Harries Jane, Moodley Jennifer, Barone Mark A, Mall Sumaya, Sinanovic Edina
Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa.
Vaccine. 2009 Jan 1;27(1):38-44. doi: 10.1016/j.vaccine.2008.10.033. Epub 2008 Oct 31.
This article reports on qualitative research investigating key challenges and barriers towards human papillomavirus (HPV) vaccine introduction in the Western Cape Province, South Africa. A total of 50 in-depth interviews and 6 focus groups were conducted at policy, health service and community levels of enquiry. Respondents expressed overall support for the HPV vaccine, underscored by difficulties associated with the current cervical screening programmes and the burgeoning HIV/AIDS epidemic in South Africa. Overall poor community knowledge of cervical cancer and the causal relationship between HPV and cervical cancer suggests the need for continued education around the importance of regular cervical screening. The optimal target populations for HPV vaccination was influenced by the perceived median age of sexual activity in South African girls (9-15 years), with an underlying concern that high levels of sexual abuse had significantly decreased the age of sexual exposure suggesting vaccination should commence as early as 9 years. Vaccination through schools with the involvement of other stakeholders such as sexual and reproductive health and the advanced programme on immunization (EPI) were suggested. Opposition to the HPV vaccine was not anticipated if the vaccine was marketed as preventing cervical cancer rather than a sexually transmitted infection. The findings assist in identifying potential barriers and facilitating factors towards HPV vaccines and will inform the development of policy and programs to support HPV vaccination introduction in South Africa and other African countries.
本文报道了一项定性研究，该研究调查了在南非西开普省引入人乳头瘤病毒（HPV）疫苗面临的主要挑战和障碍。研究在政策、卫生服务和社区等层面进行了总共50次深度访谈和6次焦点小组讨论。受访者对HPV疫苗总体表示支持，南非当前的宫颈癌筛查项目以及迅速蔓延的艾滋病毒/艾滋病疫情所带来的困难凸显了这一点。社区对宫颈癌以及HPV与宫颈癌之间因果关系的普遍认知不足，这表明有必要持续开展关于定期宫颈癌筛查重要性的教育。HPV疫苗的最佳目标人群受到南非女孩性行为平均年龄（9至15岁）的影响，同时人们也潜在担忧高水平的性虐待显著降低了性接触的年龄，这表明疫苗接种应尽早从9岁开始。建议通过学校开展疫苗接种，并让性健康和生殖健康以及扩大免疫规划（EPI）等其他利益相关方参与其中。如果HPV疫苗宣传为预防宫颈癌而非性传播感染，预计不会遭到反对。这些研究结果有助于识别HPV疫苗接种的潜在障碍和促进因素，并将为支持在南非及其他非洲国家引入HPV疫苗的政策和项目制定提供参考。
