HPV Vaccine Acceptability among Males and Females in the Philippines: A Qualitative Study

Purpose: A primary prevention strategy against HPV-associated disease is critical in the Philippines. The purpose of this study is to examine influences on HPV vaccine acceptance among adult men and women in the Philippines. Data: Qualitative data collected from seven gender-separate focus group discussions (n=57) with male and female community members, including a group of commercial sex workers, from the Visayan region. Methods: Focus groups were semi-structured, based on two vignettes and a series of probes used to stimulate discussion. The audio-recorded discussions were translated from Cebuano to English and transcribed into a series of documents. Following repeated readings, themes were identified, defined, and coded by members of the research team. After a subsample of the transcripts was coded by researchers independently, inter-rater reliability was tested and themes were then further analyzed. Results: Emergent themes revealed widespread misconceptions about STDs, as well as very little awareness and understanding about HPV, the HPV vaccine, and cervical cancer. Family and friends carried great influence in decision-making to get treated or vaccinated. Financial apprehension was paramount and nearly all participants expressed a concern that they would not be able to afford the HPV vaccine even if it was widely available. Recommendations: Powerful economic, cultural, and social factors may significantly influence HPV vaccine acceptance in the Philippines. To attain widespread coverage, a successful vaccine initiative in the region must minimize structural barriers to vaccine acceptance, incorporate a culturally-sensitive and comprehensive educational campaign, and address the influence of family and friends in HPV vaccination decisions.