Research

Human papillomavirus and cervical cancer risk perception and vaccine acceptability among adolescent girls and young women in Durban, South Africa

V L Russell, G Ogilvie, M Beksinska, M Nyrenda, S Mitchell-Foster, J Lavoie, H Harder, B Wood, P Smith, J J Dietrich, J Smit, M A Brockman, G Gray, A Kaida; on behalf of the AYAZAZI Research Team

Abstract


Background. The relationship between HIV and cervical cancer is well established. Interventions that focus on creating human papillomavirus (HPV) vaccine and cervical cancer prevention messaging for adolescents, caregivers and educators will increase uptake of HPV vaccinations, HPV testing and cervical cancer screening for high-risk adolescent girls and young women (AGYW). In order to effectively develop appropriate interventions, it is important to examine AGYW’s perceptions regarding their personal risk of acquiring HPV, as well as vaccine acceptability.

Objectives. To measure the level of perceived personal risk of acquiring HPV and developing cervical cancer; examine the sociodemographic and behavioural factors associated with perceived risk; and assess HPV vaccine acceptability.

Methods. AGYW aged 16 - 24 years participating in the AYAZAZI study in Durban, South Africa (SA), were invited to participate in the AYA-HPV Prevention Project (AHPP), and were administered a questionnaire that assessed HPV, cervical cancer and vaccine awareness and knowledge, self-perceived HPV and cervical cancer risk, HPV vaccine uptake and acceptability, and participation in cervical cancer screening. The questionnaire measured self-perceived risk of acquiring HPV and developing cervical cancer for the respondent and other young women, as well as vaccine acceptability. Data from the main AYAZAZI study (12-month) visit were linked to AHPP substudy data. Descriptive statistics were used to analyse sociodemographic variables at the 12-month time point. Self-perceived HIV, HPV and cervical cancer risk was measured using an ordinal scale. Chi-square analyses were used to examine differences in sociodemographic and behavioural factors according to self-perceived risk of HPV and cervical cancer.

Results. Only a small portion of participants (14.3%) had heard of HPV. Overall, 43.0% (n=49) perceived themselves as at low HPV risk. There were significant differences in self-perceived risk of cervical cancer by age group, income and pregnancy status. The highest proportion of AGYW who perceived themselves as at high risk of cervical cancer reported being sexually active (p=0.002). Although many participants reported not knowing about HPV prior to the study, after learning about it during the study, most said that they would be willing to receive the vaccine (97.5%).

Conclusions. Most young women in SA do not have access to the national HPV vaccine programme, as only girls in grade 4 in some public schools qualify. Almost all participants indicated that if the vaccine was free and recommended by a healthcare professional, they would accept it. Availability of the HPV vaccine and timely treatment of HPV infections are key issues to address in efforts to decrease cervical cancer worldwide.


Authors' affiliations

V L Russell, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada

G Ogilvie, School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada; British Columbia Centre for Disease Control, Vancouver, Canada

M Beksinska, MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa

M Nyrenda, Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

S Mitchell-Foster, Faculty of Medicine, University of British Columbia, Vancouver, Canada

J Lavoie, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Ongomiizwin – Indigenous Institute of Health and Healing, University of Manitoba, Winnipeg, Canada

H Harder, Faculty of Health Sciences, University of Northern British Columbia, Prince George, Canada

B Wood, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Canada

P Smith, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada

J J Dietrich, Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa

J Smit, MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa

M A Brockman, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada

G Gray, Office of the President, South African Medical Research Council, Cape Town, South Africa

A Kaida; on behalf of the AYAZAZI Research Team, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada

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Keywords

Sexually transmitted infections; Human papillomavirus; HPV; Self-risk perceptions; HPV vaccine; Self-testing; Adolescents, girls and young women; South Africa

Cite this article

South African Medical Journal 2020;110(9):887-893. DOI:10.7196/SAMJ.2020.v110i9.14367

Article History

Date submitted: 2020-08-31
Date published: 2020-08-31

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