Views on son's sexual activity influence parents' perceptions of sons' susceptibility to HPV and acceptability of HPV vaccine for boys

Background: The quadrivalent HPV (HPV4) vaccine, previously licensed only for females, has been recently licensed for use in males age 9-26. There is little research on parents' knowledge of HPV outcomes in males such as genital warts, and anal, oral and penile cancers, or acceptance of HPV4 vaccination for males.

Methods: Four single-sex focus groups of English- and Spanish-speaking parents of boys aged 9-21 were conducted to assess baseline knowledge and perceived susceptibility of HPV outcomes in their sons, benefits and barriers of vaccination, and intent to vaccinate son(s). Focus groups were recorded, transcribed, and coded for themes using Atlas Ti.

Results: Perceptions of susceptibility to HPV outcomes were related to perceptions of their child's sexual activities. Oral cancer was viewed as more likely because “there's a lot of oral sex going on,” while anal cancer was seen as uncommon because their presumably heterosexual sons were unlikely to engage in anal sex. Because the vaccine prevents a sexually transmitted disease, some parents felt this was “givin' ‘em a license to sex,” while others felt: “It takes the worry away […] about sex and making sure they're protected 'cause they're going to do it.” Parents who thought their son was sexually active were more likely to endorse the vaccine.

Conclusions: Parents' perceptions about their son's sexual behavior may be a strong indicator of HPV4 vaccine acceptability. Emphasis on protecting their child for future sex and the HPV4 vaccination being most effective when given prior to any sexual activity may be useful.