Parents’ views on human papillomavirus vaccination for sexually transmissible infection prevention: a qualitative study
Linda M. Niccolai A B C F , Caitlin E. Hansen D , Marisol Credle A B , Sheryl A. Ryan D and Eugene D. Shapiro A D E
+ Author Affiliations
- Author Affiliations
A Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT 06520, USA.
B Yale Center for Interdisciplinary Research on AIDS, New Haven, CT06520, USA.
C Yale Cancer Center, New Haven, CT06520, USA.
D Yale School of Medicine, Department of Pediatrics, New Haven, CT06520, USA.
E Yale Graduate School of Arts and Sciences, Department of Investigative Medicine, New Haven, CT06520, USA.
F Corresponding author. Email: linda.niccolai@yale.edu
Sexual Health 11(3) 274-279 https://doi.org/10.1071/SH14047
Submitted: 11 March 2014 Accepted: 6 May 2014 Published: 3 July 2014
Abstract
Background: Human papillomavirus (HPV) is the most common sexually transmissible infection (STI) in the United States (US) and an important cause of several cancers. Vaccines that prevent HPV infections are now recommended for routine use in adolescents but coverage remains suboptimal in the US. Because they are often promoted as cancer prevention vaccines, little is known about parents’ views on vaccination for prevention of an STI. Methods: In this qualitative study, parents and caregivers of children ages 10–18 years completed an in-depth interview. Participants (n = 38) were recruited from an urban hospital-based primary care centre serving a low-income population in the north-eastern US during May 2013–February 2014. Interviews were transcribed and coded using a thematic content approach. Results: Five major themes emerged with relevance to the topic of HPV vaccination for STI prevention: (1) low awareness of HPV as an STI; (2) favourable opinions about STI prevention messages for vaccination, including at young ages; (3) salience of sexual mode of transmission, given the unpredictability of adolescent sexual behaviour and high rates of other STIs and teen pregnancy; (4) recognition that sexual health is a topic of conversation between adolescents and health care providers; and(5) relevance of personal experience. Conclusions: Discussing STI prevention in the context of HPV vaccination appears to be well accepted by urban, low-income minority families. In addition to providing information on cancer prevention, these messages may help to raise awareness, acceptability and uptake of HPV vaccines.
Additional keywords: adolescents, attitudes, cancer prevention, low-income households, United States.
References
[1] Satterwhite CL, Torrone E, Meites E, Dunn EF, Mahajan R, Banes Ocfemia MC, et al Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis 2013; 40 187–93.| Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008.Crossref | GoogleScholarGoogle Scholar | 23403598PubMed |
[2] Muñoz N, Bosch FX, de Sanjosé W, Herrero R, Castellsague X, Shah KV, et al Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003; 348 518–27.
| Epidemiologic classification of human papillomavirus types associated with cervical cancer.Crossref | GoogleScholarGoogle Scholar | 12571259PubMed |
[3] Forman D, de Martel C, Lacey CJ, Soerjomataram I, Lortet-Tieulent J, Bruni L, et al Global burden of human papillomavirus and related diseases. Vaccine 2012; 30 F12–23.
| Global burden of human papillomavirus and related diseases.Crossref | GoogleScholarGoogle Scholar | 23199955PubMed |
[4] Bosch FX, Tsu V, Vorsters A, Van Damme P, Kane MA. Reframing cervical cancer prevention: expanding the field towards prevention of human papillomavirus infections and related diseases. Vaccine 2012; 30S F1–11.
| Reframing cervical cancer prevention: expanding the field towards prevention of human papillomavirus infections and related diseases.Crossref | GoogleScholarGoogle Scholar |
[5] Centers for Disease Control and Prevention FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Moral Wkly Rep 2010; 59 626–30.
[6] Centers for Disease Control and Prevention Recommendations on the use of quadrivalent human papillomavirus vaccine in males – Advisory Committee Immunization Practices (ACIP), 2011. MMWR Morb Moral Wkly Rep 2011; 60 1705–9.
[7] Schiller JT, Castellsague X, Garland SM. A review of clinical trials of human papillomavirus prophylactic vaccines. Vaccine 2012; 30 F123–38.
| A review of clinical trials of human papillomavirus prophylactic vaccines.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xhsl2ju73L&md5=20e9f3541ab0497fffd9316bc484a129CAS | 23199956PubMed |
[8] Centers for Disease Control and Prevention Human papillomavirus vaccination coverage among adolescent girls, 2007–2012, and postlicensure vaccine safety monitoring, 2006–2013 – United States. MMWR Morb Moral Wkly Rep 2013; 62 591–5.
[9] Centers for Disease Control and Prevention National and state vaccination coverage among adolescents aged 13–17 years, United States, 2012. MMWR Morb Moral Wkly Rep 2013; 62 686–93.
[10] Marlow LAV, Zimet GD, McCaffery KJ, Ostini R, Waller J. Knowledge of human papillomavirus (HPV) and HPV vaccination: an international comparison. Vaccine 2013; 31 763–9.
| Knowledge of human papillomavirus (HPV) and HPV vaccination: an international comparison.Crossref | GoogleScholarGoogle Scholar |
[11] Gertig DM, Brotheron JM, Saville AM. Measuring human papillomavirus (HPV) vaccination coverage and the role of the National HPV Vaccine Program Register, Australia. Sex Health 2011; 8 171–8.
| Measuring human papillomavirus (HPV) vaccination coverage and the role of the National HPV Vaccine Program Register, Australia.Crossref | GoogleScholarGoogle Scholar | 21592430PubMed |
[12] Baandrup L, Blomberg M, Dehlendorff C, Sand C, Andersen KK, Kjaer SK. Significant decrease in the incidence of genital warts in young Danish women after implementation of a national human papillomavirus vaccination program. Sex Transm Dis 2013; 40 130–5.
| 23324976PubMed |
[13] Public Health England (PHE). Annual HPV vaccine coverage in England: 2012–13. London: PHE; 2013. Available online at: www.gov.uk/government/uploads/system/uploads/attachment_data/file/266207/HPV_AnnualDataTable2012_13_AT_acc5.pdf [verified May 2014].
[14] Katz IT, Ware NC, Gray G, Haberer JE, Mellins CA, Bangsberg DR. Scaling up human papillomavirus vaccination: a conceptual framework of vaccine adherence. Sex Health 2010; 7 279–86.
| Scaling up human papillomavirus vaccination: a conceptual framework of vaccine adherence.Crossref | GoogleScholarGoogle Scholar | 20719215PubMed |
[15] Eng TR, Butler WT. The hidden epidemic: confronting sexually transmitted diseases. Wahington DC: Institute of Medicine National Academies Press; 1997.
[16] Medical News Today. Merck launches national advertising campaign for GARDASIL®, Merck’s new cervical cancer vaccine. Bexhill-on-Sea: MediLexicon International Ltd; 2006. Available online at: http://www.medicalnewstoday.com/releases/57419.php [verified May 2014].
[17] Cooper Robbins S, Bernard D, McCaffery K, Brotherton J, Garland S, Skiiner S. ‘Is cancer contagious?’ Australian adolescent girls and their parents: making the most of limited information about HPV and HPV vaccination. Vaccine 2010; 28 3398–408.
| ‘Is cancer contagious?’ Australian adolescent girls and their parents: making the most of limited information about HPV and HPV vaccination.Crossref | GoogleScholarGoogle Scholar | 20199758PubMed |
[18] Leader AE, Weiner JL, Kelly BJ, Hornik RC, Cappella JN. Effect of information framing on human papillomavirus vaccination. J Womens Health 2009; 18 225–33.
| Effect of information framing on human papillomavirus vaccination.Crossref | GoogleScholarGoogle Scholar |
[19] Juraskova I, Bari RA, O’Brien MT, McCaffery KJ. HPV vaccination promotion: does referring to both cervical cancer and genital warts affect intended and actual vaccination behavior? Womens Health Issues 2011; 21 71–9.
| HPV vaccination promotion: does referring to both cervical cancer and genital warts affect intended and actual vaccination behavior?Crossref | GoogleScholarGoogle Scholar | 21185992PubMed |
[20] Sperber NR, Brewer NT, Smith JS. Influence of parent characteristics and disease outcome framing on HPV vaccine acceptability among rural, Southern women. Cancer Causes Control 2008; 19 115–8.
| Influence of parent characteristics and disease outcome framing on HPV vaccine acceptability among rural, Southern women.Crossref | GoogleScholarGoogle Scholar | 17952620PubMed |
[21] Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook, 2nd edn. Thousand Oaks, CA: Sage Publications; 1994.
[22] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2011. Atlanta: US Department of Health and Human Services; 2012.
[23] Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2011. National vital statistics reports. Atlanta: Centers for Disease Control and Prevention; 2012. Available online at: http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_05.pdf [verified May 2014].
[24] Centers for Disease Control and Prevention (CDC). HPV vaccine: questions & answers. Atlanta: CDC; 2012. Available online at: http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm [verified 22 May 2014].
[25] Bynum SA, Staras SA, Malo TL, Giuliano AR, Shenkman E, Vadaparampil ST. Factors associated with Medicaid providers’ recommmendation of the HPV vaccine to low-income adolescents girls. J Adolesc Health 2013; 54 190–6.
| Factors associated with Medicaid providers’ recommmendation of the HPV vaccine to low-income adolescents girls.Crossref | GoogleScholarGoogle Scholar | 24064282PubMed |
[26] Daley MF, Crane LA, Markowitz LE, Black SR, Beaty BL, Barrow J, et al Human papillomavirus vaccination practices: survey of US physicians 18 months after licensure. Pediatrics 2010; 126 425–33.
| Human papillomavirus vaccination practices: survey of US physicians 18 months after licensure.Crossref | GoogleScholarGoogle Scholar | 20679306PubMed |
[27] Liddon N, Michael SL, Dittus P, Markowitz LE. Maternal underestimation of child’s sexual experience: suggested implications for HPV vaccine uptake at recommended ages. J Adolesc Health 2013; 53 674–6.
| Maternal underestimation of child’s sexual experience: suggested implications for HPV vaccine uptake at recommended ages.Crossref | GoogleScholarGoogle Scholar | 24035133PubMed |
[28] Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S. Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature. J Am Med Assoc Pediatrics 2013;
| Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature.Crossref | GoogleScholarGoogle Scholar |
[29] Rambout L, Tashkandi M, Hopkins L, Tricco AC. Self-reported barriers and facilitators to preventive human papillomavirus vaccination among adolescent girls and young women: a systematic review. Prev Med 2014; 58 22–32.
| Self-reported barriers and facilitators to preventive human papillomavirus vaccination among adolescent girls and young women: a systematic review.Crossref | GoogleScholarGoogle Scholar | 24176938PubMed |
[30] Kessels SJM, Marshall HS, Watson M, Braunack-Mayer AJ, Reuzel R, Tooher RL. Factors associated with HPV vaccine uptake in teenage girls: a systematic review. Vaccine 2012; 30 3546–56.
| Factors associated with HPV vaccine uptake in teenage girls: a systematic review.Crossref | GoogleScholarGoogle Scholar |
