANE Louise HOLL
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $623,418
- **Award type:** 5
- **Project period:** 2022-09-07 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10906797

## Citation

> US National Institutes of Health, RePORTER application 10906797, West Africa Self-Sampling HPV Based Cervical Cancer Control Program (WA-SS-HCCP) for WLWHA: Barriers, challenges, and needs (5U01CA275129-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10906797. Licensed CC0.

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