Factors affecting HPV vaccine uptake among ethnic minority adolescent girls: A systematic review and meta-analysis

Dorothy N S Chan; Caixia Li; Bernard M H Law; K C Choi; Pinky P K Lee; Winnie K W So

doi:10.1016/j.apjon.2023.100279

Factors affecting HPV vaccine uptake among ethnic minority adolescent girls: A systematic review and meta-analysis

Asia Pac J Oncol Nurs. 2023 Jul 31;10(9):100279. doi: 10.1016/j.apjon.2023.100279. eCollection 2023 Sep.

Authors

Dorothy N S Chan¹, Caixia Li¹, Bernard M H Law¹, K C Choi¹, Pinky P K Lee¹, Winnie K W So¹

Affiliation

¹ The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.

Abstract

Objective: Human papillomavirus (HPV) vaccination rates remain low among adolescent girls across ethnic minority groups that experience high incidences of HPV-related cervical cancer with poor outcomes. This systematic review aimed to synthesize the available evidence on the factors affecting HPV vaccination among ethnic minority adolescent girls.

Methods: Six databases (PubMed, OVID MEDLINE, EMBASE, CINAHL, PsycINFO, and Scopus) were searched from inception to October 17, 2022. Guided by the conceptual model of vaccine hesitancy, the factors affecting HPV vaccine uptake were descriptively synthesized and analyzed using meta-analyses.

Results: This review included 14 studies. The pooled uptake rate of at least one dose of HPV vaccine among ethnic minority adolescent girls was only 38% (95% confidence interval = 0.22, 0.39). At individual level, age of adolescent girls, knowledge of HPV, perceived importance of HPV vaccination, and perceived risk of HPV infection promoted the vaccine uptake. Beliefs in conspiracy theories and lack of trust in the government and HPV vaccine discouraged the utilization. At social and policy levels, health professionals' recommendations, subjective norms, sexuality-related communication, and vaccine policies such as insurance coverage facilitated HPV vaccination. The religious and moral convictions regarding abstinence from sex until marriage negatively influenced the vaccine acceptance.

Conclusions: HPV vaccination among ethnic minority adolescent girls was influenced by multi-level factors that highlighted a combined effort, including culturally sensitive health education programmes, sexuality-related communication skills training, collaboration with religious organizations, debunking conspiracy theories in HPV vaccine, and promoting school-based vaccination programs, to increase the coverage.

Systematic review registration: PROSPERO, CRD42022366805.

Keywords: Adolescent girls; Ethnic minority; Human papillomavirus; Nursing; Systematic review; Vaccine.

Publication types

Review