Human Papillomavirus and American Indians: Policies, decision-making strategies, and parental awareness

Information on parental illness beliefs, awareness, and level of consent for their child's HPV vaccination was investigated among urban American Indians in Arizona. A survey was conducted among American Indian parents of young girls between the ages of 6-18 years. Administered at the local Indian hospital and in urban Indian centers, 151 adults participated (109 females and 42 males). Despite recent media news coverage and a high prevalence of HPV and genital warts in the American Indian population, a large percentage of the study parents had never heard of, or knew little about HPV (80.8%). Although the spread of HPV and genital warts was largely attributed to sexual transmission, 30% did not know how the HPV virus was transmitted and 18% did not know how genital warts can be passed to others. Beliefs that casual contact through hand shakes, kissing, toilet seats and coughing transmit the disease were shared. Decision-making was described as a family matter, as parents may need to consult grandparents or others. Physicians and nurses were the preferred source of information and classes for family groups rather than individuals. There is a clear need for clinics to be offering educational programs to American Indian families on this topic.

Understanding the level of knowledge and illness beliefs of Indian parents enhances patient-provider communication and assists in the planning, development of policies, and delivery of educational services. Implementing educational programs on HPV should follow a culturally sensitive approach by providing information to family groupings.