Abstract
Globally, over 300,000 women die of cervical cancer annually. Given that human papillomavirus vaccines are highly effective in the primary prevention of cervical cancer, it is important to explore the barriers and facilitators to vaccination uptake in areas where the burden of disease remains high. This study, informed by the socio-ecological model, aimed to qualitatively explore vaccination uptake via in-depth interviews with eleven nurses and ten teachers involved in vaccine delivery in Iquitos, Peru. The results highlighted that vaccine uptake was influenced by multiple factors including individuals’ knowledge and attitudes, community beliefs, geography, and policy level variables. Findings suggested that professionals were informed and supportive of the HPV vaccination program but perceived that parents were uninformed about the vaccine. There is a need for community education programs, for a revision of the process of obtaining parental consent, for improved communication between professionals and for involvement of grassroots staff in policy making.
Highlights
Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide [1]
This study provides important insight into nurses’ and teachers’ perspectives on the barriers and facilitators to successful implementation of the HPV vaccination program in Iquitos
A recently published Japanese paper found that delivering a lecture to teachers increased their intention to recommend the HPV vaccine [42]
Summary
Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide [1]. Over 100 genotypes of HPV have been identified, thirteen of which are classed as high-risk [2] Persistent infection with these types of HPV can cause cervical cancer as well as other anogenital and oropharyngeal neoplasms [2]. The disease is not just more common in LMICs (18.8 cases per 100,000 versus 11.3 cases in high income countries) but mortality is higher, with LMICs suffering 90% of the total number of cervical cancer-related deaths [3]. It is the leading cause of death due to malignancy
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