Factors Associated with the Human Papillomavirus Vaccine Coverage in Gulu District, Uganda

Figures & data

Table 1 Socio-Demographic Characteristics

Characteristics	Measures	Frequency (N=197)	Percentage (%)
Age (years), Mean +SD	11+ 1.36
Education of participants	Primary 4	54	27.4
	Primary 5	71	36.0
	Primary 6	49	24.9
	Primary 7	23	11.7
Tribes of participants	Acholi	176	89.3
	Non-Acholi	21	10.7
Religion	Catholic	115	58.4
	Moslem	18	9.2
	Anglican	59	29.9
	Other religion	5	2.5
Parish	Tegwana	42	21.4
	Vanguard	32	16.2
	Agwee	41	20.8
	Iriaga	27	13.7
	Queens avenue	55	27.9

Figure 1 Care-takers of the girls.

Figure 2 HPV utilization level.

Table 2 HPV Utilization by Socio-Demographic Factors

Characteristics		Ever Received HPV Vaccine?		Total
		Yes n (%)	No n (%)
Education of participants	Primary 4	22(40.7%)	32(59.3%)	54
	Primary 5	21(29.6%)	50(70.4%)	71
	Primary 6	16(32.7%)	33(67.3%)	49
	Primary 7	9(39.1%)	14(60.9%)	23
Religion	Catholic	40(34.8%)	75(65.2%)	115
	Moslem	7(38.9%)	11(61.1%)	18
	Anglican	17(28.8%)	42(71.2%)	59
	Other religion	4(80.0%)	1(20.0%)	5
Parish	Tegwana	3(7.1%)	39(92.9%)	42
	Vanguard	12(37.5%)	20(62.5%)	32
	Agwee	11(26.8%)	30(73.2%)	41
	Iriaga	7(25.9%)	20(74.1%)	27
	Queens avenue	35(63.6%)	20(36.4%)	55
Child’s care taker	Both parents	50(35.5%)	91(64.5%)	141
	Single parent	17(34.7%)	32(65.3%)	49
	Guardian	1(14.3%)	6(85.7%)	7

Table 3 Bivariate Analysis of Knowledge Factors

Characteristics	Response	Ever Received HPV vaccine		OR (95% CI)	P-value
		Yes n (%)	No n (%)
Understanding of HPV	Virus causing other cancers	7(18.4%)	31(81.6%)	1.0
	Virus causing cancer of cervix	28(37.3%)	47(62.7%)	0.770(0.264–2.249)	0.634
	Virus that does not cause disease	4(36.4%)	7(63.6%)	0.233(0.037–0.640)	0.101
	I do not know	29(39.7%)	44(60.3%)	0.487(0.116–2.039)	0.325
How is HPV prevented	Avoid early sex	7(17.1%)	34(82.9%)	1.0
	Vaccination with HPV vaccine	28(44.4%)	35(55.6%)	0.320(0.112–0.914)	0.033
	Treatment	5(20.0%)	20(80.0%)	0.770(0.171–3.463)	0.734
	I do not know	28(41.2%)	40(58.8%)	0.324(0.057–2.049)	0.240
Who can get HPV Vaccine?	Preadolescent	31(44.9%)	38(55.1%)	1.0
	Married women	8(22.2%)	28(77.8%)	0.065(0.022–1.574)	0.350
	Elderly women	4(12.9%)	27(87.1%)	1.023(1.606–12.67)	0.561
	I do not know	25(41.0%)	36(59.0%)	0.325(0.459–11.76)	0.307
Importance of HPV vaccine	Reduces risk of cervical cancer	34(37.8%)	56(62.2%)	1.0
	Prevents other cancers	8(23.5%)	26(76.5%)	1.344(0.415–4.343)	0.621
	Reduces health care cost	0(0.0%)	7(100.0%)	0.75(0.123–0.983)	0.323
	I do not know	26(39.4%)	40(60.6%)	0.458(0.334–0.960)	0.021
HPV vaccine doses given?	One	21(28.4%)	53(71.6%)	1.0
	Two	19(39.6%)	29(60.4%)	0.423(0.173–0.733)	0.059
	Three	6(20.7%)	23(79.3%)	0.535(0.143–1.998)	0.352
	I do not know	22(47.8%)	24(52.2%)	0.677(0.093–0.826)	0.321

Table 4 Bivariate Analysis of Mobilization Factors

Characteristics	Response	Ever Received HPV Vaccine		OR (95% CI)	P-value
		Yes	No
Do they mobilize for HPV vaccine?	Yes	54(31.6%)	117(68.4%)	1.0
	No	14(53.8%)	12(46.2%)	0.443(0.023–0.923)	0.012
Who does mobilization?	VHT	25(36.2%)	44(63.8%)	1.0
	Church leaders	8(25.0%)	24(75.0%)	1.626(0.605–4.372)	0.335
	Teachers	19(30.2%)	44(69.8%)	1.082(0.487–2.4040	0.846
	I do not know	2(28.6%)	5(71.4%)	1.309(0.218–7.853)	0.768
When do they mobilize?	The day of vaccination	25(46.3%)	29(53.7%)	1.0
	A day before vaccination	17(25.4%)	50(74.6%)	2.528(1.145–5.580)	0.022
	A week earlier	10(23.8%)	32(76.2%)	3.153(1.203–8.263)	0.019
	A month before vaccination	2(25.0%)	6(75.0%)	1.422(0.575–2.369)	0.168
How long does it take to get vaccinated	Less than 30 minutes	25(33.8%)	49(66.2%)	1.0
	Between 30 mins to 1 hour	21(28.4%)	53(71.6%)	0.379(0.288–0.684)	0.201
	More than 1 hour	15(42.9%)	20(57.1%)	0.772(0.273–2.178)	0.625
	I do not know	7(50.0%)	7(50.0%)	0.407(0.074–2.233)	0.301

Table 5 Bivariate Analysis of Distance Factors

Characteristics		Ever Received HPV vaccine		OR (95% CI)	P-value
		Yes n (%)	No n (%)
Distance from home to vaccination location	Less than 1 km	32(31.4%)	70(68.6%)	1.0
	1 km	17(34.7%)	32(65.3%)	0.790(0.348–1.793)	0.573
	More than 1km	12(41.4%)	17(58.6%)	0.718(0.261–1.976)	0.522
	I do not know	7(41.2%)	10(58.8%)	0.665(0.216–2.052)	0.471
What transport means do you use	Walking	42(33.9%)	82(66.1%)	1.0
	Bicycle	18(32.1%)	38(67.9%)	1.228(0.565–2.669)	0.604
	Motor cycle	6(54.5%)	5(45.5%)	0.546(0.131–2.267)	0.405
	Vehicle	2(33.3%)	4(66.7%)	1.288(0.204–8.110)	0.787

Table 6 Multivariable Analysis of Factors Associated with Utilization of HPV Vaccine

Characteristics		AOR	(95% CI)	P-value
Understanding of HPV	Virus causing other cancers	1.0
	Virus causing cancer of cervix	0.373	(0.128–1.085)	0.075
	Virus that does not cause disease	0.284	(0.055–1.458)	0.132
	I do not know	0.580	(0.127–0.189)	0.048
How is HPV prevented	Avoid early sex	1.0
	Vaccination with HPV vaccine	1.227	(1.077–4.669)	0.007
	Treatment	0.694	(0.153–3.137)	0.635
	I do not know	0.578	(0.127–2.643)	0.489
The importance of HPV vaccine	Reduces risk of cervical cancer	1.0
	Prevents other cancers	1.231	(0.415–8.423)	0.721
	Reduces health care cost	0.56	(0.123–2.163)	0.483
	I do not know	0.571	(0.290–0.899)	0.039
Time of mobilization	The day of vaccination	1.0
	A day before vaccination	4.534	(1.802–11.40)	0.001
	A week earlier	4.431	(1.472–12.62)	0.008
	A month before vaccination	0.123	(0.627–28.87)	0.138
How long does it take to get vaccinated	Less than 30 minutes	1.0
	Between 30 mins to 1 hour	0.521	(0.154–0.906)	0.047
	More than 1 hour	0.062	(0.202–1.906)	0.405
	I do not know	0.212	(0.033–1.343)	0.100

Table 7 Participants’ Perceptions of Factors Relating to Attitude That are Associated with HPV Vaccine Utilization

Participants’ Perceptions of Factors Associated with HPV Vaccine Utilization	Agree n (%)	No Idea n (%)	Disagree n (%)
I have received information on HPV vaccine	190 (96.4)	5 (2.5)	2 (1.0)
Do you think HPV vaccine is safe?	193 (98)	3 (1.5)	1 (0.5)
HPV Vaccine is not against my religious beliefs	172(87.3)	23(11.7)	2(1.0)
I am willing to be vaccinated provided the vaccine is provided	186 (94.4)	9(4.6)	2(1.0)
Do you think there is any cost you incur in order to utilize the HPV vaccine?	39(19.8)	91(46.2)	67(33)