Academic journal article International Journal of Child and Adolescent Health

Young Men and Women's Attitudes toward HPV Vaccination for Future Sons and Daughters: Findings from the Philippines

Academic journal article International Journal of Child and Adolescent Health

Young Men and Women's Attitudes toward HPV Vaccination for Future Sons and Daughters: Findings from the Philippines

Article excerpt

Introduction

In Southeast Asia, vaccination of 70% of the preadolescent female population against HPV-16 and -18 has the potential to reduce lifetime risk of cervical cancer by up to 57% (1). Though the precise impact of male vaccination has not been as clearly elucidated, research has demonstrated that the vaccine has the potential to alleviate disease burden among young males through the prevention of external genital lesions (2-4), invasive anal cancers (5), and penile squamous cell carcinomas (6). Despite its clinical efficacy, however, the impact of male and female adolescent HPV vaccine initiatives will depend in large part on parental acceptability of the vaccine.

Few studies have assessed HPV vaccine acceptability in regions which are disproportionately affected by cervical cancer (7). Authors of numerous studies have specifically recommended more research in countries of the Asia Pacific (8-11). Of the few parental HPV vaccine acceptance studies conducted in the Asia Pacific, most have examined the attitudes of mothers (9-14), but few have also examined the attitudes of fathers (9,13,15). Moreover, existing studies have primarily focused on parental acceptance of a daughter's vaccination but, with the exception of two (10-11), have neglected to also examine attitudes toward HPV vaccination of a son. Of the two studies which have included a discussion of HPV vaccine acceptance for sons, both have focused only on the attitudes of mothers (10-11). No study from the region, to our knowledge, has simultaneously examined all four dimensions of adolescent HPV vaccine acceptance: attitudes of both men and women toward the vaccination of sons and daughters. This represents a significant gap in understanding and a potential impediment to the implementation of an adolescent HPV vaccine campaign in the region.

In 2009, two HPV vaccines, Gardasil® and Cervarix®, were licensed for use among young men and young women in the Philippines (16). Uptake of the vaccine by the current eligible generation and future generations now becomes a key issue relative to the prevention of cervical cancer in the Philippines. The age-standardized cervical cancer incidence in the Philippines is 11.7 per 100,000. An estimated 4500 new cases develop annually and over 1800 deaths from cervical cancer occur each year (17). Approximately 9.3% of Filipina women are infected with HPV, the majority of whom are infected with HPV types 16 or 18 (17). The HPV burden among Filipino men has been less thoroughly characterized; however, a case-control study conducted by Franceschi and colleagues (2002) found a prevalence of 5% among husbands of women without cervical cancer (18).

Given the difficulty of implementing organized screening programs in low-resource countries such as the Philippines (19) and given the inaccessibility of secondary prevention, a primary prevention strategy for the reduction of HPV-related disease burden is critical and necessary. Despite the potential public health impact of adolescent HPV vaccination in the Philippines, the research needed to inform the development of effective vaccination campaigns is currently lacking. The present study addresses an important gap in the literature by examining correlates of Filipino men and women's likelihood of accepting the HPV vaccine for a future son and/or daughter. The study also examines correlates of differential ratings of vaccine acceptance for sons compared to daughters.

Methods

The methods of this study have been described in detail elsewhere (20-21). Briefly, a consecutive convenience sample of females (n=435) and males (n=143) was recruited from three communities in the Philippines' Central Visayan region from June to July 2009. Local language (e.g. Cebuano) recruitment flyers distributed throughout the communities invited men and women (over the age of 18) to participate in the study and listed various pre-established times and locations (e.g. local churches or community centers) at which they could complete the questionnaire. …

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