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\begin{document}

\title{Psychosexual distress following routine primary human papillomavirus
testing: a longitudinal evaluation within the English Cervical Screening
Programme}



\author[1]{Kirsty Bennett}%
\author[2]{Jo Waller}%
\author[3]{Emily McBride}%
\author[3]{Alice Forster}%
\author[1]{Giorgio Di Gessa}%
\author[4]{Henry Kitchener}%
\author[2]{Laura Marlow}%
\affil[1]{University College London}%
\affil[2]{King's College London}%
\affil[3]{UCL}%
\affil[4]{The University of Manchester}%


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  \date{May 25, 2024}


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\begin{abstract}
Objective: To assess psychosexual distress among women receiving
different human papillomavirus (HPV) and cytology results in the context
of the English HPV primary screening pilot, shortly after women received
their results and 6 and 12-months later. Design: Longitudinal,
between-groups study. Setting: Five sites in England where primary HPV
testing was piloted. Population: Women aged 24-65 years (n=1133) who had
taken part in the NHS Cervical Screening Programme. Methods: Women were
sent a postal questionnaire soon after receiving their screening results
and 6 and 12-months later. Data were analysed using linear regression
models to compare psychosexual outcomes between groups receiving six
possible screening results. Main Outcome Measures: Psychosexual
distress, assessed using six items from the Psychosocial Effects of
Abnormal Pap Smears Questionnaire (PEAPS-Q). Results: At all three
time-points, there was an association between screening result and
overall psychosexual distress (all p\textless{}0.001). At baseline,
psychosexual distress was significantly higher among women with HPV and
normal cytology (B=1.15, 95\% CI:0.961-1.337), HPV and abnormal cytology
(B=1.02, 95\% CI:0.783-1.266) and persistent HPV (B=0.90, 95\%
CI:0.703-1.102) compared with the control group (all p\textless{}0.001).
At 6 and 12-month follow-up the pattern of results was similar, but
coefficients were smaller. Conclusions: Our findings suggest that while
simply participating in HPV testing does not appear to cause
psychosexual distress, receiving an HPV-positive result does,
particularly in the short-term. Developing interventions to minimise the
psychosexual burden of testing HPV-positive will be essential to
avoiding unnecessary harm to the millions of women taking part in
cervical screening.%
\end{abstract}%



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