Knowledge and Attitudes of Women towards Human Papilloma Virus and HPV Vaccine in Thulamela Municipality of Vhembe District in Limpopo Province, South Africa

"There is a need to educate and promote awareness on cervical cancer screening methods among women to reduce the burden of morbidity and mortality."

The human papillomavirus (HPV) vaccines Gardasil and Cervarix became available and were registered in South Africa by the Medicines Control Council (MCC) in 2006, but rollout was delayed until 2015 in rural primary schools of Limpopo Province. Concerned that no adequate information about efficacy is being given to the community to change their attitudes and perceptions so as to improve its uptake, these researchers undertook a study to assess the knowledge of HPV and HPV vaccine among rural women in Vhembe district in Limpopo.

A quantitative cross-sectional survey was employed in Vhembe district, where 1,546 women aged 30 years and above were recruited from 4 clinics to participate in the study between June and August 2015. Most participants were black women of Vha-Venda and Vatsonga ethnic groups. Data were collected through self-reporting questionnaires; participants were given an information leaflet and consent form together with the questionnaire. Key results:

• 74.1% had not heard about HPV.
• 85% did not know how the virus was transmitted.
• 97.5% did not know that HPV caused cervical cancer.
• 91.2% did not know about the HPV vaccine.
• 94.3% did not know who was eligible for HPV vaccination.
• 93.1% did not know the age range for vaccination.
• 91.2% were not certain about having their daughters immunised against HVP.

Thus, awareness on HPV and HPV vaccine among women in Vhembe district is limited. According to the researchers, "Most women associate HPV with HIV, and stigma is attached to the disease, in rural communities HIV is associated with promiscuity or low sexual morals, so there is a need to inform women about the relationship of HPV and cervical cancer to change their attitudes and perceptions and improve the uptake of the vaccines." More general recommendations include:

• Healthcare providers are important sources of information and should recommend the vaccine. In fact, they should be fully immersed in health education and health promotion as providers of information, dispelling myths and beliefs surrounding cervical cancer. Haesebaert et al. reported that mothers trust information from physician and healthcare providers about vaccination, and mothers who were provided with HPV vaccine information were significantly more likely to intend to vaccinate their daughters than those who did not receive such information.
• Incorporating community-based carers and community radio stations to educate women and reinforce regular screening could help raise awareness and increase uptake.
• The school health service and nurses should intensify health education campaigns in communities so that adolescents, women, and men understand the etiology of cervical cancer and its association with sexually transmitted infections as well as preventative measures (screening tests).