Parental knowledge, attitudes, beliefs and acceptance of human papillomavirus vaccination among their daughters: a cross-sectional study in Yerevan, Armenia

Abstract

Armenia has the highest cervical cancer mortality rate among countries of Western Asia. Moreover, cervical cancer is the second most frequently diagnosed cancer type among females aged 15 to 44 years old residing in Armenia. Oncogenic Human Papillomavirus (HPV) infections constitute the leading cause for cervical cancer development. The current study aimed to investigate the parental acceptance of the HPV vaccination for their girls aged 11-14 years old who attend public school in Yerevan, Armenia. The study also aimed to uncover participants’ level of HPV-related knowledge and HPV-related health consequences; furthermore, the purpose of the present study was to elucidate if the association between HPV vaccine acceptance, HPV and cervical cancer related knowledge, and attitudes towards HPV vaccination exists. A cross-sectional, quantitative study was implemented by the research team. The study was approved by the Institutional Review Board (IRB) of the American University of Armenia (AUA). Twelve of the largest public schools in Yerevan, Armenia were selected for participant recruitment. After obtaining permission from the Directors of the selected schools, the web-link containing the online study survey was sent to the study population. Online data collection was anonymous—no personal information or contact information for participants was collected. Overall, 190 parents completed the online survey and 173 were included in the final analysis. The descriptive analysis revealed that the mean HPV vaccine acceptability score was 10.3 (possible score range is from 5 to 20). The mean knowledge score was 3.9 out of 14. While parents of 11-14 year old school girls reported a lack of trust towards HPV vaccination, they did report an unmet need for more comprehensive information regarding this topic. Through linear regression analyses (unadjusted and adjusted) no association was found between parental acceptability, knowledge and attitudes towards the HPV vaccine. To address low knowledge on HPV and poor HPV vaccine acceptability in Yerevan, Armenia, further HPV-related educational programs and additional research is recommended in order to improve parental knowledge, and also to reveal the underlying factors of HPV vaccine acceptability and coverage.