Knowledge and Attitude of the Human Papilloma Virus and Vaccine in School Going Adolescent Girls in Nairobi County, Kenya

Abstract

Introduction Cervical cancer is one of the most common cancers among females globally and is an outcome of persistent infection of the lower genital tract by Human Papilloma Virus (HPV). The HPV vaccine known to prevent cervical cancer is recommended by the Center of Diseases Control & Prevention (CDC) for both girls and boys. The Ministry of health rolled out the vaccine to 10 year old girls in 2019. Several studies have been done globally, regionally and locally on knowledge and attitude of HPV and vaccination amongst adolescents and their care givers with several misconceptions, beliefs and attitudes noted amongst them. Study Justification Adolescents being the primary target group for vaccination are a major group of stakeholders in the success of the immunization program that was recently rolled out in Kenya. Their opinion is important as HPV infection and cancer of cervix preventive measures uptake can be determined by their attitude. This study aimed to assess the level of knowledge and attitude of adolescent school girls on human papilloma virus infection and vaccine. Methodology This was a cross sectional mixed method study amongst 553 school going adolescent girls in selected public primary schools in Nairobi. Questionnaires were administered to the adolescent girls and focus group discussions held. The level of knowledge was reported in quantitative terms and attitudes described using qualitative methods. Results Majority of the girls 385 of 553 (69.6%) did not know what HPV was. Only 257 (46.6%) of 552 participants knew that HPV infection is prevented by HPV vaccination. About 60% of the participants had heard of HPV vaccine. School was the main source of information for 161(49.4%) of 326 participants while hospital and friends were the least with 31(9.5%) and 11(3.4%) respectively. More than half 296 (54.3%) of 545 girls associated HPV vaccine with

prevention of cervical cancer. Almost all the girls 528 (95.5%) had not received the vaccine citing lack of awareness in 324(63.2%) of 513 girls and lack of availability in 93(18.1%). Majority of the girls had a positive attitude towards the HPV vaccine as 342(61.8%) of 540 girls would encourage other girls to get vaccinated. The girls also believed that HPV causes cancer and if the vaccine would protect them they would get it. The main barrier for those who would not encourage others was lack of awareness in 109 (54.5%) of 198 girls and fear of harm in 78 (39.4%). Some of the barriers that came out in the discussions were misconceptions in the community and pain from the injection. Conclusion The level of knowledge about HPV and HPV vaccine was found to be generally low. They however had a positive attitude towards the vaccine. School was chosen to be the main source of information about HPV vaccine. The main barriers towards HPV vaccination were lack of awareness, availability, misconceptions, pain at the injection site and fear of adverse effects.