title: Cervical cancer and HPV: Awareness and vaccine acceptability among parents in Morocco.
abstract: Cervical cancer is a major public health concern in Morocco where it represents the second most common and lethal cancer in women. Human papillomavirus (HPV) vaccines have been licensed in Morocco since 2008 but there are no available data on their acceptability. This study aimed to assess awareness of HPV and the vaccine, and to identify factors associated with acceptability of the vaccine among parents in Morocco. We carried out a questionnaire-based survey using face-to-face interviews in a sample of 852 parents (670 mothers and 182 fathers) with at least one unmarried daughter ≤26 years. We collected data within public and private health centres and clinics in four regions in Morocco between July and August 2012. The main outcome measure was parental acceptability of the HPV vaccine for their daughter(s). Responses revealed very low awareness of HPV infection (4.7%) and the HPV vaccine (14.3%). None of the participants had vaccinated their daughter(s) against HPV and vaccine acceptability was low among mothers (32%) and fathers (45%). Higher education and income, previous awareness of the HPV vaccine and endorsement of the belief that a recommendation from the Ministry of Health or a doctor to have the vaccine would be encouraging, were associated with mothers' HPV vaccine acceptability. Non-acceptability among mothers was associated with having more than two daughters, believing the vaccine was expensive, lack of information and believing that whatever happens to an individual's health is God's will. The only factor associated with the fathers' acceptability of the vaccine was the cost of the vaccine. Increasing HPV and HPV vaccine awareness through educational campaigns, along with active recommendation by physicians and a publically funded vaccination programme could increase parental acceptability of the HPV vaccine in Morocco.
authors.affiliation: Laboratory of Virology, Microbiology and Quality/ETB, Faculty of Sciences and Technics, University Hassan II Mohammedia, Morocco; University of Liège, Laboratory of Experimental Pathology, GIGA Cancer, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Mouallif
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Research Department of Epidemiology and Public Health, UCL, Gower Street, London WC1E 6BT, United Kingdom.
authors.forename: Harriet L
authors.initials: HL
authors.lastname: Bowyer
authors.affiliation: Laboratory of Virology, Microbiology and Quality/ETB, Faculty of Sciences and Technics, University Hassan II Mohammedia, Morocco.
authors.forename: Soukaina
authors.initials: S
authors.lastname: Festali
authors.affiliation: University of Liège, Department of Biostatistics, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Adelin
authors.initials: A
authors.lastname: Albert
authors.affiliation: Department of Biology, Faculty of Sciences and Technics, University Moulay Ismaïl, Errachidia, Morocco.
authors.forename: Younes
authors.initials: Y
authors.lastname: Filali-Zegzouti
authors.affiliation: University of Liège, Laboratory of Experimental Pathology, GIGA Cancer, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Samuel
authors.initials: S
authors.lastname: Guenin
authors.affiliation: University of Liège, Laboratory of Experimental Pathology, GIGA Cancer, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Delvenne
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Research Department of Epidemiology and Public Health, UCL, Gower Street, London WC1E 6BT, United Kingdom.
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
authors.affiliation: Laboratory of Virology, Microbiology and Quality/ETB, Faculty of Sciences and Technics, University Hassan II Mohammedia, Morocco. Electronic address: m.ennaji@yahoo.fr.
authors.forename: Moulay Mustapha
authors.initials: MM
authors.lastname: Ennaji
mesh_terms: D000328:Adult; D000368:Aged; D001364:Awareness; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009018:Morocco; D030361:Papillomavirus Infections / Q000150:complications* / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D010290:Parents; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014611:Vaccination / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Acceptability; Awareness; Cervical cancer; HPV vaccination; Parents; Predictors