HPV vaccine acceptance among women in the Asian Pacific: a systematic review of the literature.

OBJECTIVE: To inform human papillomavirus (HPV) vaccination programs in the Asian Pacific region by elucidating factors associated with women's intent to receive the vaccine.

METHODS: Quantitative and qualitative studies on female HPV vaccine acceptance within countries of the Asian Pacific region were systematically reviewed. Academic Search Premier, CINAHL, Medline, Psychology and Behavioral Sciences Collection, PsycINFO, and Sociological Collection were searched for original research articles exploring primary acceptance of the HPV vaccine among women published between January 1995 and February 2010.

RESULTS: Of the 60 studies yielded by the search, 18 met inclusion criteria (13 quantitative, 5 qualitative). All quantitative studies were cross-sectional and all but one assessed vaccination intent rather than actual uptake. Awareness and knowledge of HPV, HPV-related conditions, and HPV vaccination varied greatly among studies. Several studies found women's perceived susceptibility to HPV-related conditions to be positively associated with HPV vaccine intent. Across seven quantitative studies in five countries, women's concerns about the vaccine's safety and efficacy were associated with their intent to be vaccinated. Social consequences and support from social referents were also influential in many women's decisions. Qualitative research also revealed that many women were concerned that the vaccine would affect fertility.

CONCLUSION: HPV vaccine campaigns should address gaps in knowledge regarding HPV, genital warts, and cervical cancer, and should attend to concerns about vaccine safety and efficacy. Strategies should also be undertaken to decrease social stigma surrounding receipt of the HPV vaccine and to foster familial and partner support of women's decision to be vaccinated.