Attitudes and Intentions Related to Adoption of the HPV Vaccine among Adolescent Girls and their Mothers in Akinyele Local Government Area of Oyo State

Download Article

DOI: 10.21522/TIJPH.2013.04.02.Art035

Authors : Ukwo Joy Michael


Cancer of the cervix is the second most common cancer and the second leading cause of cancer deaths in women worldwide (WHO, 2004, Schoell, Janicek, Mirhasshemi 1999). Each year an estimated 500,000 cases are newly diagnosis (WHO, 2004, schoell et .al 1999), a significant proportion of which will be in advanced stage (Guidozzi, 1999). In developing countries, it is the most commonly occurring type of cancer among women, accounting for 80% of the cases (WHO, 2004, Guidozzi, 1996). Cervical cancer is one of the most common cancers affecting U.S. women – now ranks 14 in frequency in this population (Armstrong .C, 2007). In 2007, an estimated of 11,150 women in the United States was diagnosed with cervical cancer, and an estimated 3,670 die of this disease (Armstrong .C, 2007).The lifetime risk of cervical cancer was estimated at 3.7% in the absence of cervical cancer screening (Brabin L et. al 2006).


[1.] Abogunrin, A. J. (2004). Sexual behaviour, condom use, and attitudes towards HIV/AIDS among schoolgoing adolescents in Nigeria. Unpublished Ph.D dissertation, University of Ilorin, Ilorin.

[2.] Abraham S: Vaginal and speculum examination in medical curricula. Aust N Z J Obstet Gynaecol 1995, 35:5660.

[3.] Adab P. Screening for cervical cancer in Hong Kong [abstract]. Presented at the Fifth Hong Kong International Cancer Congress; 1998 Nov 10; Hong Kong

[4.] Adegoke, A. A. (2003). Adolescents in Africa: Revealing the problems of teenagers in a contemporary African society. Ibadan: Haddasah Publishing.

[5.] Adegoke, A. A. (2004).Adolescence and adolescent problems in schools. In Adeyemi Idowu, Guidance and counselling in education. Ilorin: Indemac Publishers (Nig.) Ltd.

[6.] Adekeye, O. A. (2005). Adolescents and the HIV pandemic. Ilorin Researcher: Journal of the Postgraduate Students Association, University of Ilorin. 3 (1): 2328.

[7.] Adekeye, O. A. (2009). HIV Voluntary Counselling and Testing for Young People: The antidote for a healthy and positive living in Nigeria. The Counsellor: 25 (1)

[8.] Adewole IF, Benedet JL, Brian TC, Fallen M. Evolving a strategic approach to cervical cancer control in Africa. Gynecologic Oncology Vol 99, Issue 3, Suppl 1, Dec 2005, pages S209S212.

[9.] Ajayi I. O. and Adewole I. F. (1998). Knowledge and attitude of general outpatient attendants in Nigeria to cervical cancer screening. Cent. Afr. J. Med. Vol.44, No.2:4143.

[10.] Akinboye, J. O. (1985). Guidance and counselling strategies for handling adolescents and youth problems, (2nd ed.), Ibadan: Claverianum Press.

[11.] Alliance for Cervical Cancer Prevention (ACCP): Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers. Seattle; 2004:2428.

[12.] Amazigo, U; Silva, N.; Kaufman, J. and Obikeze, D.S. (1997). Sexual activity and contraceptive knowledge and use among inschool adolescents in Nigeria. International Family Planning Perspectives, 23, 2833. Retrieved on 8th May 2010 from

[13.] American Cancer Society, Detailed Guide: Cervical Cancer; The Centers for Disease Control and Prevention, United States Cancer Statistics: 2002 Incidence and Mortality, 2005. 69

[14.] Araoye, M. O and Fakeye, O. O. (1998). Sexuality and contraception among Nigerian adolescents and youth. African Journal of Reproductive Health. 2 (2), 1114. Retrieved on 5th March 2010 from

[15.] Armstrong C. ACIP Releases Recommendations on Quadrivalent Human Papillomavirus Vaccine Am FAM Physician. May 1, 2007; 75(9); 13911380.

[16.] Ayiga, N.; James, P.M. Ntozi, Ahimbisibwe, F E.; Odwee, J. and Okurut, F. N. (2000). Deaths, HIV testing and sexual behaviour change and its determinants in northern Uganda. Department of Population Studies, Makerere University, Kampala, Uganda. Retrieved on 5th May 2010 from

[17.] Ayinde, A. E., Adewole, I. F. & Babarinsa I. A. (1998) Trends in Cervical Cancer Screening in Ibadan Nigeria. A fouryear review. W. Afr. J. Med. Vol. 17: No.1:2530.

[18.] Babarinsa, I. A. and Adewole, I. F. (1998). Knowledge and attitude to utilization of cervical cytology screening by female workers in a Nigerian Teaching Hospital. Nig. Med. Pract. Vol. 35; No: 4852.

[19.] Babarinsa, I. A.; Akang, E. E. U. & Adewole I. F. (1998) Pattern of Gynecological Malignancies at Ibadan Cancer Registry (19761996). Nig. Qt. J. Med.8:103106.

[20.] Brabin L, Roberts SA, Farzaneh F, Kitchener HC. Future acceptance of adolescent human papillomavirus vaccination: a survey of parental attitudes. Vaccine. 2006;24:3087–94: 10.1016/j.vaccine.2006.01.04

[21.] Bulletin of the World Health Organization. Controversial new vaccine to prevent cervical cancer 2006;

[22.] Cavalli F, Hansen HH, Kaye SB. Textbook of Medical Oncology. Martin Dunitz Ltd; 1997.

[23.] Center for Biologics Evaluation, Product Approval Information – Licensing Action, June 2006. The Centers for Disease Control and Prevention, HPV Vaccine Questions and Answers, June 2006 Ibid.

[24.] Chan DW. Sex misinformation and misconceptions among Chinese medical 15 students in Hong Kong. Med Educ 1986; 20:390–8. 20. Baumrind D. The average expectable environment is not good enough: a response to Scars. Child Dev 1993; 64:1299–317.

[25.] Chirenje MZ, Rusakaniko S, Kirumbi L, Ngwall WE, MakulaTlebere P, Kaggwa S, MpanjuShumbusho W, Makoa L: Situational analysis for cervical cancer diagnosis and treatment in East, Central and southern African 2005.

[26.] Chirenje ZM, Chipato T, Kasule J, Rusakaniko S, Gaffikin L, and Blumenthal P, Sangvi H: Visual inspection of the cervix as a primary means of cervical cancer screening: results of a pilot study. Cent Afri J Med 1999, 45:3033. 70

[27.] Coombes R. Life saving treatment or giant experiment? BMJ. 2007; 334:721–723: 10.1136/bmj.39164.510127.AD.

[28.] Cronje HS, Cooreman BF, Beyer E, Bam RH, Middlecote BD, and Divall PD: Screening for cervical neoplasia in a developing country utilizing cytology, cervicography and the acetic acid test. Int J Gynaecol Obstet 2001, 72:1517.

[29.] Cronje HS, Parham GP, Cooreman BF, de Beer A, Divall P, Bam RH: A comparison of four screening methods for cervical neoplasia in a developing country. Am J Obstet Gynecol 2003, 188:395400.

[30.] Dell DL, Chen H, Ahmad F, Stewart DF. Knowledge about Human Papillomavirus among adolescents. Obstet Gynecol. 2000; 96:653–6: 10.1016/S00297844(00)010097.

[31.] Diaz ML. Human Papilloma Virus Prevention and Treatment. Obstet Gynecol Clin North Am. June 2008; 35(2); 19921. NCCN Clinical Practical Guidelines in Oncology: Cervical cancer. 1st ed. 2008. Accessed June 10, 2008

[32.] Dinh TA, Rosenthal SL, Doan ED, Trang T, Pham VH, Tran BD, Tran VD, Bao Phan GA, Chu HKH, Breitkopf CR. Attitudes of Mothers in Da Nang, Vietnam toward a Human Papillomavirus Vaccine. Journal of Adolescent Health. 2007; 10:1016.

[33.] Editorial. Should HPV vaccines be mandatory for all adolescents? The Lancet. 2006;368

[34.] Editorial. Who should be vaccinated against human papillomavirus? The Lancet Infectious Diseases. 2006; 6:1: 10.1016/S14733099(05)703017.

[35.] Elovainio L, Nieminen P, Miller AB: Impact of cancer screening on women's health. Int J Gynaecol Obstet 1997, 58:137147. MacGregor JE: Screening for cervical cancer. In Contemporary Obstetrics and Gynecology. Edited by: Chamberlain G. London: Butterworth 1988:343356.

[36.] Ezem B. U 2007 Awareness and uptake of cervical cancer screening in Owerri, South Eastern Nigeria Department of Obstetrics and Gynecology, Imo State University Teaching Hospital, Orlu, Nigeria

[37.] Fawzy FI, Coombs RH, Gerber B. Generational continuity in the use of substances: the impact of parental substance use on adolescent substance use. Addict Behavior 1983; 8:10914.

[38.] Friedman AL, Shepeard H. Exploring the knowledge, attitudes and beliefs, and communicating preferences of the general public regarding HPV: findings from CDC focus group research and implications for practice. Health Education Behaviour. 2007; 34:471–485: 10.1177/1090198106292022. 71

[39.] Gajalakshmi CK, Krishnamurthi S, Ananth R, and Shanta V: Cervical cancer screening in Tamilnadu, India: a feasibility study of training the village health nurse. Cancer causes control 1996, 7:520524.

[40.] Goldie SJ, Kohli M, Grima D, et al. Projected clinical benefits and costeffectiveness of a human papillomavirus 16/18 vaccine. J Natl Cancer Inst 2004; 96:604–15.

[41.] Harper DM, Franco EL, Wheeler C, Ferris DG, Jenkins D, Schuind A, Zahaf T, Innis B, Naud P, De Carvalho NS, RoteliMartins CM, Teixeira J, Blatter MM, Korn AP, Quint W, Dubin G. GlaxoSmithKline HPV Vaccine Study Group. Efficacy of a bivalent L1 viruslike particle vaccine in prevention of infection with human papillomavirus type 16 and 18 in young women: a randomized control trial. The Lancet. 2004; 364:1757–1765. 10.1016/S01406736(04)173984.

[42.] Harper DM, Franco EL, Wheeler C, Ferris DG, Jenkins D, Schuind A, et al. Efficacy of a bivalent L1 viruslike particle vaccine in prevention of infection with human papilloma virus types 16 and 18 in young women: a randomized controlled trial. Lancet 2004, 364 (9447), 17571766.

[43.] Hoch mans A, Ratzkowski E, Schrieber H. Incidence of carcinoma of cervix in Jewish women in Israel. Br J cancer 1955; 9:358 364).

[44.] Holcomb B, Bailey JM, Crawford K, Ruffin MT. Adults knowledge and behaviors related to human papillomavirus infection. 2004; 17:26–31.

[45.] Kahn JA, Rosenthal SL, Hamann T, Bernstein DI. Attitudes about human papillomavirus vaccine in young women. Int J STD AIDS 2003; 14:300–6.

[46.] Kandel DB, Wu P. The contributions of mothers and fathers to the intergenerational transmission of cigarette smoking in adolescence. J Res Adolescent 1995; 5:225–52.

[47.] Kapiga SH, Msamanga GI, Spiegelman D, Mwakyoma H, Fawzi WW, Hunter DJ: Risk factors for squamous intraepithelial lesions among HIV1 seropositive women in Dares Salaam, Tanzania. Int J Gynaecol Obstet 1999, 67:8794.

[48.] Koutsky LA, Ault KA, Wheeler CM, Brown DR, Barr E, Alvarez FB, Chiacchierini LM, Jansen KU. A controlled trial of a human papillomavirus type 16 vaccine. The New England Journal of Medicine. 2002; 347:1645–51. 10.1056/NEJMoa020586.

[49.] Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human papillomavirus type 16 vaccine. N England J Med 2002; 347:1645–51.

[50.] Lehtinen M, Apter D, Dubin G, Kosunen EL, KyhaOsterlund L, Lunnas T, Luostarinen T, Niemi L, Palmroth J, Petaja T, Rekonen S, Salmivesi S, SiitariMattlia M, Svartsjo S, 72 Tuomivaara L, Viikki M, Pukkala E, Paavonen J. Enrolment of 22,000 adolescent women to cancer registry follow up for long term human papillomavirus vaccine efficacy: guarding against guesses. International journal of STD and AIDS. 2006; 17:517–521. 10.1258/095646206778145550.

[51.] Leroy V, Ladner J, DeClercq A, Meheus A, Nyiraziraje M, Karita E, Dabis F: Cervical dysplasia and HIV type 1 infection in African pregnant women: a cross sectional study, Kigali, Rwanda. The Pregnancy and HIV Study Group (EGE). Sex Transm Infect 1999, 75:103106.

[52.] Lo B. HPV vaccine and adolescents' sexual activity. BMJ. 2006; 332:1106–1107. 10.1136/bmj.332.7550.1106.

[53.] Lowndes CM, Gill OM. Cervical cancer, human papilloma virus and vaccination. BMJ. 2005; 331:915–916: 10.1136/bmj.331.7522.915.

[54.] Lowndes CM. Editorial review: Vaccines for cervical cancer. Epidemiology Infect. 2006; 134:1–12. 10.1017/S0950268805005728.

[55.] Maggwa BN, Hunter DJ, Mbugua S, Tukei P, Mati JK: The relationship between HIV infection and cervical intraepithelial neoplasia among women attending two family planning clinics in Nairobi, Kenya. 16. AIDS 1993, 7:733738.

[56.] Mahlck CG, Jonsson H, Lenner P: Pap smears screening and changes in cervical cancer mortality in Sweden. Int J Gynaecol Obstet 1994, 44:267272.

[57.] Marlow LAV, Waller J, Wardle J. Parental attitudes to prepubertal HPV vaccination. Vaccine. 2007; 25:1945–1952. 10.1016/j.vaccine.2007.01.059.

[58.] Martin D. Health Reporter: Daily Mail. National Newspaper, UK. p. 11. Saturday May 5, 2007. [59.] Mati JK, Mbugua S, Wanderi P: Cervical cancer in Kenya: prospects for early detection at primary level. Int J Gynaecol Obstet 1994, 47:261267.

[60.] McIntyre P. Finding the viral link: the story of Harald Zur Hausen. Cancer World. 2005.

[61.] Megan E. Roberts, BA Meg Gerrard, PhD, Rachel Reimer, PhD, Frederick X. Gibbons MotherDaughter Communication and Human Papillomavirus Vaccine Uptake by College Students (Published online April 12, 2010PEDIATRICS (doi:10.1542/peds.2009 2888)

[62.] Merck, Merck to Create New Patient Assistance Program for Vaccines, May 26, 200663. Merck, Merck Vaccine Patient Assistance Program, September 2006. 73

[64.] Mirembe F: The changing pattern of carcinoma cervix in Uganda. In Proceedings of the Scientific Conference of the Association of Obstetricians of Uganda: International Conference Centre, Kampala, Uganda, 22–23 Jan., 1993. Association of Obstetrician and Gynecologists Uganda (AOGU); 1993:5461.

[65.] Mmiro FA: Gynecology and oncology in Africa. J Obstet Gynaecol E Centr Afr 1987, 6:6668.

[66.] Morris M, TortolleroLuna G, Malpica A, et al.: Cervical intraepithelial neoplasia and cervical cancer. Obstet Gynecol Clin North Am 1996, 23:347410.

[67.] National Vaccine Information Center, State Exemptions, June 2006. Ibid.Sprigg, P. July 15, 2006.

[68.] Noakes K, Yarwood J, Salisbury D. Parental response to the introduction of a vaccine against human papilloma virus. Hum Vaccin. 2006; 2:243–8.

[69.] Ogilvie GS, Remple VP, Marra F, McNeil SA, Naus M, Pielak KL, Ehlen TG, Dobson SR, Money DM, Patrick DM. Parental intention to have daughters receive the human papillomavirus vaccine. CMAJ. 177:1506–12. 2007 Dec 4.

[70.] Olamijulo J, Duncan ID: Is cervical cytology screening of teenagers worthwhile? BrGynaecol Obstet 1995, 102:515516.

[71.] Olshen E, Woods ER, Austin SB, Luskin M, Bauchner H. Parental acceptance of the human papillomavirus vaccine. Journal of Adolescent Health. 2005; 36:124. 10.1016/j.jadohealth.2004.11.062.

[72.] Parkin D. M. (2000) Personal Communication, IARC .Planning Appropriate Cervical Cancer Programs. 2nd Edition 2000 Program for Appropriate Technology in Health (PATH).

[73.] Parkin DM, Ferlay J, HamdiCherif M, Sitas F, Thomas JO, Wabinga H, Whelan SL: Cancer in Africa, epidemiology and prevention. In IARC Scientific Publication, No 153. IARC Press Lyon, France; 2003:167179. 268–275.

[74.] Peckham, Pinedo, Veronesi Oxford textbook of Oncology sections 8–20. Vol. 2. Oxford: Oxford University press; 1995.

[75.] Poland GA, Jacobson RM, Koutsky LA, Tamms GM, Railkar R, Smith JF, Bryan JT, Cavanaugh PF, Jansen KU, Barr E. Immunogenicity and reactogenicity of a novel vaccine for human papillomavirus 16: a 2year randomized controlled clinical trial. Mayo clinic proceedings. 2005;80:601–61074

[76.] Poland GA, Jacobson RM, Koutsky LA, Tamms GM, Railkar R, Smith JF, Bryan JT, Cavanaugh PF, Jansen KU, Barr E. Immunogenicity and reactogenicity of a novel vaccine for human papillomavirus 16: a 2year randomized controlled clinical trial. Mayo clinic proceedings. 2005; 80:601–610.

[77.] ProFamily, ProVaccine—But Keep It Voluntary, The Centers for Disease Control and Prevention, Vaccines for Children (VFC) Program, July 19, 2006.

[78.] Raley, J.C., K.A. Follow will, G.D. Zimet, et al. September–December 2004. Gynecologists' Attitudes Regarding Human Papilloma Virus Vaccination: A Survey of Fellows of the American College of Obstetricians

[79.] Riedese l JM, Rosenthal SL, Zimet GD, Bernstein DI, Huang B, Lan D, Kahn JA. Family physicians' attitudes about HPV vaccines. Journal of Adolescent Health. 2005; 36:124– 125. 10.1016/j.jadohealth.2004.11.063.

[80.] Rimal RN. Intergenerational transmission of health: the role of intrapersonal, interpersonal, and communicative factors. Health Education Behaviors 2003; 30:10–28.

[81.] Rose M. Official social classifications in the UK. Guildford: University of Surrey; 1998.

[82.] Ryder AG, Alden LE, Paulhus DL. Is acculturation onedimensional or bi dimensional? A headtohead comparison in the prediction of personality, selfidentity, and adjustment. J Pers Soc Psychol 2000; 79(1):49–65.

[83.] Southern African countries Bulletin of the World Health Organization 2001, 79:127132.

[84.] Steinbrook R. The Potential of Human Papilllomavirus Vaccines. NEJM. 2006; 354:1109– 1112. 10.1056/NEJMp058305.

[85.] The Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices (ACIP), June 2006.

[86.] The Centers for Disease Control and Prevention, HPV and HPV Vaccine – Information for Healthcare Providers, June 2006.

[87.] The Centers for Disease Control and Prevention, HPV Vaccine Questions and Answers, June 2006.

[88.] The Office of Minority Health, Eliminate Disparities in Cancer Screening & Management, June 30, 2006. The Centers for Disease Control and Prevention, CDC Press Briefing: ACIP Recommends HPV Vaccination, June 29, 2006.

[89.] Villa LL, Costa RL, Petta CA, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 viruslike particle vaccine in young women: a randomised 75 doubleblind placebocontrolled multicentre phase II efficacy trial. Lancet Oncol 2005; 6:271–8.

[90.] Waller Marlow L, Wardle J. Public awareness that HPV is a risk factor for cervical cancer. Br J Cancer. 2007; 97:691–94: 10.1038/sj.bjc.6603927.

[91.] Woodhall SC, Lehtinen M, Verho T, Huhtala H, Hokkanen M, Kosunen E. Anticipated Acceptance of HPV Vaccination at the Baseline of Implementation: A Survey of Parental and Adolescent Knowledge and Attitudes in Finland. Journal of Adolescent Health. 2007; 40:466–469. 10.1016/j.jadohealth.2007.01.005.

[92.] World Health Organization (WHO). Primary Prevention of Cervical Cancer. WHO, Geneva, October 3November 2, CAN/85.1 (1985).

[93.] World Health Organization, Comprehensive Cervical Cancer Control: A Guide to Essential Practice, 2006.

[94.] Zach S, Netz Y. Like mother like child: three generations’ patterns of exercise behavior. Fam Syst Health 2007; 25:419–34.

[95.] Zimet GD, Liddon N, Rosenthal SL, LazcanoPonce E, Allen B. Psychosocial aspects of vaccine acceptability. Vaccine. 2006;24: S201–209. 10.1016/j.vaccine.2006.06.017. 11. 2006 Canadian statistics [homepage on the Internet]. 2008. Available at: