title: Factors related to non-compliance to HPV vaccination in Roraima-Brazil: a region with a high incidence of cervical cancer.
abstract: To evaluate the HPV vaccination coverage in Boa Vista, Roraima (Brazil) and to identify personal and socioeconomic factors related to non-compliance to HPV vaccination.
  
  
  
  A school-based, cross-sectional study was conducted by distributing a self-administered questionnaire to the parents or guardians of pre-adolescent girls. The questionnaire addressed compliance to, knowledge about and perception of HPV and the HPV vaccine. Between July and November 2015, 13 private and public schools were visited based on a random cluster sampling method.
  
  
  
  A total of 1337 questionnaires were distributed to all female students in the target age group, and 797 were completed and returned (the participation rate was 59.6 %). The vaccination coverage rate was 82.7 % and was higher among public school students than among private school students (84.1 % vs 56.3 %; p = 0.003). Most parents (60 %) incorrectly answered more than half of the questions related to HPV knowledge, and limited knowledge about HPV and the HPV vaccine correlated with lower compliance to vaccination (adjusted OR = 1.42; 95 % CI: 1.01 to 2.76). In the perception analysis, the belief that the HPV vaccine is important for the daughter was an important protective factor (adjusted OR = 0.62; 95 % CI: 0.23 to 0.93), and concern about adverse effects of the HPV vaccine was a risk factor for non-compliance (adjusted OR = 1.66; 95 % CI: 1.01 to 2.71). Family income, religion and education level of the parents or guardians did not correlate with compliance to vaccination.
  
  
  
  HPV vaccination coverage was high in Boa Vista, Brazil, but knowledge about the vaccine was deficient. This deficiency was associated with a distorted perception and was negatively associated with compliance to vaccination. Actions aimed at informing the public about the HPV vaccine, including its risks and benefits, are needed to attain higher vaccination coverage in Brazil.
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Cibelle Carneiro
authors.initials: CC
authors.lastname: Farias
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Dkaion Vilela
authors.initials: DV
authors.lastname: Jesus
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Hendel Santana
authors.initials: HS
authors.lastname: Moraes
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Ingrid Ferreira
authors.initials: IF
authors.lastname: Buttenbender
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Isabella Seixas
authors.initials: IS
authors.lastname: Martins
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Mayara Gabrielle
authors.initials: MG
authors.lastname: Souto
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Paulo Henrique Brasil Hass
authors.initials: PH
authors.lastname: Gonçalves Filho
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Randielly Mendonça
authors.initials: RM
authors.lastname: Costa
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Sarah de Oliveira
authors.initials: Sde O
authors.lastname: Silva
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Thais Suelen Israel
authors.initials: TS
authors.lastname: Ferreira
authors.affiliation: Medical student of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Valéria Vieira da Silva
authors.initials: VV
authors.lastname: Coutinho
authors.affiliation: Professor of Health Science of Universidade Federal de Roraima, Boa Vista, Brazil.
authors.forename: Helvia Rochelle Tavora
authors.initials: HR
authors.lastname: Minotto
authors.affiliation: Professor of Health Science of Universidade Federal de Roraima, Boa Vista, Brazil. allex.j.fonseca@gmail.com.|Department of Research on Health Science, Universidade Federal de Roraima, Boa Vista, Brazil. allex.j.fonseca@gmail.com.|Centro de Ciência da Saúde, UFRR. Secretaria do Curso de Medicina, Campus de Paricarana, s/n. Universidade Federal de Roraima, CEP: 69-307.000, Boa Visa, Roraima, Brazil. allex.j.fonseca@gmail.com.
authors.forename: Allex Jardim
authors.initials: AJ
authors.lastname: Fonseca
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D010290:Parents / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cervical cancer; Papillomavirus; Vaccine; Vaccine coverage