title: HPV vaccine acceptability in Africa: a systematic review.
abstract: OBJECTIVE
  The objective of this study was to provide a systematic review of peer-reviewed literature on the factors associated with HPV vaccine acceptability among adults in African countries.
  
  
  METHODS
  A systematic search was conducted across five electronic databases: EMBASE, PsychINFO, CINAHL, Global Health and Ovid MEDLINE, to identify studies related to HPV vaccination acceptability in African countries (August 2013). The Health Belief Model was used to guide data abstraction and synthesis.
  
  
  RESULTS
  Fourteen unique studies representing ten sub-Saharan African countries were identified, with more than half published within the last two years. Acceptability of the HPV vaccine for daughters was high (range 59-100%); however, vaccine-related awareness and knowledge were low. Perceived barriers including accessibility and cost concerns were important for acceptance, as were cues to action from healthcare providers and governments.
  
  
  CONCLUSIONS
  This review suggests that acceptability of the HPV vaccine in countries in this region will be high. Broad knowledge gaps were highlighted regarding HPV and cervical cancer and these should be addressed. Education on the vaccine's effectiveness and reducing perceived barriers to vaccination would also be useful. Public endorsement by governments and healthcare providers will likely also increase acceptance.
authors.affiliation: Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Cunningham
authors.affiliation: Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada; Kingston General Hospital Research Centre, Kingston, Ontario, Canada.
authors.forename: Colleen
authors.initials: C
authors.lastname: Davison
authors.affiliation: Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada; Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada. Electronic address: aronson@queensu.ca.
authors.forename: Kristan J
authors.initials: KJ
authors.lastname: Aronson
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000517:prevention & control / Q000523:psychology*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology / Q000821:virology; D014626:Vaginal Smears / Q000523:psychology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Acceptability; Africa; Attitudes; Human papillomavirus; Review; Vaccination