Article Characteristics
The study locations were highly diverse and featured a wide spread
across Africa (8/36, 22.2%), Asia (8/36, 22.2%), North America (11/36,
30.6%), South America (2/36, 5.6%), Australia (1/36, 2.8%), Europe
(6/36, 16.7%). High-income countries included the United States,
Canada, Denmark, Sweden, Japan, Korea, Australia, and the United
Kingdom. Low- and middle-income countries included Brazil, China, Ghana,
Malaysia, Nigeria, Oman, and Saudi Arabia.
The included study designs were largely qualitative and observational.
The majority (25/36, 69.4%) included either surveys or questionnaires,
with the remainder including either focus groups (7/36, 19.4%) or
interviews (2/36, 5.6%). All studies were graded as medium risk for
bias using the Risk of Bias Instrument for Cross-Sectional Surveys of
Attitudes and Practices.
The 36 studies included a total of 14362 participants, with an average
sample size of 410.3 (SD 662.7) participants per study. Around half
(17/36, 47.2%) of studies specifically targeted students. The average
age of participants across all studies was 22.4 years (SD 4.5).
The majority of studies (31/36, 86.1%) discussed barriers and
facilitators to Pap testing specifically, while one study analyzed
self-sampling (1/36, 2.8%), one study targeted HPV DNA testing (1/36,
2.8%), and the remainder (4/36, 11.1%) were not specified.