Knowledge of cervical cancer and acceptability of prevention strategies among human papillomavirus-vaccinated and human papillomavirus-unvaccinated adolescent women in Eldoret, Kenya

Abstract

Cervical cancer is a critical public health concern in sub-Saharan Africa. Adolescents are key targets in primary prevention strategies. Following a human papillomavirus (HPV) vaccination initiative (Gardasil) in Eldoret,Kenya, the knowledge and source of information of cervical cancer and acceptance of prevention strategies among vaccinated and unvaccinated adolescents were evaluated. A cross-sectional comparative study enrolled60 vaccinated and 120 unvaccinated adolescent women. Institutional ethical approval was obtained and signed consent was obtained from the parents. Data collection was performed using interviewer-administered questionnaires derived from factual statements based on information from print material used for community sensitizationon cervical cancer. The median age of the participants was 14.0 years (interquartile range [IQR]=13.0–15.0). Of 60vaccinated adolescents, 56 (93.3%) had heard of the HPV vaccine compared with 6 (5%) of unvaccinated participants (p<0.001). Of 60 vaccinated participants, 58 (96.7%) had heard of cervical cancer compared with 61(50.8%) unvaccinated participants (p<0.001). Both cohorts identified the school as the main source of information for cervical cancer. The two groups also showed similarity in their selection of cervical cancer prevention strategies acceptable to them such as delaying sexual debut, limiting number of sexual partners, and use of condoms for protection against sexually transmitted infections. Of 120 unvaccinated participants, 63.7% expressed willingness to be vaccinated. Exposure to the HPV vaccine was associated with a higher knowledge of cervical cancer. The adolescents predominantly rely on the school for health