JMIR Publications

ABSTRACT

Background:

HPV self-collection is a newly approved, evidence-based strategy to increase cervical cancer screening participation, particularly among under-screened populations, but public understanding of and attitudes toward this option may be shaped substantially by social media platforms such as TikTok. It remains unclear whether commonly used keyword-based search strategies reliably identify self-collection-related content, and whether the content that reaches the widest audiences aligns with public health priorities.

Objective:

This study aimed to characterize the content, framing, and engagement patterns of TikTok videos related to HPV testing, cervical cancer screening, and HPV self-collection, and to identify factors associated with high engagement.

Methods:

We conducted a cross-sectional, retrospective content analysis of TikTok videos retrieved using a structured keyword-based search strategy (eg, "HPV," "HPV test," "Pap smear," "self," "at home," "self test"). Videos were coded for content type, tone, creator type (healthcare professional versus non–healthcare professional), and health messaging domains adapted from prior social media content analyses. Engagement was assessed as a composite of likes, shares, comments, and saves, analyzed both as a continuous measure and as a binary high-engagement indicator (top quartile). Associations between content characteristics and engagement were evaluated using multivariable logistic regression and negative binomial regression.

Results:

Videos meeting inclusion criteria were predominantly educational (86.8%) and positive in tone (73.7%), and nearly half were created by healthcare professionals (48.7%). Screening benefits (73.7%) and explicit medical education (71.1%) were the most frequently referenced themes; mentions of racism or racial discrimination as a barrier were rare (6.6%). Total engagement was highly right-skewed (median 188 interactions, IQR 104–2526). In adjusted analysis, videos created by healthcare professionals were significantly less likely to achieve high engagement (OR 0.14, 95% CI 0.03–0.57; P=.006) and had significantly lower total engagement in negative binomial regression (IRR 0.17, 95% CI 0.04–0.74; P=.02). Anecdotal or experiential content was also associated with lower total engagement after adjustment (IRR 0.15, 95% CI 0.04–0.51; P=.002).

Conclusions:

TikTok content related to HPV self-collection is predominantly educational and positively framed, but the videos that achieve the greatest reach are not those created by healthcare professionals. This gap between clinical authority and platform engagement raises concerns about the consistency and completeness of self-collection messaging reaching the widest audiences and suggests that public health efforts to promote HPV self-collection may benefit from collaboration between clinicians and creators skilled in platform-specific communication. Clinical Trial: Not applicable.