A systematic review of knowledge and attitudes towards HPV vaccinationamong Chinese women

Introduction: Cervical cancer is the second most prevalent cancer among female and one of the top causes of cancer death worldwide. Human Papillomavirus (HPV) infection is the primary factor of cervical cancer. HPV vaccine has potential to contribute greatly by curbing the development of cervical disease and to optimize public health outcomes. Chinese populations were disproportionally affected by cervical cancer and the cultural backgrounds of Chinese are distinctively different from other races. In near future, there is possibility that China may introduce the vaccine. Little is known about Chinese’s perceptions on HPV vaccine and the situation in Chinese community may be different. To achieve an effective prevention of cervical cancer in China, a comprehensive understanding of Chinese women’s knowledge, attitudes and practices on HPV vaccination is crucial before introduction of HPV vaccine to ensure high uptake and coverage among Chinese women. Objectives: To investigate the knowledge, attitudes and the associated factors on HPV vaccination among Chinese women. Methods: Published studies on knowledge and attitudes of HPV vaccination in preventing cervical cancer in Chinese population were identified by using the major databases: Global Health, Medline, Pubmed, CINAHL, PsycINFO and CKNI from 2005 to 2012. 15 articles were included after reviewing for eligibility. Results: The overall awareness of HPV and HPV vaccine among Chinese women was low. Chinese women generally showed knowledge deficit about HPV and HPV vaccine. Despite inadequate knowledge, level of acceptance of HPV vaccination among Chinese women was high. Several major reasons influencing the attitudes of HPV vaccination among Chinese were cost, concerns on efficacy and safety of HPV vaccine, social influences, perceived likelihood of being infected with HPV, and recommendations and endorsements from others. Different level of parental acceptance was resulted in different studies. They concerned the safety of HPV vaccine and worried that HPV vaccination may promote unsafe sex of daughters. Discussion: Policy makers should seriously consider implementation of HPV program for low-resource setting after balancing the cost and benefit of HPV vaccine program. Raising the awareness and knowledge level concerning HPV vaccine among Chinese population should be set as the urgent priority. To improve the public awareness and acceptance of HPV vaccination, education interventions should be targeted at both recipients and parents. Factors influencing the acceptability of HPV vaccination must be considered in constructing public health strategies for advocating HPV vaccination. Vaccination promotion campaign should be carefully framed for culturally sensitive setting. Healthcare professionals have important roles in recommending vaccination. Integration of policy and community perspectives and multi-level interventions are essential to maximize the public health benefits of HPV vaccination.published_or_final_versionPublic HealthMasterMaster of Public Healt