In the Name of Prevention: Maternal Perspectives on School-Based HPV Vaccination in Rural Southern Chile

Abstract

Purpose

Since the introduction of the HPV vaccine in Chile in 2014, there have been few studies exploring community perspectives on the vaccine, specifically of parents of adolescents. This study sought to identify maternal factors and family dynamics that affect HPV vaccination behavior.

Participants and Methods

Participants were recruited at an OB/GYN clinic in Linares, Chile. Participation was voluntary, and eligibility required 1) having an adolescent daughter between 9 and19 years-old and 2) demonstrating a willingness to discuss HPV-related topics. Thirty semi-structured interviews were conducted to generate qualitative data analyzed using Grounded Theory methodology.

Results

Three thematic constructs emerged from the interviews. Mothers’ motivations to vaccinate centered on disease prevention and trust in the medical system but were influenced by notions of sexual liberalism and promiscuity. Second, participants desired, but often had trouble finding, adequate information about vaccine safety and turned to the internet. Third, joint decision making in the family about vaccination led to open family discussions about sex and sexuality.

Conclusion

Chile’s school-based opt-out HPV vaccination program engenders a unique landscape of maternal decision-making, risk-benefit analysis, information-seeking, and at-home discussion. More studies are needed around the variable role of fathers in the decision-making process.

Keywords:

• Latin America
• reproductive health
• preventative care
• adolescents

Data Sharing Statement

Data are available from the corresponding author upon reasonable request.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Declaration of Helsinki and its later amendments or comparable ethical standards. Albert Einstein College of Medicine IRB Approval #2018-8782; Local Chilean Health Committee of Science and Ethics Approval documents available upon request.

Informed Consent

Informed consent was obtained from all participants in the study and included publication of anonymized responses.

Acknowledgments

This study was a collaboration between Albert Einstein College of Medicine (Bronx, NY, USA) and Universidad Autonoma de Chile (Linares, Region de Maule, CL). First, we thank Ms. Jill Raufman and Dr. Louis Weiss at the Global Health Department for helping make travel for students possible. Second, we thank the study participants and the providers and staff at the OB/GYN clinic for their participation and help in making our study possible. Third, we thank Valeria Quetada Hernandez and Sebastian Cancino Meier, students from Universidad Autonoma de Chile who helped review our transcriptions and Dra. Encarnacion Garcia, Dra. Ivonne Moreno, Dra. Mariely Ramos, Dra Racelmy Torres, and Sra. Sandra Ixia Rodriguez Guerrero, and Sra. Viviana Jara who consulted and supported us during analysis.

Disclosure

The authors reported no conflicts of interest for this work.

Additional information

Funding

Medical student researchers have received travel funding for conduction of interviews in Chile from Kuperman International Health Endowment Fund at Albert Einstein College of Medicine.