Attitudes towards human papillomavirus vaccination among African parents in a city in the north of England: a qualitative study.

Edith T Mupandawana,Ruth Cross

doi:10.1186/s12978-016-0209-x

Abstract

BackgroundHuman papillomavirus (HPV) is sexually transmitted and has been conclusively linked to cervical cancer and genital warts. Cervical cancer is attributed to approximately 1100 deaths annually in UK, and is the second most common female cancer globally. It has been suggested that black African women are more predisposed to HPV infection and cervical cancer. A vaccine has been developed to reduce HPV infection, and in the UK, has been offered to 12–13 year old adolescent girls through schools as part of their childhood immunization programme since 2008. Upon programme initiation, it was noted that vaccine uptake was lower in schools where girls from ethnic minority groups were proportionately higher.The study’s objectives were to explore factors influencing UK based African parents’ acceptance or decline of the HPV vaccine, whether fathers and mothers share similar views pertaining to vaccination and any interfamily tensions resulting from differing views.MethodsA qualitative study was conducted with five African couples residing in north England. Face to face semi-structured interviews were carried out. Participants were parents to at least one daughter aged between 8 and 14 years. Recruitment was done through purposive sampling using snowballing.ResultsHPV and cervical cancer awareness was generally low, with awareness lower in fathers. HPV vaccination was generally unacceptable among the participants, with fear of promiscuity, infertility and concerns that it’s still a new vaccine with yet unknown side effects cited as reasons for vaccine decline. There was HPV risk denial as religion and good cultural upbringing seemed to result in low risk perceptions, with HPV and cervical cancer generally perceived as a white person’s disease. Religious values and cultural norms influenced vaccine decision-making, with fathers acting as the ultimate decision makers. Current information about why the vaccine is necessary was generally misunderstood.ConclusionTailored information addressing religious and cultural concerns may improve vaccine acceptability in African parents.

Highlights

Human papillomavirus (HPV) is sexually transmitted and has been conclusively linked to cervical cancer and genital warts
The final theme relates to perceptions of risk and includes the subthemes risk neutralisation; culture as cervical cancer risk and culture as protection against HPV infection
Whereas the western population is reported as willing to discuss HPV vaccination with their daughters and make a joint decision [33], the present study found that neither of the parents would discuss the vaccine with their daughters, and decisions would be made on their behalf, with the children doing as they are told

Summary

Introduction

Human papillomavirus (HPV) is sexually transmitted and has been conclusively linked to cervical cancer and genital warts. Cervical cancer is attributed to approximately 1100 deaths annually in UK, and is the second most common female cancer globally. It has been suggested that black African women are more predisposed to HPV infection and cervical cancer. A vaccine has been developed to reduce HPV infection, and in the UK, has been offered to 12–13 year old adolescent girls through schools as part of their childhood immunization programme since 2008. The humanpapilloma virus (HPV) is sexually transmitted and has been conclusively linked to cervical cancer (CC) and genital warts [1, 2]. HPV infection is so common that it’s suggested that 20 % of sexually active adolescent girls will be infected by the age of 18 [4]. CC ranks second in the most common female cancers globally [7], and is the main cause of female cancer mortality worldwide [8], especially in Sub-Saharan Africa [9]

Methods

Results

Conclusion