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Are Senegalese adolescents aware of and willing to receive the HPV vaccine?

With growing rates of cervical cancer, barriers to HPV vaccination need to be better understood.

Friday, September 1, 2017

THE DISCONNECT BETWEEN AWARENESS, WILLINGNESS to act, and access to care in the case of Human papillomavirus (HPV) vaccines can have serious health consequences. Researchers from the (MHS, DrPH) of the UCLA Fielding School of Public Health (FSPH) conducted a study with the Drexel Dornsife School of Public Health and the Senegalese Centre Régional de Formation, de Recherche et de Plaidoyer en Santé de la Reproduction (CEFOREP) with the goal of better understanding the factors that influence HPV vaccine uptake in Senegalese adolescents and young adults. "The study provides evidence that can inform tailored communication strategies and interventions to strengthen HPV vaccine uptake in Senegal, and also highlights how collaborations between institutions and countries can build upon existing strengths and partnerships," says lead author and FSPH alumnus Phillip Massey (MPH ’09, PhD ’13), currently working as an assistant professor in the Department of Community Health and Prevention at Drexel University Dornsife School of Public Health. 

Only 27% of the 2,286 Senegalese adolescents and young adults randomly surveyed from schools and community centers in five urban, suburban, and rural regions of Senegal (Dakar, Thies, Fatick, Mbour and Ziguinchor) had heard of HPV. Furthermore, only 28% of those aware of the disease were willing to get vaccinated. "We often presume that higher education and urban residence equate to better health outcomes, especially in lower-resource settings. However, our findings challenge this notion and underscore the importance of empirical assessments of population characteristics prior to the development of outreach and intervention efforts," shares professor Jessica Gipson( PhD, MPH, BS), associate professor in the Department of Community Health Sciences and co-author of the research study Human papillomavirus (HPV) awareness and vaccine receptivity among Senegalese adolescents (Tropical Medicine & International Health, January 2017). 

Using multivariable logistic regression models, the researchers came to three major findings:

  1. Those who spend most of their lives in rural areas are 63% more likely to have heard of HPV in comparison to those who have mostly lived in an urban setting.
  2. Among the surveyed Senegalese adolescents and young adults, adolescents whose fathers had higher levels of education were more likely to be aware of HPV, yet were less willing to get vaccinated.
  3. Senegalese boys and girls who had spoken with a healthcare provider about the HPV vaccine were nearly twice as likely to indicate that they would be willing to take the vaccine. 

"As planned communication campaigns to increase HPV immunization rates ramp up in this region, targeted messaging as well as appropriate media formats should be considered," shares Professor Deborah Glik (ScD, FAAHB) of FSPH’s Department of Community Health Sciences. 

In this part of Africa, sexually transmitted diseases such as HPV have historically been a much greater problem than HIV/AIDs. For the last two decades, the development and utilization of HPV vaccines in the developed world has helped to lower HPV rates. In Senegal, the progression of HPV into cervical cancer has led to high rates of cervical cancer (41.4 per 100.000, compared to 29.3 overall in West Africa). Low levels of HPV awareness and lack of infrastructure to facilitate early detection and treatment have not kept up with increasing incidence and made cervical cancer the most common cause of cancer-related deaths (30% of all cancer deaths) in this region. The results presented in this study can inform the objectives, messages and channels used for HPV communication strategies, leading to improved HPV and cervical cancer prevention in Senegal. 

The study, Human papillomavirus (HPV) awareness and vaccine receptivity among Senegalese adolescents, was published in the Tropical Medicine and International Health journal in January, 2017 and authored by: Dr. Phillip Massey and Ruth Boansi of the Drexel Dornsife School of Public Health; Thierno Dieng of CEFOREP and FSPH’s Dr. Jessica Gipson, Rachel Adams, Helene Riess, Dr. Michael Prelip and Dr. Deborah Glik. The work was supported by NIH-NICHD Fogarty Behavioral and Social Science.

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