Healthcare providers' perspectives on the acceptability and uptake of HPV vaccines in Zimbabwe.

BACKGROUND: Human papillomavirus (HPV) vaccines are a critical strategy in the prevention of cervical cancer, especially in countries like Zimbabwe where cervical cancer screening rates are low. In Zimbabwe, cervical cancer is the leading cause of cancer-related deaths in women but the HPV vaccine is not yet widely available. This study examined healthcare providers': (1) perceptions of current hospital practices and issues in cervical cancer prevention and treatment in Zimbabwe; (2) knowledge of HPV and HPV vaccines; and (3) perspectives on introducing HPV vaccination programs in Zimbabwe, including potential facilitators and barriers to successful implementation. METHOD: In-depth semi-structured interviews were conducted at a rural hospital with 15 healthcare providers in Zimbabwe. Interviews included eight main questions and a number of additional probes that reflected the study's purpose. Data were analyzed using thematic analysis. RESULTS: Participants reported that women are not consistently being screened for cervical cancer. There were generally low levels of knowledge about HPV and HPV vaccines, but participants asked many questions indicating a desire to learn more. Although they were highly supportive of implementing HPV vaccination programs in Zimbabwe, they also identified a number of likely psychosocial, cultural, and logistical barriers to successful implementation, including cost, vaccine schedule, and hospital infrastructure. However, participants also provided a number of culturally relevant solutions, including education and community engagement. CONCLUSION: This study provides insight from healthcare providers about barriers to implementation and possible solutions that can be used by policy makers, practitioners, and other stakeholders to facilitate the successful implementation of forthcoming HPV immunization programs in Zimbabwe.

The paradox of HPV vaccines: how to reach sexually inexperienced women for protection against a sexually transmitted infection.

PURPOSE: The current study examined the impact of a human papillomavirus (HPV) vaccine message tailored for sexually inexperienced women. METHODS: We included 193 young women, aged 17 to 26, attending university, who completed an on-line questionnaire. The participants were randomly assigned to three conditions that manipulated the type of information they received on HPV and the vaccine: control (minimal information, sexual transmission information omitted), detailed (emphasized sexual transmission of HPV), or tailored (the same as detailed, but also emphasized the benefit to sexually inexperienced women). RESULTS: Women with no sexual experience intended to receive an HPV vaccine more in the tailored condition than the detailed condition (q = 3.46; p < .05) and the control condition (q = 5.11; p < .01). There was no difference between the detailed condition compared with the control condition (q = 1.45; p = NS). CONCLUSION: This study found that a message tailored for sexually inexperienced women resulted in higher intentions to receive the HPV vaccine compared with messages that were not tailored. When providing information about HPV vaccines to sexually inexperienced patients, it may be particularly important to emphasize that HPV vaccines are most efficacious if received before the onset of sexual activity. The results suggest that this is more effective in increasing sexually inexperienced women's interest in the vaccine than avoiding information about sexual transmission altogether.

Discussions about self-obtained samples for HPV testing as an alternative for cervical cancer prevention.

OBJECTIVES: Patient-collected samples for human papillomavirus (HPV) testing have shown promise, thus opening up a new possibility for cervical cancer screening. The purpose of this study was to explore women's beliefs about collecting their own samples for HPV testing instead of participating in conventional Pap testing. METHODS: Three focus groups were conducted in diverse cities in Ontario, Canada. One group included women from a small under-serviced northern city, one included culturally diverse women from a large urban city, and one included culturally diverse women from a medium sized under-serviced city. Transcripts were coded using open and axial coding as well as focused coding procedures and were organized using qualitative software. The Health Belief Model (HMB) was used as a framework for designing the focus group guide and interpreting the results. RESULTS: Six overriding themes were identified in the analysis: (1) need (and desire) for information about cervical cancer and HPV, (2) concerns about self-sampling, (3) perceived potential of self-sampling, (4) logistics remain unanswered, (5) need for education and promotion of self-sampling, and (6) need for options. CONCLUSION: The six themes were connected to some or all of the HBM components. In particular, self-sampling provides a different benefits-minus-barriers equation, which might make it a preferred screening option for some women.