Uptake and factors associated with uptake of human papillomavirus vaccination among adolescent girls aged 13-18 years seeking health services at Kiswa Health Center III

Abstract

Background: HPV is a highly prevalent sexually transmitted infection with a significant role in the cause of cervical cancer. In Uganda, the cervical cancer age-standardized incidence rate is estimated to be 56.2 per 100,000 women. Vaccination against HPV has the potential to lessen HPV-related cervical cancer. This study aimed to investigate the uptake and factors associated with uptake of Human Papillomavirus vaccination among adolescent girls aged 13-18 years seeking health services at Kiswa health center III. Methods: A cross sectional study design with mixed methods was conducted in the adolescent clinic of Kiswa health center III called Naguru Teenage Information and Health Center. 134 adolescent girls aged 13-18 years were subjected to interviewer-administered questionnaires. These selected by systematic random sampling. Seven key informant interviews were conducted with health workers purposively selected at the adolescent clinic. Quantitative data was analyzed using STATA version 14. Prevalence ratios with their confidence intervals were reported. Qualitative data was analyzed using thematic analysis. Results: 25 (18.7%) of the 134 respondents reported uptake of a single dose of HPV vaccine. For the sociodemographic factors, the uptake of HPV vaccine was lower among Acholi/Langi [aPR=0.3, 95% CI: 0.09-0.6, P=0.002] and Basoga [aPR=0.2, 95% CI: 0.08-0.8, P=0.001] respondents as compared to Baganda respondents. Parent information on HPV vaccine[aPR=0.3, 95% CI: 0.1-0.8, P=0.001] and perception benefits of HPV vaccine [aPR=0.3, 95% CI: 0.1-0.9, P=0.002] were associated with HPV vaccine uptake. The health facility factors found to be significantly associated with HPV vaccine uptake included the knowledge on the location of the nearest HPV vaccination site [aPR=0.3, 95% CI: 0.1-0.8, P=0.005], distance to the health facility [aPR=0.5, 95% CI: 0.2-0.7, P=0.019], and health worker recommendations [aPR=0.3, 95% CI: 0.1-0.7, P=0.001]. For the qualitative inquiry, two primary themes emerged: facilitators of HPV vaccine uptake with emerging subthemes such as vaccine availability, human resource, health education programs and healthcare provider recommendation; and barriers to HPV vaccine uptake with emerging subthemes such as inadequate funding, few health workers and vaccine stock-outs. Conclusion: The uptake of HPV vaccine was low and therefore recommend more health education campaigns and sensitization to increase awareness about the vaccine to adolescents and parents.