HPV self-testing set to revolutionise cervical cancer detection in Kenya

When Rachel Adhiambo Odoyo picked up a self-testing kit for Human Papillomavirus (HPV), she expected nothing more than to simply know her status.

The 33-year-old clinical officer and mother of two had no symptoms, no pain, no discomfort, but just a commitment to practise what she teaches. She wanted to know her status, the same way she urges every woman she meets to do.

But the tiny brush and vial would return a result that left her anxious-she tested positive for HPV types 16 and 18, the two strains linked to cervical cancer.

“I did not have any symptoms,” recalls Odoyo. “I was just testing to be sure. But I turned out positive.”

Odoyo underwent thermocoagulation (thermablation), a quick, one-stop procedure that destroys HPV-infected cells before they turn cancerous. Further, she took a biopsy test that confirmed she was cancer-free.

“Biopsy results was my biggest relief,” adds the clinical officer “Though I knew HPV does not mean you have cancer, I got reassurance that HPV means you must act early so that cancer never develops.”

Today, Odoyo has become one of the strongest ambassadors for cervical, HPV, and breast cancer screening at Matibabu Foundation Hospital, a Level Four facility.

She is a link between the community and the hospital, reaching women’s groups, church gatherings, and remote villages that rarely access cancer services, and bringing them into the hospital corridors for lifesaving screening.

Odoyo observes that for women in rural Kenya, screening opportunities are often scarce. For example, many have never seen a speculum, whereas a number associate cancer with death and avoid any test that might bring ‘bad news.’

The adoption of AmpFire HPV DNA testing technology, donated by Rotary International, has been a game-changer in HPV screening, enabling early detection of the virus long before it turns cancerous.

With this technology, women can now self-collect samples privately, reducing the embarrassment and fear often associated with traditional speculum exams.

“The new technology has changed perceptions of HPV screening. A woman simply uses a small brush to collect her own sample, and within a short time, we have the results. It has taken away the fear of speculum exams,” observes the clinical officer.

The machine also detects high-risk HPV strains and delivers results quickly, allowing health workers to screen, triage, and treat women in a single visit, an approach that is particularly lifesaving in areas where women must walk long distances to reach health facilities.

Odoyo and her team at the facility target mothers attending post-natal clinics at six weeks, women aged 30 to 65 years at Mother and Child Health department, and outpatient departments, women’s chamas and church groups, and even young women in technical colleges.

HIV-positive women begin screening at 25 and repeat it annually, while HIV-negative women can screen every five years.

“If someone tests positive, we do visual assessment to check for lesions,” she explains. “If present, we do thermablation and take a biopsy. If cancer is suspected, we refer immediately.” Her team also follows up women who miss appointments through phone calls, text messages, and even boda boda women sent to pick them from their homes.

The Standard meets Anne Aluoch Odhiambo, a Community Health Promoter in Ugenya market, encouraging women to screen for HPV, a role that is not just part of her work, it is a personal mission.

Day after day, she travels through villages, knocking on doors, gathering women in church groups and chamas, urging them to take the test that could save their lives.

But for a long time, Odhiambo felt she couldn’t fully persuade women unless she first did what she was asking them to do.

“As a CHP, I felt I needed to walk my talk. I always tell women that knowing your HPV status is the first step to preventing cervical cancer. So I asked myself—have I tested? What example am I setting?”

After gaining some courage, the CHP picked a self-testing kit, stepped into the small private room at the facility, and collected her own sample just the same way she demonstrates to women in the community. The results turned out negative.

“I was anxious about my results because cancer is a scary disease to treat as it comes with financial complications. Having them turn negative was a big relief for me. But more than that, it gave me confidence.

Now when I speak to women, I speak from experience. I know exactly what they feel, the fear, the hesitation, the waiting. And I can tell them, honestly, that the process is simple and painless,” says the CHP.

Odhiambo uses every platform she can find to spread the message including church gatherings, village meetings, market days, even funerals where community members converge.

“Cancer is a disease I wouldn’t want anyone to suffer from. So if I can convince even one woman to screen early, then I have done my part,” she says.

Her commitment is slowly changing perceptions in remote villages. Women who once avoided screening out of fear now approach her after church, asking how they can get the self-test kit. Others invite her to their homes to explain the process to their sisters, daughters and neighbours.

“When they hear that I tested myself, they trust the process more. They see that I am not just talking, I am living what I teach,” says Odhiambo.

Specialised care

At the Matibabu Patient Support Centre, nurse Evelyne Okello is often the next person women meet after an HPV-positive result. Her role spans both emotional support and life-saving intervention.

“When HPV results arrive, they indicate negative or positive,” she explains. “Those who test negative receive a message. But anyone positive, especially for HPV 16 and 18, is called back immediately.”

Once they return, Okello performs VIA (Visual Inspection with Acetic Acid) to check the cervix for any visible changes. If VIA is negative (no lesions), she proceeds with thermoablation, whereas if lesions are present, the woman is referred to theatre for more specialised care.

Thermoablation, she explains, is simple but effective.

“We place the patient on a couch, visualise the cervix, apply acetic acid, and confirm there are no masses. Then the thermablation device is placed on the cervix. It applies heat for about a minute to destroy infected cells,” says the nurse. Most women go home the same day, advised to avoid sexual activity for six weeks to allow healing.

To Okello, the new HPV molecular testing machine donated by Rotary International is a game changer.

“This machine works,” she says. “Early diagnosis saves lives. If we find HPV early, we treat early. And if we treat early, we prevent cancer.”

For many women in rural Siaya, cervical cancer screening has always been out of reach. Speculum exams were feared, trips to health facilities expensive, and pain associated with the unknown.

“Women feel more comfortable with self-testing,” Odoyo says. “It has removed the biggest barrier, fear.”

The programme’s integrated approach screen, triage and treat means women rarely need more than one visit.

For those who hesitate, health workers follow up through texts, phone calls, or even motorcycle-riding community health volunteers who pick them from home.

According to Western Kenya regional coordinator, Rose Waringa, the HPV screening should be encouraged at village level, as most remote areas lack facilities and human resources for screening and treatment.

Most people in the village, she says, screen for HPV when women have already developed advanced stages of cervical cancer that are hard to treat and come with high costs.

“Cervical cancer screening, testing and community mobilisation have always been difficult in rural Kenya,” says Waringa.

“Most facilities are poorly equipped, and access is a challenge. Rural communities are disadvantaged. Economic status is low, awareness is low, and services are far. So having such a machine available here, at no cost, is a milestone,” she observes.

The AmpFire machine is modern, simplified, and free, bringing many women out for screening, with those testing positive put on HPV treatment, while those with cancer are referred for treatment.

To strengthen outreach, Matibabu Foundation Hospital introduced boda girls—trained female riders who escort referred women safely to the facility. The machine now serves not only Siaya, but neighbouring counties including Vihiga and Kakamega.

Amid a growing number of cancer cases, Waringa observes that cancer screening should be as routine as HIV or malaria testing.

“The earlier we screen, the better the chances of saving a life. And women must avoid delays caused by herbal medicine or relying only on prayers. Screening is what saves lives,” says the official.

She also notes the overwhelming cost of cancer treatment, calling it a national concern that should be addressed by stakeholders and policymakers.

On her part Dr Diana Wangeshi Njuguna, a nurse educator and researcher at Dedan Kimathi University, regrets that despite cervical cancer being treatable, HPV-triggered disease continues to claim lives in Kenya.

“Each day, at least nine women die of cervical cancer,” she notes. Men, she explains, are carriers of HPV, which is primarily acquired through sexual contact. Women, on the other hand, are more likely to develop persistent HPV infections and related diseases such as cervical cancer due to anatomical, biological, and behavioral factors.

Dr Njuguna explains that HPV is implicated in up to 90 per cent of cervical cancer cases, with high-risk strains especially types 16 and 18 being the leading triggers.

While the virus can sometimes be cleared naturally, persistent infection, particularly in women with compromised immunity, increases the risk of cancer development.

“HPV can remain in the cervix for years,” says the researcher. “It alters the cervical environment, and over 10 to 20 years, it may lead to cervical cancer. Persistent infection, immunity, and timely treatment of HPV infections all determine whether a woman progresses from HPV infection to cervical cancer.”

The good news, she stresses, is that HPV can be detected and treated before it turns cancerous. For this reason, every woman aged 25 years and above is encouraged to undergo regular cervical screening.

Gold standard

However, she notes that lack of awareness and knowledge about HPV and cervical cancer keeps many women from getting screened, leaving them to present with advanced disease.

“Cervical cancer is preventable, and every woman deserves the chance to live her life to the fullest,” she says. “Sexual activity is part of life. If a woman acquires HPV, she can be treated and remain free from cervical cancer.”

HPV can be detected through HPV DNA testing, recommended by the World Health Organization as the gold standard for detecting high-risk strains. But the method remains expensive and less accessible in Kenya.

“HPV DNA testing is efficient and reliable. It detects high-risk types before symptoms appear. But it requires trained experts and is still costly for most women,” she explains. Consequently, most health facilities rely on Visual Inspection with Acetic Acid (VIA), a simple, low-cost method.

Despite its preventability, uptake of screening in Kenya remains low, which Dr Njuguna attributes to myths, stigma, and lack of awareness—even among educated women. Distance from health facilities, costs, and shortages of trained staff further limit access, especially in remote areas.

To eliminate cervical cancer, Dr Njuguna urges the government to engage community leaders, including clergy, chiefs, and local influencers, who can sensitise communities about HPV vaccination, screening, and treatment.

Kenya has made progress through new cancer centres and improved hospital capacity, including oncology nurses and clinical and medical oncologists.

Yet treatment remains financially overwhelming for many families.

Screening saves lives

Dr Njuguna highlights the importance of government support, particularly through the Social Health Authority (SHA), to ease the burden. She also underscores the often-overlooked role of men in prevention.

“Men are carriers of HPV. They play a key role in prevention,” she says. “Cervical cancer affects women disproportionately, but prevention starts with both partners.”

As Kenya works toward the global goal of eliminating cervical cancer, Dr Njuguna concludes, “Screening saves lives, treatment exists, and every woman—regardless of where she lives—deserves access to care.”

The HPV AmpFire machine at Matibabu Foundation Hospital has the capacity to screen up to 700 samples per day, though currently, the facility processes around 45 samples daily, according to laboratory officer Geoffrey Lang’at.

On a monthly basis, this translates to approximately 150 to 200 samples.

Lang’at explains that a sample is collected on a brush and placed into the machine, which uses molecular amplification technology to detect the DNA of high-risk HPV types, especially 16 and 18.

Results are ready in about an hour and are reported as either positive or negative.

Women who test negative are reassured and advised on when to screen next, usually within three to five years. Those who test positive undergo further evaluation, including VIA.

If no lesions are visible, the machine’s findings allow for immediate, minimally invasive treatment of HPV-infected cells, known as thermocoagulation or thermablation. If lesions are detected, the patient may be referred for a biopsy or advanced treatment.

According to Lang’at, the technology is advanced and enables early detection of HPV before cancer develops.

Other benefits of the technology include privacy through self-sampling, faster results compared to traditional methods like Pap smears, and the ability to screen a large number of women in a short time a crucial advantage in rural communities where access to health services is limited.