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<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<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.