Knowledge, Attitudes, and Perceptions of the Arabic-Speaking Community in Sydney, Australia, toward the Human Papillomavirus (HPV) Vaccination Program: A Qualitative Study

Abstract

Background: Little is known about acceptability of the human papillomavirus (HPV) vaccine among parents of adolescents from culturally and linguistically diverse backgrounds in Australia. This study aimed to explore the knowledge and attitudes of parents from Arabic backgrounds towards HPV vaccination offered to their children in the national school-based vaccination program. Methods: Qualitative interviews were conducted in Western Sydney, with parents of adolescents from Arabic backgrounds. Recruitment was via informal personal contacts and passive snowballing. Face-to-face semi-structured interviews were conducted in Arabic. These were audio-recorded, transcribed, and translated into English. Thematic analysis was used to identify emerging themes. Results: Commonly identified themes across fifteen interviews included: (1) lack of awareness and knowledge of HPV and its vaccination, (2) awareness and understanding of the government vaccination information sheet, (3) parents’ preferences for information provision, (4) the role of parents’ religious beliefs in forming attitudes about HPV vaccination, and (5) lost opportunities to educate parents about HPV vaccination during general practitioner (GP) visits. Conclusion: The findings point to the need to address cultural, language, and communication barriers to improve awareness and acceptability of HPV vaccination in the Arabic community. Educational strategies should be tailored to this community based on their specific information needs and preferences.

Arab American Mothers’ HPV Vaccination Knowledge and Beliefs

“…Mothers felt that language discordance was a barrier to HPV/HPVV communication with the provider, including the possibility that the message was lost when a child interpreted the encounter. Similar issues were detected among Arab immigrant parents in Australia [ 28 ]. Providers need Arabic language educational materials to distribute to Arabic-speaking parents and ready access to professional medical interpretation services.…”

“…Recent MENA studies have found women’s HPVV knowledge and awareness to be “poor” [ 26 , 27 ]. In a qualitative study among Arab, mostly immigrant, parents of vaccine-eligible children in Sydney, Australia, not having enough information to make a decision was also an HPVV barrier [ 28 ]. Our findings suggest that, although the HPVV has been approved for over fifteen years, information about it has not been disseminated sufficiently through the NYC Arab immigrant parent population.…”

“…Misinformation and negative opinions from people in their social networks and religious and cultural beliefs around promiscuity, sex, and STIs were also perceived as HPVV barriers. Arab participants in the Australian study felt that religion played an integral role in their HPVV decision making [ 28 ]. In our study, HPVV awareness and uptake were significantly associated with participants’ religious affiliation (Islam or Christianity).…”

“…Media messaging in the Abu Dhabi government’s HPVV campaign focused on scientific evidence about cervical cancer and HPVV efficacy [ 14 ]. However, knowing HPV’s mode of transmission is important to Arab immigrant parents [ 28 ]. Upon survey completion, we provided a 10-min tailored HPVV information session in English or Arabic to participants [ 22 ].…”

Identification Level of Awareness and Knowledge of Emirati Men about HPV

“…According to an advisory committee in June 2019, the HPV vaccination may be given to persons aged 27 to 45 years. This advice is based not just on safety and effectiveness, but rather on vaccination effectiveness and cost-efficiency [ 11 , 12 ].…”