title: Protecting our Khmer daughters: ghosts of the past, uncertain futures, and the human papillomavirus vaccine.
abstract: OBJECTIVE
  The FDA approved the first human papillomavirus (HPV) vaccine in 2006. Research into parental decision-making and concerns about HPV vaccination highlights questions about parenting and parents' role in the crafting of their daughters' future sexuality. In contrast to much of this literature, we explore narratives from interviews with Cambodian mothers of HPV vaccine-age eligible daughters who experienced genocide and came to the USA as refugees.
  
  
  METHODS
  We conducted in-depth, in-person interviews with 25 Cambodian mothers of HPV vaccine-age eligible daughters. Interviews were conducted in Khmer and translated into English for analysis. We followed standard qualitative analysis techniques including iterative data review, multiple coders, and 'member checking.' Five members of the research team reviewed all transcripts and two members independently coded each transcript for concepts and themes.
  
  
  RESULTS
  Interview narratives highlight the presence of the past alongside desires for protection from uncertain futures. We turn to Quesada and colleagues' concept structural vulnerability to outline the constraints posed by these women's positionalities as genocide survivors when faced with making decisions in an area with which they have little direct knowledge or background: cervical cancer prevention.
  
  
  CONCLUSIONS
  Our study sheds light on the prioritization of various protective health practices, including but not exclusive to HPV vaccination, for Khmer mothers, as well as the rationalities informing decision-making regarding their daughters' health.
authors.affiliation: a Department of Anthropology, History, and Social Medicine , University of California , San Francisco , CA , USA.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Burke
authors.forename: Huyen H
authors.initials: HH
authors.lastname: Do
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Talbot
authors.forename: Channdara
authors.initials: C
authors.lastname: Sos
authors.forename: Srey
authors.initials: S
authors.lastname: Ros
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D002160:Cambodia / Q000208:ethnology; D002648:Child; D005260:Female; D005544:Forecasting; D063365:Genocide / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D030361:Papillomavirus Infections / Q000208:ethnology / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control; D014861:Washington / Q000453:epidemiology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cambodian immigrants; HPV; cervical cancer; uncertainty