·        Review this week’s media presentation, as well as Chapter 1 of the Schuiling and Likis text.

·        Select and research one of the following women’s health issues: birth control, abortion, family planning, human papillomavirus (HPV) vaccine, human immunodeficiency virus (HIV) in women, or another issue approved by the course Instructor.

·        Consider the impact of political, social, and sociocultural factors on the women’s health issue you selected.

·        Reflect on how the personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.

Discussion 1: Women’s health and Health Promotion

HPV is the most common sexually transmitted infection (STI) in America, infecting over six million people each year (Schuiling & Likis, 2017).  The purpose of this discussion is to discuss the women’s health issue, HPV vaccinations.  The impact of political, social, and sociocultural factors will also be explained.  A detailed explanation of how personal perceptions of providers might influence the willingness or ability to provide care to patients in relation to the HPV vaccine.

Human Papillomavirus Vaccine

HPVs are a group of more than 200 viruses which encompass over forty types that are directly spread via sexual contact, through the skin, or mucous membranes.  HPVs are categorized into two categories, low-risk and high-risk.  Examples of low-risk HPV types are 6 and 9, and are noncancer-causing viruses; however, they do cause genital and anal warts.  High-risk HPV types are 16 and 18, and they can cause cervical, anal, oropharyngeal, vaginal, or penile cancers (National Cancer Institute, 2015).

The HPV vaccine was developed in 2006 as a preventative measure to decrease the incidence of HPV, genital warts, and anal dysplasia (Islam et al., 2018).  There are three types of vaccines, bivalent, quadrivalent, and 9-valent, and all protect against strains 16 and 18 (Schuiling & Likis, 2017).  These vaccines have a high efficacy rate, show a high degree of clinical effectiveness, and are cost-effective among adolescent males and females (Islam et al., 2018).  The targeted age for these vaccines are adolescents that are 11 and 12 years old, but it can be given as early as 9 years old and up to the age of 26.  It is also recommended for ones that have a preexisting HPV infection to protect against other strains (Schuiling & Likis, 2017),

 The Impact of Political, Social, and Sociocultural Factors on this Issue

            There are many factors that come into play with HPV vaccines.  Despite the desired vaccination rates, the United States remains at a suboptimal rate for vaccination uptake rates.  First, is the political factor regarding the mandation of HPV vaccinations.  When the HPV vaccine was introduced many states lobbied for legislation for the mandation; however, it created much controversy.  A study showed that when political parties shared controversy towards the HPV vaccines through the news media, there were negative consequences against the vaccine.  Furthermore, this study states that liberals and conservatives were more aware of the vaccine and its benefits compared to moderates (Gollust, Attanasio, Dempsey, Benson, & Fowler, 2013).

There are social and psychological factors that influence HPV vaccine uptake.  These factors are influenced by ones’ beliefs, attitudes, and perceptions.  A highly studied reason why adolescents are not getting vaccinated against HPV is parental acceptance.  The HPV vaccine administration rate is significantly lower at 39% compared to than other routine vaccines such as Tdap and meningococcal conjugate.  It has been studied that most parents refuse the vaccine due to lack of education (Islam et al., 2018).

Sociocultural factors are another issue that affects uptake rate of the HPV vaccine.  It is noted that HPV vaccine awareness is higher among those in a higher socioeconomic class as compared to their counterparts (Gollust et al., 2013).  In a rural area of Kentucky, it is documented that there are barriers for females such as lack of transportation, constrained budget, and living in areas that are hard to reach a clinic to follow up with subsequent vaccines (Mills, Head, & Vanderpool, 2013).  Areas of the United States with prominent levels of poverty have a higher incidence of HPV-associated cancers.  There are also racial/ethnic disparities that are documented with higher rates of HPV-associated cancers.  African American women are less likely to initiate the HPV vaccine and compete the series when compared to their counterparts (Okafor, Hu, & Cook, 2015).

Personal Perceptions of Providers

Provider recommendations and personal perceptions and attitudes are key factors in HPV vaccine uptake.  Prior research has documented providers’ personal perceptions drive recommendation for the vaccines.  Examples of reasons that can impede vaccination rates in relations to providers are some providers believe that there are potential side effects since the vaccine is relatively new, and they are reluctant to give multiple vaccines on the same day.  Some providers also believe that HPV is not a significant health issue, that cervical cancer can be prevented with Pap tests, they find it difficult to have the conversation with parents, and they forget to offer it since it is not a mandated vaccine (Perkins & Clark, 2013).

In conclusion, HPV is a preventable STI that can be prevented with the proper education, screening, and vaccines.  There are political, social, and sociocultural factors that impede HPV vaccination rates in the United States.  Providers are in a position to offer and provide education on this vaccine without pondering upon their perceptions and attitudes.  It is of the utmost importance that all providers educate and offer vaccines and treatment for this treatable disease by using the most up-to-date evidence-based practice and by providing the proper education without allowing their own personal perceptions impede the process.

References

Gollust, S. E., Attanasio, L., Dempsey, A., Benson, A. M., & Fowler, E. F. (2013). Political and news media factors shaping public awareness of the HPV vaccine. Women’s Health Issues: Official Publication of The Jacobs Institute of Women’s Health, 23(3), e143-e151. doi:10.1016/j.whi.2013.02.001

Islam, J. Y., Khatun, F., Alam, A., Sultana, F., Bhuiyan, A., Alam, N., & … Nahar, Q. (2018). Knowledge of cervical cancer and HPV vaccine in Bangladeshi women: A population based, cross-sectional study. BMC Women’s Health, 18, 1-13. doi:10.1186/s12905-018-0510-7

Mills, L. A., Head, K. J., & Vanderpool, R. C. (2013). HPV vaccination among young adult women: A perspective from Appalachian Kentucky. Preventing Chronic Disease, 10, 2-8. Retrieved from https://www.cdc.gov/pcd/issues/2013/pdf/12_0183.pdf

National Cancer Institute. (2015). HPV and cancer. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet

Okafor, C., Hu, X., & Cook, R. L. (2015). Racial/ethnic disparities in HPV vaccine uptake among a sample of college women. Journal of Racial and Ethic disparities, 2, 311-312. Retrieved from https://link.springer.com/content/pdf/10.1007%2Fs40615-014-0074-7.pdf

Perkins, R. B., & Clark, J. A. (2013). What affects human papillomavirus vaccination rates? A qualitative analysis of providers’ perceptions. Women’s Health Issues: Official Publication of The Jacobs Institute of Women’s Health, 22(4), e379-e386. doi:10.1016/j.whi.2012.04.001

Schuiling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3^rd ed.). Burlington,

MA: Jones and Bartlett Publishers.