Predictors of HPV vaccine acceptability: a theory-informed, systematic review

OBJECTIVE: To inform future human papillomavirus (HPV) vaccination programs, we systematically reviewed studies of HPV-related beliefs and HPV vaccine acceptability, organizing the findings using health behavior theory and cervical cancer risk factors. METHODS: We searched Medline, CINAHL, and PsycINFO from 1995 to January, 2007 for studies of HPV beliefs and HPV vaccine acceptability among adolescents, young adults, and parents of adolescents in the United States. RESULTS: We identified 28 studies. Most were small, cross-sectional studies of parents and adults. Most parents reacted positively to the possibility of vaccinating their daughters against HPV. Vaccination acceptability was higher when people believed the vaccine was effective, a physician would recommend it, and HPV infection was likely. Cost and, for 6% to 12% of parents, concerns that vaccination would promote adolescent sexual behavior were barriers to vaccination. African American, Hispanic, and white respondents were equally accepting of the HPV vaccine. Parents with lower levels of education reported higher vaccine acceptability. Many studies inadequately reported on other variables associated with cervical cancer mortality. CONCLUSIONS: HPV vaccine programs in the United States should emphasize high vaccine effectiveness, the high likelihood of HPV infection, and physicians' recommendations, and address barriers to vaccination.     

某市妇女子宫颈癌筛查及HPV疫苗认知调查

目的了解山西省某市城乡居民在子宫颈癌筛查以及接受人乳头瘤病毒(HPV)疫苗接种的情况。方法采用整群抽样调查方法,对某市城区和农村≥25岁女性进行子宫颈癌筛查并对HPV疫苗接受情况进行调查。结果共调查2 269名女性,其中城市居民341人,农村居民1 928人;有43.4%的城区和76.5%的农村女性知晓子宫颈癌,72.4%的城区和78.9%的农村女性了解子宫颈癌筛查的目的 ,23.8%的城市和6.1%的农村女性知晓HPV的传播途径,78.3%的城区和92.2%的农村女性愿意支付部分筛查产生的费用,且愿意支付的费用在每人100元以内;而对预防子宫颈癌的HPV疫苗,仅有50.7%城区和34.6%农村女性愿意接种,不愿意接种的主要原因是价格因素。结论降低子宫颈癌筛查和接种HPV疫苗的费用,或及早实现HPV疫苗生产的国产化以降低价格,加大人群子宫颈癌防治的宣传教育,对子宫颈癌的防治有重要意义。     

Evaluation of a <Emphasis Type="Italic">Radionovela</Emphasis> to Promote HPV Vaccine Awareness and Knowledge Among Hispanic Parents

Hispanic women have more than a 1.5-fold increased cervical cancer incidence and mortality compared to non-Hispanic white women in the United States. The Centers for Disease Control recommends the HPV vaccine for females at ages 11 and 12 years, though it is approved for females aged 9–26 to protect against the primary types of high-risk HPV (HPV-16 and HPV-18) that cause approximately 70% of cervical cancer cases. Few culturally-tailored Spanish HPV vaccine awareness programs have been developed. This study evaluates the efficacy of a Spanish radionovela as an educational tool. Rural Hispanic parents of daughters aged 9–17 (n = 88; 78 mothers and 10 fathers) were randomized to listen to the HPV vaccine radionovela or to another public service announcement. Participants completed a 30 min pretest posttest questionnaire. Parents who listened to the HPV radionovela (intervention group) scored higher on six knowledge and belief items. They were more likely to confirm that HPV is a common infection (70% vs. 48%, P = .002), to deny that women are able to detect HPV (53% vs. 31%, P = .003), to know vaccine age recommendations (87% vs. 68%, P = .003), and to confirm multiple doses (48% vs. 26%, P = .03) than control group parents. The HPV vaccine radionovela improved HPV and HPV vaccine knowledge and attitudes. Radionovela health education may be an efficacious strategy to increase HPV vaccine awareness among Hispanic parents.     

English Proficiency, Knowledge, and Receipt of HPV Vaccine in Vietnamese-American Women

Cervical cancer is one of the most important disease burdens experienced by Vietnamese-American women. Human papillomavirus (HPV) is the etiological agent in almost all cases of cervical cancer. We surveyed Vietnamese-American women to determine receipt of HPV vaccine and assessed if limited English proficiency and knowledge related to HPV vaccine were associated with HPV vaccine uptake. Of the 113 Vietnamese-American women who participated in the study, 58 % (n = 68) was born in Vietnam. The mean years of residency in the United States was 12.75 years. Only 16 (14 %) reported receiving HPV vaccine and 11 (9 %) reported receiving all three shots. Thirteen women responded that they are not at all likely to receive HPV vaccine. Of the whole sample, 47 % (n = 53) reported proficiency in spoken and written English. English proficiency was significantly associated with receipt of HPV vaccine (OR = 4.4; confidence interval (95 % CI) = 1.2; 16.50; p = 0.03). Of the knowledge items, 70 % (n = 79) responded correctly that HPV increases the risk for cervical cancer. However, as many as 60 % responded incorrectly, that HPV infection can be cured with medication. The item, “People infected with HPV can be cured with medication,” was the most important variable associated with receipt of HPV vaccine. Specifically, those with correct response were 3.8 times more likely to report receiving the HPV vaccine (OR = 3.8; 95 % CI = 1.1; 13.5; p = 0.04). Important public health needs are the development and evaluation of educational programs on HPV and cervical cancer that are designed for Vietnamese-American women.     

Clinical Trial Experience With Prophylactic Human Papillomavirus 6/11/16/18 Vaccine in Young Black Women

PurposeHuman papillomavirus (HPV) is the causative agent of cervical cancer. Black women are disproportionally diagnosed and have higher mortality from cervical cancer in the United States. Here we describe the prophylactic efficacy and safety of a quadrivalent HPV-6/11/16/18 vaccine in black women.MethodsA total of 700 black women from Latin America, Europe, and North America (aged 16–24 years) received the vaccine or placebo in one of two studies. Analyses focused on the efficacy and safety of the vaccine.ResultsBaseline rates of Chlamydia trachomatis infection and history of past pregnancy were more than twice as high in black women compared with the non-black women who were enrolled in these trials. HPV-6/11/16 or 18 DNA was detected in 18% of black women versus 14.6% in non-black women at day 1. For black women, vaccine efficacy against disease caused by HPV-6/11/16/18 was 100% for cervical intraepithelial neoplasia (0 vs. 15 cases; 95% confidence interval, 64.5%–100%) and 100% for vulvar and vaginal intraepithelial neoplasia and condylomata acuminata (0 vs. 17 cases; 95% confidence interval, 69.3%–100%). There were no serious vaccine-related adverse experiences. A similar proportion of pregnancies resulted in live births (75.8% vaccine; 72.7% placebo) and fetal loss (24.2% vaccine; 27.3% placebo).ConclusionsProphylactic quadrivalent HPV-6/11/16/18 vaccination of young black women demonstrated high efficacy, safety, and tolerability. HPV vaccination has the potential to reduce cervical cancer-related health disparities both in the United States and around the world.     

Exploring the knowledge, attitudes, beliefs, and communication preferences of the general public regarding HPV: findings from CDC focus group research and implications for practice.

Genital human papillomavirus (HPV) infection is the most common sexually transmitted virus in the United States, causing genital warts, cervical cell abnormalities, and cervical cancer in women. To inform HPV education efforts, 35 focus groups were conducted with members of the general public, stratified by gender, race/ethnicity, and urban/rural location. Focus groups explored participants' knowledge, attitudes, and beliefs about HPV and a hypothetical HPV vaccine as well as their communication preferences for HPV-related educational messages. Audience awareness and knowledge of HPV were low across all groups. This, along with an apparent STD-associated stigma, served as barriers to participants' hypothetical acceptance of a future vaccine. Although information about HPV's high prevalence and link to cervical cancer motivated participants to learn more about HPV, it also produced audience fear and anxiety. This research suggests that HPV- and HPV-vaccine-related education efforts must be approached with extreme caution. Other practical implications are discussed.     

甘肃宫颈癌高发区女性HPV及其疫苗认知状况调查

目的调查甘肃省宫颈癌高发地区陇南市武都区女性对人乳头瘤病毒（HPV）的认知及对HPV疫苗接种的态度情况。方法采用随机整群抽样的方法抽取武都区2个乡,其中符合筛选条件的30—49岁女性1681人,使用问卷调查女性对HPV认知情况和接种HPV疫苗的态度。结果接受调查女性中1585人（94．29％）没有听说过HPV,但有1584人（94．23％）愿意接受HPV疫苗接种;40岁以下人群对HPV疫苗接种的接受程度明显高于40岁以上人群（P〈0．01）;女性对HPV知晓率与所受教育程度和家庭收入呈正相关（P〈0．01）;调查女性不愿意接种HPV疫苗的原因主要是对宫颈癌的风险意识不足;调查人群中有637人愿意接受医疗机构提供的HPV疫苗,972人接受政府提供的,两项合计占总调查人数的95．71％;有74．84％的人希望国家能够负担部分接种HPV疫苗的费用;本次调查女性中有131人（7．79％）HPV检测呈阳性,HPV感染与未感染女性在HPV认知及其疫苗相关态度调查结果基本一致。结论甘肃省陇南市武都区女性缺乏对宫颈癌和HPV的认知,但是对HPV疫苗的信任和接受程度很高,因此急需通过多种方式加强对陇南地区女性宫颈癌相关科普知识的普及以及改善当地居民生活水平。     

HPV vaccine acceptability in Ghana, West Africa

Objective

Cervical cancer is a leading cause of cancer-related mortality among women in Ghana. As of this writing no data are available concerning knowledge, attitudes and acceptability of human papillomavirus (HPV) vaccination by women in Ghana.

Methods

Between November and December 2009, a self-administered survey was used to elicit information from 264 Ghanaian women, ages 18-65.

Results

Overall, 40% had heard about HPV vaccine and 94% were willing to vaccinate themselves or their daughters. Ideal age for vaccination was 12.7 years. Most women (75%) thought the vaccine should be received regardless of one's number of sex partners. The most prevalent concerns were whether the vaccine would be administered safely using clean needles (82%), and possible future side effects (77%). Concerns about cost and vaccine encouraging earlier sex were reported by nearly half. Significant barriers to vaccine acceptance were women's lack of knowledge about the gravity of cervical cancer in Ghana and utility of Pap test in detecting it, low perceived risk for cervical cancer, low social support to vaccine use, and low self-efficacy to find a doctor or clinic to get vaccinated (p < 05). About 55% of the women did not know the vaccine only works among those who are not yet infected with HPV. Schools and television were the most preferred methods of educating the public and cervical cancer prevention ranked as the ideal message (80%). Most respondents believed the decision to vaccinate their daughter should be made by both parents (34%) or in conjunction with the daughter (37%), as opposed to the government (17%).

Conclusions

Educational programs addressing specific barriers identified in the current study have the potential to significantly improve HPV vaccine uptake in Ghana.     

996名门诊部患者对HPV疫苗的认知与评价分析

目的 了解公众对HPV疫苗的认知程度和对其有效性与安全性的评价,探索影响公众对该疫苗认知和评价的因素。方法 对某门诊部的996名女性患者进行问卷调查,对调查结果进行统计分析。结果 受访者对HPV疫苗认知的平均得分为 2.25 分;不同年龄、居住地、职业、受教育程度和收入水平的受访者对HPV疫苗的认知程度不同,差异有统计学意义（P＜0.05）;在对HPV疫苗有效性的评价方面,年龄较大、城市、已就业、高学历的受访者高于年龄较小、农村、未就业、低学历的受访者（OR值与95%CI分别为:1.89（1.43～2.35）、2.21（1.78～2.64）、3.36（3.05～3.67）、3.87（3.50～4.24））,高收入的受访者低于低收入的受访者（OR值与95%CI为0.87（0.79～0.95））;在对HPV疫苗安全性的评价方面,年龄较大的受访者高于年龄较小的受访者（OR值与95%CI为:2.78（2.53～2.97））,城市、高学历的受访者低于农村、低学历的受访者（OR值与95%CI分别为:0.76（0.58～0.94）,0.68（0.50～0.86））。结论 受访者对HPV疫苗的认知程度较低,年龄、居住地、职业、学历、经济收入等是影响受访者对HPV疫苗的有效性与安全性的评价的主要因素。     

Understanding HPV Vaccine Uptake Among Cambodian American Girls

Cervical cancer incidence rates vary substantially among racial/ethnic groups in the United States (US) with women of Southeast Asian descent having the highest rates. Up to 70 % of cervical cancers could be prevented by widespread use of the human papillomavirus (HPV) vaccine. However, there is a lack of information about HPV vaccine uptake among Southeast Asian girls in the US. We conducted a telephone survey of Cambodian women with daughters who were age-eligible for HPV vaccination. Survey items addressed HPV vaccination barriers, facilitators and uptake. Our study group included 86 Cambodian mothers who lived in the Seattle metropolitan area. The proportions of survey participants who reported their daughter had initiated and completed the HPV vaccine series were only 29 and 14 %, respectively. Higher levels of vaccine uptake were significantly associated with mothers having heard about the HPV vaccine from a health professional and having received a recent Pap test. Commonly cited barriers to HPV vaccination included lack of knowledge about the HPV vaccine, not having received a physician recommendation for HPV vaccination and thinking the HPV vaccine is unnecessary in the absence of health problems. Linguistically and culturally appropriate HPV educational programs should be developed and implemented in Cambodian American communities. These programs should aim to enhance understanding of disease prevention measures, increase knowledge about the HPV vaccine and empower women to ask their daughter’s doctors for HPV vaccination.     

HPV and cervical cancer testing and prevention: knowledge, beliefs, and attitudes among Hispanic women

Cervical cancer is a preventable disease resulting from infection with high-risk types of sexually transmitted human papillomaviruses (HPVs). Public knowledge of HPVs and their link to cervical cancer is limited. Participation in cervical cancer prevention programs, including Pap and HPV screening and HPV vaccine acceptance, is crucial for limiting the incidence of cervical cancer. Hispanic women suffer the highest cervical cancer incidence rates in the United States. In this study, we conducted community-based focus groups with Hispanic women to explore knowledge and attitudes relating to cervical cancer, HPV, HPV testing, and HPV vaccination. Study findings suggest a need to increase public health literacy in relation to HPV, the link between HPV and cervical cancer, and HPV primary and secondary prevention options. Health care providers should be prepared to share information with patients that supports and promotes informed decision making about HPV testing and vaccines and their complementary roles in cervical cancer screening and prevention.     

Knowledge of HPV among United States Hispanic women: opportunities and challenges for cancer prevention

In the United States, Hispanic women contribute disproportionately to cervical cancer incidence and mortality. This disparity, which primarily reflects lack of access to, and underutilization of, routine Pap smear screening may improve with increased availability of vaccines to prevent Human Papillomavirus (HPV) infection, the principal cause of cervical cancer. However, limited research has explored known determinants of HPV vaccine acceptability among Hispanic women. The current study examines two such determinants, HPV awareness and knowledge, using data from the 2007 Health Interview National Trends Survey (HINTS) and a cross-section of callers to the National Cancer Institute's (NCI) Cancer Information Service (CIS). Study data indicate that HPV awareness was high in both samples (69.5% and 63.8% had heard of the virus) but that knowledge of the virus and its association with cervical cancer varied between the two groups of women. The CIS sample, which was more impoverished and less acculturated than their HINTS counterparts, were less able to correctly identify that HPV causes cervical cancer (67.1% vs. 78.7%) and that it is a prevalent sexually transmitted infection (STI; 66.8% vs. 70.4%). Such findings imply that future research may benefit from disaggregating data collected with Hispanics to reflect important heterogeneity in this population subgroup's ancestries, levels of income, educational attainment, and acculturation. Failing to do so may preclude opportunity to understand, as well as to attenuate, cancer disparity.     

Hypercholesterolemia prevalence, awareness, and treatment in blacks and whites: the Minnesota Heart Survey

Two cross-sectional population-based surveys were conducted in 1985 and 1986 to describe cardiovascular risk factors in blacks and whites in the Twin Cities. A total of 1,254 blacks and 2,934 whites ages 35-74 years participated. The surveys consisted of a home interview followed by survey center visit during which nonfasting serum total cholesterol level was measured and medication use during the past year was reviewed. Age-adjusted mean values for serum total cholesterol were significantly higher among white than black participants for both men (207 vs 193 mg/dl, P less than 0.001) and women (206 vs 202 mg/dl, P less than 0.05). Blacks had significantly higher serum HDL cholesterol levels than whites (men, 49 vs 41 mg/dl, P less than 0.001; women, 56 vs 54 mg/dl, P less than 0.01). The age-adjusted prevalence of hypercholesterolemia (serum total cholesterol greater than or equal to 240 mg/dl on the day of survey and/or current use of cholesterol lowering medication) was significantly higher among white than black men (18.3% vs 12.2%, P less than 0.01). No significant race differences were noted for women (whites, 19.7% vs blacks, 16.6%). Among hypercholesterolemic men, 66% of whites current use of cholesterol lowering medication) was significantly higher among white than black men (18.3% vs 12.2%, P less than 0.01). No significant race differences were noted for women (whites, 19.7% vs blacks, 16.6%). Among hypercholesterolemic men, 66% of whites current use of cholesterol lowering medication) was significantly higher among white than black men (18.3% vs 12.2%, P less than 0.01). No significant race differences were noted for women (whites, 19.7% vs blacks, 16.6%). Among hypercholesterolemic men, 66% of whites and 80% of blacks were unaware of their condition; among women, 72% of whites and 79% of blacks were unaware. Among individuals told by a physician they had "high blood fats," 2.9% of whites and no blacks were using medication for elevated blood cholesterol levels, while 70% of whites and 63% of blacks reported being advised to follow a low-fat-low-cholesterol diet. These data emphasize the need for education programs for physicians and patients regarding detection and control of hypercholesterolemia.     

Prevalence of human papillomavirus (HPV)-vaccine types by race/ethnicity and sociodemographic factors in women with high-grade cervical intraepithelial neoplasia (CIN2/3/AIS), Alameda County,California, United States

We evaluated racial/ethnic differences in prevalence of oncogenic HPV types targeted by the quadrivalent HPV vaccine (16/18) and nonavalent HPV vaccine (31/33/45/52/58) in women diagnosed with CIN2/3/AIS after quadrivalent HPV vaccine introduction (2008–2015). Typing data from 1810 cervical tissue specimen from HPV-IMPACT (Alameda County, California, US), a population-based CIN2/3/AIS surveillance effort, were analyzed. Using log-binomial regression, we calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) comparing type prevalence by race/ethnicity, adjusted for health insurance, age, CIN2/3/AIS grade, and time period, overall and in the “early vaccine era” (2008–2011) and “later vaccine era” (2012–2015). Overall, oncogenic HPV16/18 prevalence was significantly lower among black (43%) and Hispanic (43%) women compared with white (52%) women (aPR (95% CI): 0.80 (0.70, 0.93) and 0.80 (0.70, 0.91), respectively). In 2008-2011, proportion of HPV16/18 detected was significantly lower in black (47%), Hispanic (46%), and Asian (42%) women compared to white (58%) women (aPR (95% CI): 0.80 (0.67, 0.96), 0.75 (0.63, 0.90), and 0.73 (0.58, 0.90), respectively). There were no significant differences in 2012-2015. Between the two eras, HPV16/18 prevalence declined in white (−11%), black (−9%), and Hispanic (−6%) women, and increased in Asian women (12%). Decreasing HPV 16/18 prevalence in CIN2/3/AIS lesions in white, black, and Hispanic women may suggest benefit from quadrivalent vaccination. In our unadjusted analysis of HPV31/33/45/52/58, prevalence did not differ significantly by race/ethnicity, but was significantly higher among Hispanic women (32%) compared to white women (27%) after adjustment (aPR (95%CI): 1.22 (1.02, 1.47). Prevalence was also non-significantly higher among black (32%) and Asian (33%) women. This analysis suggests that the nonavalent vaccine’s potential for impact against cervical precancers will not be lower in women of color compared to white women. These data underscore the importance of equitable vaccination in facilitating continued declines of vaccine-preventable HPV types among all women.     

The HPV Vaccine: A Comparison of Focus Groups Conducted in South Africa and Ohio Appalachia

Worldwide, cervical cancer is one of the leading causes of morbidity and mortality among women. Even though women in developing countries account for approximately 85 % of the cervical cancer cases and deaths, disparities in cervical cancer rates are also documented in developed countries like the United States (U.S.). Recently, formative research conducted in the U.S. and developing countries like South Africa have sought to gain a better understanding of the knowledge, beliefs, and attitudes about cervical cancer prevention, HPV, and the acceptance of the HPV vaccine. This study compares findings from two independent focus group studies. One study was conducted in a segregated township in Johannesburg, South Africa (n = 24) and the other study was conducted in Ohio Appalachia (n = 19). The following seven themes emerged during the discussions from both studies: HPV and cervical cancer; health decision making; parent–child communication; healthy children; HPV vaccine costs; sexual abuse; and HPV vaccine education. Findings from both studies indicate the importance of the role of mothers and grandmothers in the health care decision-making process for children and a lack of awareness of HPV and its association with cervical cancer. While there was interest in the HPV vaccine, participants voiced concern about the vaccine’s cost and side effects. Some participants expressed concern that receipt of the HPV vaccine may initiate adolescent sexual behavior. However, other participants suggested that the HPV vaccine may protect young women who may experience sexual abuse. The importance of developing culturally appropriate educational materials and programs about cervical cancer prevention and the HPV vaccine were expressed by participants in both countries.     

Women's knowledge of human papillomavirus (HPV) and their attitudes toward HPV vaccine: preparing for HPV vaccination in China

To explore women's knowledge of human papillomavirus (HPV) and attitudes toward the HPV vaccine in Zhejiang, China, women attending the checkup clinics were invited to participate. A questionnaire-guided interview was conducted with a representative sample of 1490 women, and 1432 effective questionnaires were obtained. The authors found 39.1% of women in urban areas and 27.1 % in rural areas had heard of HPV, whereas 23.7% and 15.1%, respectively, had heard of the HPV vaccine. The mean score of HPV knowledge was 3.75 in urban areas and 3.18 in rural areas, with a significant difference (P = .016). Of the sample who had heard of the HPV vaccine, the supportive mean score was 2.59 and 2.11, with a significant difference (P = .003). Women with more HPV knowledge were more likely to support the HPV vaccination (r = 0.50 and r = 0.61). The authors conclude that inadequate knowledge and misconceptions about HPV are common. Attitudes toward HPV vaccine are unsatisfactory. Education campaigns targeting different populations are needed prior to the introduction of an HPV vaccine.     

Knowledge and attitudes about human papillomavirus (HPV) and HPV vaccines among women living in metropolitan and rural regions of China

Infection with the human papillomavirus (HPV) is one of the most common sexually transmitted infections and causes virtually all cervical cancer globally. The recent development of two safe and clinically effective vaccines against HPV is a promising step towards lowering cervical cancer rates in the future. What Chinese women think about HPV and the vaccines remains unknown. We undertook a population-based survey, which was embedded in a cervical cancer screening project and was designed to assess women's knowledge about HPV and their acceptability to the vaccines. We found that only 15.0% of women in our study reported to have ever heard of HPV, and this knowledge differs by rural (9.3%) and metropolitan areas (21.6%) and also by education. Most (84.6%) participants were willing to be vaccinated if HPV vaccine became available to them. The present study documents ways in which women learn about HPV and indicates the potential barriers and success of introducing HPV vaccine to China.     

Knowledge,Attitudes, and Beliefs Regarding HPV Vaccination: Ethnic and Cultural Differences Between African-American and Haitian Immigrant Women

BackgroundBlack women have higher rates of cervical cancer and lower rates of HPV vaccination than White women in the United States, and Haitians may be an especially vulnerable subgroup of Black women. To reduce these disparities, understanding differences among subgroups of Black women is crucial.MethodsThe objective of our study was to assess similarities and differences in the knowledge, attitudes, beliefs, and practices toward HPV vaccination and actual vaccination rates among African-American and Haitian immigrant women and their daughters. We used validated surveys of HPV knowledge, trust in physicians, acculturation, and constructs of the health belief model: Perceived susceptibility, severity, and barriers. We probed women's thought processes about vaccination using open-ended questions. We then reviewed medical records to determine vaccination rates.ResultsNineteen African Americans and 51 Haitians participated. Although 75% of Haitians and 63% of African Americans intended to vaccinate their daughters, only 47% of African-American and 31% of Haitian daughters were vaccinated. African Americans were more knowledgeable than Haitians and had more prior experience with HPV disease. Most African Americans felt that vaccination fell within the parental role, whereas many Haitians felt uncomfortable vaccinating against sexually transmitted infections because they felt children should not be having sex. Both ethnic groups wanted more information about HPV vaccines.ConclusionCultural differences between African-American and Haitian immigrant mothers revealed distinct barriers for vaccine acceptance. Improving HPV vaccine rates in Black women may require culturally competent and sensitive approaches that address ethnic-specific barriers.     

Practical implementation of HPV vaccines in clinical practice

Human papillomavirus (HPV) currently infects approximately 20 million people in the United States. An effective new vaccine has been approved for girls and young women aged 9 to 26 years that can decrease the spread of infection due to HPV and the future incidence of cervical cancer and genital warts. Family physicians should be aware of parental or patient attitudes and knowledge about HPV and concerns about HPV vaccination if they are to successfully implement HPV vaccination in their practices.     

Knowledge,attitudes, and practices among Saudi women regarding cervical cancer,human papillomavirus (HPV) and corresponding vaccine

AimTo our knowledge there are no studies exploring Saudi women’s understanding of the importance of the human papillomavirus (HPV) vaccine. In the present study, we examined the awareness of HPV and women’s attitudes toward the HPV vaccine.MethodNine focus groups were formed in Riyadh City, Saudi Arabia, including 77 women between the ages of 18 and 45 years old. Face-to-face interviews were conducted in 58 female healthcare providers to examine women’s awareness of cervical cancer, HPV, barriers, acceptance, beliefs, and attitudes towards the HPV vaccine.ResultsFocus group discussions revealed a lack of knowledge and awareness of cervical cancer, HPV, and the HPV vaccine. Cultural concerns regarding screening and vaccinating for a conventionally known sexually transmitted infection were an emerging theme in addition to not perceiving cervical cancer screening as necessary because women with no signs and symptoms considered themselves not at risk for developing cervical cancer. Approximately 30% of healthcare providers other than physicians were unaware of prevention methods, and 63.3% did not practice any screening methods for cervical cancer and attributed the lack of screening to “no specific reasons at all”.ConclusionBecause of the unfavorable knowledge and attitude of HPV infection and the associated vaccine from the women in the present study, emphasis should be directed to educate and promote awareness of women to the risk factors of cervical cancer and to the need for screening programs and the administration of the vaccine.