Human Papillomavirus Infection, Vaccination, and Cervical Cancer Communication: The Protection Dilemma Faced by Women in Southern Appalachia

Abstract

Human papillomavirus is the most frequently occurring sexually transmitted infection and has been recognized as the necessary cause of cervical cancer. Understanding the shift in public awareness caused by recent changes to cervical prevention is critical to addressing cervical cancer disparities in Appalachia. Since the human papillomavirus vaccine was approved for prevention, little data have been collected regarding human papillomavirus risk assessment and vaccine perceptions among Appalachian women. The purpose of the authors in this study was to investigate communication and cultural issues via a social scripting framework that could influence human papillomavirus vaccine uptake among southern Appalachian women; and explore participants' perceptions of human papillomavirus, cervical cancer, and the vaccine. A qualitative, descriptive design was employed to examine these issues in eight counties in northeast Tennessee and southwest Virginia. Thirty-nine women aged 18-49 years participated in a single individual interview or focus group session from October 2007 through August 2008. Interview and focus group data were audio-taped and transcribed verbatim. Two major themes emerged from the data: the human papillomavirus vaccine protection dilemma and spheres of silence surrounding the human papillomavirus vaccine protection dilemma. Study findings suggested areas for future research and may assist healthcare professionals in approaching southern Appalachian women as they make decisions regarding cervical cancer prevention.

Perceptions of genetic research in three rural Appalachian Ohio communities

“…Other studies have examined the perceptions and attitudes of genetics, genetic testing, and genomic information of those at high-risk for breast cancer and Alzheimer's disease, women who were offered prenatal testing, African-American and EuropeanAmerican populations, as well as medical professionals, and consumers of genetic services (Lobb et al 2006;Hiraki et al 2009;Hines-Martin et al 2004;Etchegary et al 2008;O'Daniel et al 2010;Hernandez et al 2006). Although thoughts about cancer and vaccines have been addressed in the Appalachian population (Hutson et al 2007;Hutson et al 2011;Dorgan et al 2009;Vanderpool et al 2010), the topic of genetic research studies has not. Thus, our study fills this void in the literature and adds new information on the Appalachian population.…”

“…For example, they knew or suspected what human papilloma virus (HPV) was; however, they lacked the knowledge to make the connection between HPV and cervical cancer (Hutson et al 2011). Together, these findings suggest that it may be critical for researchers working in Appalachian communities to create an educational plan prior to the start of starting a research study.…”

“…This problem further underscores the importance of establishing trust within Appalachian communities (Behringer et al 2006). Similarly, it has been reported that many Appalachians are suspicious of medical industries such as drug companies (Hutson et al 2011) and that distrust in medical research and researchers is a key factor in minority groups' decreased willingness to participate in research studies (Braunstein et al 2008;Corbie-Smith et al 1999).…”

Barriers and facilitators to HPV vaccination of young women in high-income countries: a qualitative systematic review and evidence synthesis

“…Despite generally positive perceptions to the HPV vaccine, parents expressed worries concerning side-effects and safety [38,39,48,49,51,53,56,63,64]: “ My first thought was , I am sendin ’ my ten - year old to this clinic to put dead HPV cells in her. What if the HPV that they are shooting in her body … what if it comes to life ?” [African American, mother, USA] [65].…”

The importance of coherently understanding cervical cancer vaccination: factors associated with young Australian women’s uptake of the HPV vaccine

“…Research to date has also investigated a limited range of cognitive and affective factors associated with HPV vaccination behaviours. From a cognitive perspective, knowledge about (Perez, Cruess, & Strauss, 2016;Vermandere et al, 2014), belief in the efficacy and safety of the HPV vaccine (Chan, Chan, Ng, & Wong, 2012;Fernández et al, 2014;Hutson, Dorgan, Duvall, & Garrett, 2011;Manhart et al, 2011;Marchand, Glenn, & Bastani, 2012;Taylor et al, 2012), greater perceived severity of HPV (Kahn et al, 2008), greater perceived social acceptability of receiving the vaccine (Jowkowski & Geshnizjani, 2016;Kahn et al, 2008), and greater anticipated regret if one was unvaccinated and later contracted HPV (Christy et al, 2016;McRee, Katz, Paskett, & Reiter, 2014) are associated with increased intentions and uptake. From an affective perspective, worry about developing cervical cancer (Krakow et al, 2015) is also associated with increased acceptance and uptake.…”