title: Ethnic differences in human papillomavirus awareness and vaccine acceptability.
abstract: BACKGROUND
  Studies of human papillomavirus (HPV) awareness and HPV vaccine acceptability have included few non-white participants, making it difficult to explore ethnic differences. This study assessed HPV awareness and HPV vaccine acceptability in a sample of women representing the major UK ethnic minority groups.
  
  
  METHODS
  A cross-sectional study design was used to assess awareness of HPV and acceptability of HPV vaccination. Participants were recruited using quota sampling to ensure adequate representation of ethnic minority women: Indian, Pakistani, Bangladeshi, Caribbean, African and Chinese women (n = 750). A comparison sample of white British women (n = 200) was also recruited.
  
  
  RESULTS
  Awareness of HPV was lower among ethnic minority women than among white women (6-18% vs 39% in white women), and this was not explained by generational status or language spoken at home. In a subsample who were mothers (n = 601), ethnicity and religion were strongly associated with acceptability of HPV vaccination. Acceptability was highest among white mothers (63%) and lowest among South Asians (11-25%). Those from non-Christian religions were also less accepting of the vaccine (17-34%). The most common barriers to giving HPV vaccination were a need for more information, sex-related concerns and concern about side-effects. South Asian women were the most likely to cite sex-related concerns, and were also least likely to believe the vaccine would offer their daughters protection.
  
  
  CONCLUSIONS
  These findings suggest some cultural barriers that could be addressed in tailored information aimed at ethnic minority groups. They also highlight the importance of recording ethnicity as part of HPV vaccine uptake data.
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London WC1E 6BT, UK. l.marlow@ucl.ac.uk
authors.forename: L A V
authors.initials: LA
authors.lastname: Marlow
authors.forename: J
authors.initials: J
authors.lastname: Wardle
authors.forename: A S
authors.initials: AS
authors.lastname: Forster
authors.forename: J
authors.initials: J
authors.lastname: Waller
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D001208:Asia / Q000208:ethnology; D002648:Child; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D006113:United Kingdom
chemical_list: D053918:Papillomavirus Vaccines