HPV vaccine: uptake and understanding among global Indigenous communities - a qualitative systematic review

Brianna Poirier; Sneha Sethi; Gail Garvey; Joanne Hedges; Karen Canfell; Megan Smith; Xiangqun Ju; Lisa Jamieson

doi:10.1186/s12889-021-12147-z

HPV vaccine: uptake and understanding among global Indigenous communities - a qualitative systematic review

BMC Public Health. 2021 Nov 10;21(1):2062. doi: 10.1186/s12889-021-12147-z.

Authors

Brianna Poirier¹, Sneha Sethi², Gail Garvey³, Joanne Hedges², Karen Canfell⁴, Megan Smith⁴, Xiangqun Ju², Lisa Jamieson²

Affiliations

¹ Australian Research Centre for Population Oral Health, University of Adelaide, 4 North Terrace, 4 North Terrace, Adelaide, SA, 5000, Australia. Brianna.poirier@adelaide.edu.au.
² Australian Research Centre for Population Oral Health, University of Adelaide, 4 North Terrace, 4 North Terrace, Adelaide, SA, 5000, Australia.
³ School of Public Health, Faculty of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia.
⁴ The Daffodil Centre at the University of Sydney, A Joint Venture with Cancer Council, PO Box 572, Kings Cross, NSW, 1340, Australia.

Abstract

Background: Indigenous populations have a high prevalence of Human Papillomavirus (HPV) infection and a high incidence of HPV associated cancers, such as cervical and oropharyngeal cancer. There is an effective HPV vaccination program in almost all developed countries to prevent the incidence of cervical cancer, but reports suggest that the uptake of these vaccinations by Indigenous populations is low. The objective of this qualitative systematic review was to explore the knowledge and beliefs of global Indigenous populations regarding HPV vaccines. This review was performed to identify the barriers faced by Indigenous peoples and to provide evidence for more effective and acceptable execution of vaccination policies for Indigenous peoples.

Methods: Two investigators independently searched MEDLINE, PubMed, SCOPUS, and Web of Science databases using a pre-specified search strategy to identify qualitative studies on narratives of Indigenous peoples regarding HPV vaccine awareness, knowledge and experiences across all geographic and income-level settings.

Results: After performing the literature search and quality appraisals 5 papers were included in the final review. Three core synthesised findings were identified: reasons for acceptance or hesitancy, and areas for improvement. Lack of correct knowledge and mistrust in the healthcare system were important categories observed in all papers included in the review. Other categories within the conceptual model included prioritising disease prevention, health professional guidance, family support and supportive community environment.

Conclusion: Qualitative systematic reviews are an excellent means of exploring the gaps in current healthcare practices. Indigenous healthcare research should be grounded in community experiences and feedback. This review provides insights into HPV vaccination understanding and acceptance amongst Indigenous populations, from which recommendations for increasing resonance of vaccination strategies with Indigenous communities can be formed.

Keywords: Cervical cancer; HPV vaccine; Human papillomavirus infections; Indigenous women health; Qualitative systematic review.

Publication types

Review
Systematic Review

MeSH terms

Delivery of Health Care
Female
Health Knowledge, Attitudes, Practice
Humans
Papillomavirus Infections* / prevention & control
Papillomavirus Vaccines*
Patient Acceptance of Health Care
Uterine Cervical Neoplasms* / prevention & control
Vaccination

Substances

Papillomavirus Vaccines