Expanding Access to Preventative Care: HPV Self-Screening, Community Health, and Cultural Interventions
A Research and Community Intervention Project by Repro Uncensored and Autumn Breon, in Partnership with ProDx Health
At Repro Uncensored, our research examines how access to sexual and reproductive health services is shaped not only by medical availability, but also by stigma, culture, infrastructure, and the environments in which care becomes visible, trusted, and usable. Despite the existence of effective screening technologies, significant gaps persist globally in routine HPV testing and early cervical cancer prevention due to cost, medical avoidance, lack of awareness, and structural barriers to accessing clinical spaces.
These disparities are not evenly distributed. In the United States, Black women face a significantly higher burden of cervical cancer incidence and mortality, with studies showing approximately a 41% higher chance of developing cervical cancer compared to white women. Such inequities reflect longstanding structural barriers to preventative care access, including medical mistrust, inequitable healthcare infrastructure, and reduced access to regular screening. Addressing these disparities requires not only improved technologies, but new care delivery models that are community-embedded, culturally responsive, and accessible outside traditional clinical settings.
In response, Repro Uncensored and multidisciplinary artist Autumn Breon initiated a collaborative research and community intervention project designed to embed preventative reproductive healthcare directly into cultural and community environments. Developed in partnership with ProDx Health and informed by the clinical research leadership of Dr. Andreas M. Kogelnik, MD, PhD, the initiative aims to create a scalable model for delivering HPV self-screening and reproductive health resources across diverse public spaces in the United States and globally.
As a first pilot, the partnership offered free HPV self-screenings during Los Angeles Art Week at BUTTER Art Fair through Autumn Breon’s Care Machine, an artistic and community care platform that reframes health resources as collective, visible, and shared. This pilot was conceived not as a one-time activation, but as a proof of concept for a broader model that can be adapted and deployed across cultural institutions, community gatherings, and public-facing environments worldwide.
By situating preventative screening within a cultural space, the initiative explored how decentralizing reproductive health services can increase engagement, reduce stigma, and reimagine preventative care as part of everyday public life rather than something confined to clinical institutions. The partnership with ProDx Health ensures that this model remains grounded in clinical rigor while expanding into community-led contexts that traditional health systems often struggle to reach.
The following research conversation with Dr. Andreas M. Kogelnik, MD, PhD, CEO of ProDx Health, provides clinical and technological context for this intervention, examining the role of self-collected HPV testing in expanding participation in preventative care and contributing to a broader shift toward decentralized, community-based health infrastructures.
Decentralizing Preventative Care Through Community-Embedded Health Models
We know most cervical cancers are linked to HPV, yet many people still don’t get screened regularly. Why do you think access to HPV testing remains such a gap, even when the technology exists?
Dr. Andreas M. Kogelnik: Part of it is simply awareness. People don’t like going to the doctor for starters. Add to that having someone examining their privates. The advancement of options for HPV testing is relatively recent and so education hasn’t caught up yet. Never mind that reproductive health discussions in general can trigger all kinds of stigmas. Lots of little barriers add up fast when we’re talking about these issues. But cancer prevention should really be on every woman’s mind whether you’re 18 or 70. We need to normalize the conversation in every corner and culture. Men need to be part of the discussion too.
Self-collection PCR swabs are slightly less sensitive than clinician-collected samples, but they significantly increase participation. How do you think about that balance between clinical sensitivity and real-world access?
Dr. Andreas M. Kogelnik: The difference between PCR tests that are self-collected and your doctor’s samples is really small and narrowing. Access has become the primary issue particularly in this day and age. There are simply far too many women who don’t get screened and have preventable or treatable conditions that are missed as a result.
Because self-screening is more private and less invasive, it can reach people who might otherwise avoid traditional exams. Who do you see benefiting most from this model?
Dr. Andreas M. Kogelnik: Self-collect opens the door wide open for screening of women who may already have barriers to getting care — for example rural, economic, underserved, doctor-avoidant, cost, or time barriers. It’s not yet a full replacement for traditional exams, but it absolutely is a far better solution for those that otherwise wouldn’t get those exams done for any reason. These tests improve access to care and start to bring anyone with barriers to care or simple neglect of care to a simpler, more time and cost efficient way of screening. More access means better outcomes for all women.
Stepping back more broadly, what does accessible and preventative screening like HPV testing mean for how we think about health overall, beyond just cervical cancer?
Dr. Andreas M. Kogelnik: There’s a global trend towards moving more and more care out of the office and into the community. Overall that’s a good thing, but we can’t forget that these screenings do need a connection back into the health system. Hopefully “at-home” screenings like this engage people to not only think about cervical cancer but more about their health as a whole.
You’ve described decentralized and self-collected testing as a major shift. In your view, what makes this approach truly revolutionary for prevention and for the future of reproductive and sexual health?
Dr. Andreas M. Kogelnik: Self-collection is a different level of patient engagement. It brings health care directly back to the patient to think about and engage in totally new ways that many people miss out on, especially in terms of preventive care.
Finally, this initiative is also about democratizing access to care and information. What does it mean to you to bring HPV screening out of clinical settings and into community and cultural spaces like this?
Dr. Andreas M. Kogelnik: Health care should be about individual engagement but all too often it’s not. Community settings and cultural events especially like BUTTER are generally immersive engagement for all kinds of senses, thoughts, ideas and more. So putting these screenings into this setting starts a conversation, an experience, an education and an awareness about yourself and hopefully one that continues on afterwards.
Research Implications and Global Scaling Vision
This pilot intervention demonstrates how decentralized screening technologies, when combined with cultural and community-based infrastructures, can shift both access to care and the social meaning of preventative health. Designed in partnership with ProDx Health and informed by laboratory and clinical expertise, the initiative serves as a research-grounded model intended for replication and adaptation across multiple locations in the United States and internationally.
Importantly, the intervention model directly responds to documented disparities in cervical cancer outcomes, including the significantly higher incidence among Black women in the United States. By embedding screening within trusted cultural environments, the project aims to reduce structural barriers to participation in preventative care while supporting earlier detection and more equitable health outcomes.
Rather than functioning as a one-time activation, the pilot establishes a scalable framework for integrating HPV self-screening into cultural institutions, artistic venues, and community-led environments where traditional healthcare systems may not always be accessible or trusted. Dr. Kogelnik’s insights highlight that self-collected HPV testing is not only a technological advancement, but part of a broader structural shift toward more accessible, patient-engaged models of preventative care that operate both within and beyond clinical settings.
Moving forward, the partnership between Repro Uncensored, Autumn Breon’s Care Machine, and ProDx Health aims to expand this intervention model across cities and regions globally, adapting to local cultural contexts while maintaining clinical rigor. By combining laboratory expertise, community-centered design, and cultural infrastructure, the project seeks to build a scalable global ecosystem of accessible HPV screening and preventative reproductive health engagement that meets people where they are and integrates care into the fabric of everyday public life.