A qualitative analysis of factors influencing HPV vaccine uptake in Soweto, South Africa among adolescents and their caregivers.
A qualitative analysis of factors influencing HPV vaccine uptake in Soweto, South Africa among adolescents and their caregivers.
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DOI：
10.1371/journal.pone.0072094
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Gray GE
中科院分区：
文献类型：
--
作者：
Katz IT;Nkala B;Dietrich J;Wallace M;Bekker LG;Pollenz K;Bogart LM;Wright AA;Tsai AC;Bangsberg DR;Gray GE
在南非，致癌性人乳头瘤病毒（HPV）的流行率可能高达64%，宫颈癌是女性癌症相关死亡的主要原因。有效预防性疫苗的开发为初级预防提供了机会。鉴于心理社会力量在疫苗接种中的重要性，我们试图阐明影响低收入南非青少年在索韦托首次接种HPV疫苗的因素。HPV疫苗被介绍给南非低收入乡镇的青少年，作为全国性试验的一部分，以了解青少年参与未来针对人类免疫缺陷病毒（HIV）的疫苗研究。我们对有目的抽样的青少年及其护理人员进行了深入的半结构化访谈，以了解是什么力量影响了HPV疫苗的接种。访谈记录，转录，翻译，并使用专题分析进行审查。在招募的224名青少年中，201人开始接种疫苗; 192人（95.5%）接受了第二次免疫接种; 164人（81.6%）完成了三次接种。在我们对39个照顾者和照顾者的定性研究中，我们发现，推动疫苗接种的因素反映了艾滋病毒高流行率、性暴力、贫困和大量女性户主家庭的社会文化背景。青少年行使高度的自主权，往往主动作出决定。医疗保健提供者和同行提供了在家里没有的支持和指导。艾滋病毒流行对决策的影响是巨大的，导致与会者错误地将HPV和艾滋病毒混为一谈。在一个认为性暴力猖獗和艾滋病毒流行程度的环境中，青少年和照顾者试图通过寻求针对性传播感染的疫苗来减少伤害。尽管谨慎同意，但对疫苗的靶点仍存在困惑。今后促进性传播感染疫苗的干预措施需要向参与者提供大量信息，特别是在决策方面可能行使很大程度自主权的青少年。
In South Africa, the prevalence of oncogenic Human Papillomavirus (HPV) may be as high as 64%, and cervical cancer is the leading cause of cancer-related death among women. The development of efficacious prophylactic vaccines has provided an opportunity for primary prevention. Given the importance of psycho-social forces in vaccine uptake, we sought to elucidate factors influencing HPV vaccination among a sample of low-income South African adolescents receiving the vaccine for the first time in Soweto. The HPV vaccine was introduced to adolescents in low-income townships throughout South Africa as part of a nationwide trial to understand adolescent involvement in future vaccine research targeting human immunodeficiency virus (HIV). We performed in-depth semi-structured interviews with purposively-sampled adolescents and their care providers to understand what forces shaped HPV vaccine uptake. Interviews were recorded, transcribed, translated, and examined using thematic analysis. Of 224 adolescents recruited, 201 initiated the vaccine; 192 (95.5%) received a second immunization; and 164 (81.6%) completed three doses. In our qualitative study of 39 adolescent-caregiver dyads, we found that factors driving vaccine uptake reflected a socio-cultural backdrop of high HIV endemnicity, sexual violence, poverty, and an abundance of female-headed households. Adolescents exercised a high level of autonomy and often initiated decision-making. Healthcare providers and peers provided support and guidance that was absent at home. The impact of the HIV epidemic on decision-making was substantial, leading participants to mistakenly conflate HPV and HIV. In a setting of perceived rampant sexual violence and epidemic levels of HIV, adolescents and caregivers sought to decrease harm by seeking a vaccine targeting a sexually transmitted infection (STI). Despite careful consenting, there was confusion regarding the vaccine’s target. Future interventions promoting STI vaccines will need to provide substantial information for participants, particularly adolescents who may exercise a significant level of autonomy in decision-making.
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影响因子：
3.1
作者：
Gerend, Mary A.;Shepherd, Melissa A.;Lustria, Mia Liza A.
通讯作者：
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影响因子：
2.3
作者：
Firnhaber, Cynthia;Van Le, Hoa;Smith, Jennifer S.
通讯作者：
Smith, Jennifer S.
DOI：
10.1001/archpediatrics.2009.50
发表时间：
2009-05-01
影响因子：
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作者：
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通讯作者：
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影响因子：
5.5
作者：
Fife, KH;Wheeler, CM;Johnson, DA
通讯作者：
Johnson, DA
影响因子：
3.5
作者：
Fazekas, Karah I.;Brewer, Noel T.;Smith, Jennifer S.
通讯作者：
Smith, Jennifer S.