Study Explores Providers' Perceptions of Parental Concerns About HPV Vaccination

A new Boston University School of Medicine (BUSM) study has found that low-income and minority parents may be more receptive to vaccinating their daughters against human papillomavirus (HPV), while white, middle-class parents are more likely to defer the vaccination. The findings appear online in the May issue of the Journal of Health Care for the Poor and Underserved.

Cervical cancer incidence and mortality are markedly higher for low-income and minority women due to higher rates of HPV and limited access to screening and treatment. Vaccination for HPV has the potential to reduce health care disparities in cervical cancer rates if girls are vaccinated prior to sexual experimentation. Although providers felt that parents wanted to prevent cervical cancer in their daughters, some had concerns about safety of the vaccine and promoting early or unsafe sexual activity.

"Approximately 33,000 Americans will get an HPV-related cancer each year, many of which can be prevented by vaccination," says lead author Rebecca Perkins, MD, professor of obstetrics and gynecology at BUSM. "Solid communication between parents and providers is the key to improving HPV vaccination rates, which is what this study seeks to measure."

Researchers interviewed 34 pediatric and family medicine physicians and nurse practitioners in four community health centers serving Boston's low-income, minority populations. The providers answered open-ended interview questions about how they thought parents felt about vaccinating their daughters against HPV. They also were asked to role-play their HPV vaccination script using language they typically use to introduce the HPV vaccine to parents.

Immigrants, especially those from Latin America, viewed the vaccination more positively because they had experience with vaccine-preventable diseases and cervical cancer in their home countries. While providers did not note any difference in the sexual behaviors of adolescents from families of different ethnic backgrounds or incomes, they found that immigrant parents had more realistic impressions of their daughters' sexual activity than White middle-class parents.

The findings of this study may be applicable to larger disparities seen nationwide in HPV vaccination rates. Funding for this study was provided by an American Cancer Society Mentored Research Scholar Grant MRSG- 09-151-01.