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      Aceptabilidad de la vacuna contra el Virus Papiloma Humano en padres de adolescentes, en Colombia Translated title: Human papillomavirus (HPV) vaccine acceptability amongst parents of adolescents in four Colombian areas

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          Abstract

          Objetivo La vacuna contra el VPH es una nueva tecnología disponible para el control del cáncer de cuello uterino. Se espera, que en el menor tiempo posible esta vacuna pueda tener cobertura universal. Este artículo presenta la aceptabilidad que tiene los padres de adolescentes en Colombia hacia la vacuna contra el VPH y hace una aproximación a sus determinantes. Métodos Estudio cualitativo en cuatro regiones en Colombia. Se realizaron 17 grupos focales con padres de niñas y niños entre 11 a 14 años estudiantes de colegios públicos y privado. Se realizó análisis de contenido por etapas: lectura abierta, codificación, análisis estructural e interpretación crítica. Se compararon los resultados por región. Resultados El 85 % de los convocados participaron. Los padres de colegios oficiales, estaban dispuestos a vacunar a su hija (o) s y harían un esfuerzo frente a los altos costos de la vacuna. Vacunar a la edad de 12 años para prevenir una infección de transmisión sexual, genera resistencia. Los padres de colegios privados fueron más críticos y expresaron una menor aceptabilidad. En dos regiones consideran que vacunar tiene el riesgo de promover la promiscuidad. Conclusiones La aceptabilidad a la vacuna varía en relación con el contexto sociocultural y educativo. Promover la vacuna para prevenir una infección de transmisión sexual en niñas muy jóvenes (<12 años) puede generar obstáculos para su aceptabilidad; se recomienda promoverla para prevención del cáncer de cuello uterino.

          Translated abstract

          Objective The recently licensed vaccine for preventing cervical cancer offers a fresh opportunity for cancer control; vaccination coverage is a major determinant in its effectiveness. This article presents perceived knowledge and acceptability by parents of adolescents in Colombia regarding the HPV vaccine. Methods A qualitative study was carried out in four areas of Colombia. 16 focus groups were conducted with parents selected from a sample of private and official schools;4 focus groups were run in each region according to gender. All groups were tape-recorded for further transcription and analysis. Content was analyzed via the following steps: reading, coding, structural analysis and critical appraisal. Results 85 % of parents so contacted participated. Parents from state schools were willing for their children to be vaccinated and make an effort to pay the high cost of such vaccine. Resistance is produced by vaccinating at age 12 to prevent sexually-transmitted infection. Private school parents were more critical and expressed lower acceptability. In two areas parents considered that vaccination involved the risk of promoting promiscuity. Conclusions Parents' acceptability of vaccination varied according to socio-cultural and educational context. Promoting vaccination for preventing a sexually-transmitted infection amongst the parents of very young girls (<12 years) can hamper their acceptability of it; it is thus recommended that it be promoted for preventing cervical cancer and that it should be aimed at a wider age-range for vaccination.

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            Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial.

            A randomised double-blind placebo-controlled phase II study was done to assess the efficacy of a prophylactic quadrivalent vaccine targeting the human papillomavirus (HPV) types associated with 70% of cervical cancers (types 16 and 18) and with 90% of genital warts (types 6 and 11). 277 young women (mean age 20.2 years [SD 1.7]) were randomly assigned to quadrivalent HPV (20 microg type 6, 40 microg type 11, 40 microg type 16, and 20 microg type 18) L1 virus-like-particle (VLP) vaccine and 275 (mean age 20.0 years [1.7]) to one of two placebo preparations at day 1, month 2, and month 6. For 36 months, participants underwent regular gynaecological examinations, cervicovaginal sampling for HPV DNA, testing for serum antibodies to HPV, and Pap testing. The primary endpoint was the combined incidence of infection with HPV 6, 11, 16, or 18, or cervical or external genital disease (ie, persistent HPV infection, HPV detection at the last recorded visit, cervical intraepithelial neoplasia, cervical cancer, or external genital lesions caused by the HPV types in the vaccine). Main analyses were done per protocol. Combined incidence of persistent infection or disease with HPV 6, 11, 16, or 18 fell by 90% (95% CI 71-97, p<0.0001) in those assigned vaccine compared with those assigned placebo. A vaccine targeting HPV types 6, 11, 16, 18 could substantially reduce the acquisition of infection and clinical disease caused by common HPV types.
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              Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis.

              To examine likelihood of parental acceptance of human papillomavirus (HPV) vaccination for young adolescent girls, together with reasons for acceptance and nonacceptance. The ultimate goal of this research is to inform policy decisions and educational planning in this area. A random-digit-dial telephone survey of parents in California households was conducted, yielding 522 parents with an eligible daughter. Cross tabulations and odds ratios were employed to analyze likelihood of vaccination acceptability. Reasons provided for acceptance or nonacceptance were analyzed qualitatively. Overall, 75% of the sample reported that they would be likely to vaccinate a daughter before age 13 years. Hispanic parents were more likely to accept vaccination than were non-Hispanic parents, whereas African-American and Asian-American parents were less likely. Other subgroups less likely to accept vaccination were identified. Five clusters of reasons by nonaccepting parents emerged: pragmatic concerns about effects on sexual behavior, specific HPV vaccine concerns, moral concerns about sexual behavior, general vaccine concerns, and denial of need. A sixth group of interest comprised those who would vaccinate before age 16 years, but not age 13. Consistent with previous studies on this topic, a large majority of California parents endorsed HPV vaccination for daughters by the recommended age. Although important subgroup disparities were found, majorities of all subgroups supported vaccination. This information, together with the identified clusters of cognitive decision factors for nonacceptance, has implications for policy decisions and educational planning in this area. Suggestions for further research on subgroup disparities and on cognitive factors involved in parents' decisions arise from these findings.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rsap
                Revista de Salud Pública
                Rev. salud pública
                Instituto de Salud Publica, Faculdad de Medicina -Universidad Nacional de Colombia (Bogotá )
                0124-0064
                December 2010
                : 12
                : 6
                : 961-973
                Affiliations
                [1 ] Instituto Nacional de Cancerología Colombia
                Article
                S0124-00642010000600008
                afa4fd1f-498f-47c3-becb-412bdb19772d

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Colombia

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=0124-0064&lng=en
                Categories
                Health Policy & Services

                Public health
                attitude,practice,uterine cervical neoplasm,Colombia,Vacunas contra el Virus Papiloma Humano,neoplasias del cuello uterino,prevención primaria,conocimientos,actitudes y práctica en salud,Papillomavirus vaccine,health knowledge

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