AN EVALUATION OF NIGERIAN PARENTS’ KNOWLEDGE, ATTITUDES, AND PRACTICES CONCERNING HPV VACCINATION

CHAPTER ONE INTRODUCTION 1.1 Background of the Study The prevalence of Human Papillomavirus (HPV), a globally significant viral infection, differs significantly across regions. Sub-Saharan Africa remains particularly vulnerable, with HPV posing a major public health threat (Newman et al., 2018). Most HPV infections are contracted shortly after individuals become sexually active, as the virus is predominantly transmitted through sexual contact. Global studies reveal that approximately 75% of sexually active individuals contract HPV at some point in their lives (Newman et al., 2018). In numerous developing countries, women—especially those of reproductive age—face numerous health and societal challenges. In Nigeria, about 73% of males and 23.7% of females acquire genital HPV infections within the first three years of initiating sexual activity. According to Brewer and Fazekas (2017), HPV infection is widespread among young women aged 16 to 22. HPV infections are often transient, dormant, and go undetected for extended periods due to immune responses. Nevertheless, persistent high-risk HPV infections have consistently been linked to the emergence of precancerous lesions, eventually leading to cervical cancer (CC). One of the primary barriers to HPV vaccination is a lack of parental knowledge and awareness about HPV and its associated health risks. Research suggests that many parents are unaware that HPV can lead to cancer and that vaccination can serve as a preventive measure (Brewer & Fazekas, 2017). Additionally, persistent misinformation and myths surrounding the vaccine’s safety and efficacy further contribute to vaccine hesitancy (Gottvall et al., 2015). Various factors such as cultural and religious beliefs, fear of side effects, and distrust in the healthcare system can influence parents’ attitudes toward HPV vaccination (Newman et al., 2018). Studies have shown that such attitudes often arise from limited knowledge or inaccurate perceptions regarding the long-term benefits of the vaccine (Reiter et al., 2019). Healthcare providers play a crucial role in shaping parents’ views and behaviors regarding HPV vaccination. Evidence suggests that strong, clear recommendations from healthcare professionals significantly increase the likelihood that parents will vaccinate their children (Gilkey et al., 2016). Conversely, when healthcare professionals fail to effectively communicate the importance of the vaccine or address specific parental concerns, it can lead to missed opportunities for vaccination (Holman et al., 2015). This highlights the importance of using strategic communication and equipping healthcare providers with the necessary training to address parental worries and advocate for the vaccine. Furthermore, demographic factors such as socioeconomic status, cultural background, and educational attainment play a significant role in shaping parental awareness, attitudes, and behaviors toward HPV vaccination. Research indicates that parents with higher education levels and better access to healthcare services are more inclined to vaccinate their children against HPV (Newman et al., 2018). Conversely, parents from disadvantaged or marginalized groups may face additional challenges such as limited access to health facilities, language barriers, and a lack of educational resources about HPV and the vaccine (Gilkey et al., 2016). Given these complexities, it is essential to evaluate parental knowledge, attitudes, and practices (KAP) concerning HPV vaccination in Nigeria to help bridge the gap in vaccine coverage. 1.2 Statement of the Problem HPV is a major public health concern, having been associated with various cancers including cervical, anal, and oropharyngeal cancers. Vaccination against HPV, particularly before individuals are exposed to the virus, has been proven effective in significantly reducing infection rates and related health complications (Centers for Disease Control and Prevention [CDC], 2021). Despite the availability and proven efficacy of the HPV vaccine, vaccination rates remain suboptimal in numerous regions. This is largely attributed to parents' knowledge, attitudes, and practices (KAP) regarding the vaccine (Holman et al., 2015). Parental involvement is crucial since they make most healthcare decisions for their children, especially concerning vaccinations administered during pre-adolescence and adolescence. Studies show that many parents hesitate to vaccinate their children due to a lack of understanding about HPV and the vaccine's benefits, as well as misinformation (Brewer & Fazekas, 2017). This hesitancy often stems from unawareness about the long-term health benefits of the vaccine (Gottvall et al., 2015). Additionally, cultural norms, concerns over vaccine safety, and false information further influence parental decisions (Newman et al., 2018). To counter these challenges, it is essential to deeply understand the knowledge, attitudes, and practices of parents regarding HPV vaccination. This understanding can inform the creation of targeted educational interventions that directly address existing misconceptions and information gaps. Consequently, this study aims to assess the knowledge, attitudes, and practices (KAP) regarding HPV vaccination among Nigerian parents. 1.3 Objective of the Study The main objective of this study is to evaluate the knowledge, attitudes, and practices (KAP) related to HPV vaccination among Nigerian parents. Specifically, the study seeks to: i. Assess the level of parental knowledge about HPV and the associated health risks. ii. Examine parents' understanding of the benefits of HPV vaccination in Nigeria. iii. Analyze parental attitudes toward vaccinating their children against HPV. iv. Offer recommendations to improve parental knowledge and foster positive attitudes toward HPV vaccination. 1.4 Research Questions To guide the research, the following questions have been formulated: i. What is the level of knowledge among parents regarding HPV and its associated health risks? ii. How well do parents understand the benefits of the HPV vaccine in Nigeria? iii. What are parents’ attitudes toward HPV vaccination for their children? iv. What strategies can be recommended to enhance parental knowledge and attitudes about HPV vaccination? 1.5 Significance of the Study The insights gained from this research can enable healthcare professionals to effectively address specific misconceptions and cultural beliefs that hinder the acceptance of the HPV vaccine among parents. By identifying common sources of parental information, the study can help guide the development of customized educational content and outreach initiatives that clearly communicate accurate and persuasive messages about HPV and the importance of vaccination. Moreover, the study holds academic relevance as it will contribute to existing scholarly literature, expand library resources, and serve as a valuable reference for future researchers in the field. 1.6 Scope of the Study This study focuses on evaluating the knowledge, attitudes, and practices (KAP) concerning HPV vaccination among Nigerian parents. Empirically, the study will explore parents’ knowledge of HPV and its related health risks, examine their understanding of the vaccine's benefits, analyze their attitudes toward vaccinating their children, and propose practical recommendations for increasing awareness and positive perception of HPV vaccination. Geographically, the research is confined to Agwara Local Government Area (LGA) in Niger State. 1.7 Limitations of the Study As with most academic endeavors, this study encountered a few constraints. These include: Time Constraints: The researcher had to balance the research process with other academic responsibilities, such as attending lectures and completing coursework. Financial Limitations: Considerable financial resources were needed for typesetting, printing, sourcing relevant literature, and collecting data. Material Availability: Locating adequate literature and relevant information posed a challenge due to limited available resources on the specific topic under study. 1.8 Definition of Terms Human Papillomavirus (HPV): A group of over 200 related viruses, some of which are known to cause cancers like cervical, anal, and oropharyngeal cancer. It is primarily transmitted through sexual activity (Centers for Disease Control and Prevention, 2021). HPV Vaccination: A vaccine aimed at protecting individuals from the most common and harmful strains of HPV. It is typically recommended for preteens, teenagers, and young adults (World Health Organization, 2022). Knowledge: In the context of this study, it refers to the awareness and understanding parents have regarding HPV, its health implications, and the preventive benefits of vaccination. Attitude: This encompasses the beliefs, perceptions, and feelings that parents hold about HPV vaccination, including whether they are receptive, hesitant, or resistant to vaccinating their children. Practice: Refers to the actual steps and decisions parents take regarding HPV vaccination, including whether they choose to vaccinate their children. Vaccine Hesitancy: The delay in acceptance or outright refusal of vaccines despite availability, often due to misinformation, cultural concerns, or perceived health risks. Vaccination Uptake: This refers to the proportion of individuals, particularly children in this context, who receive the HPV vaccine based on decisions made by their parents.