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Preparing for HPV vaccination in South Africa: Key challenges and opinions

机译：南非HPV疫苗接种的准备工作：主要挑战和意见

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This article reports on qualitative research investigating key challenges and barriers towards human papillomavirus (HPV) vaccine introduction in the Western Cape Province, South Africa. A total of 50 in-depth interviews and 6 focus groups were conducted at policy, health service and community levels of enquiry. Respondents expressed overall support for the HPV vaccine, underscored by difficulties associated with the current cervical screening programmes and the burgeoning HIV/AIDS epidemic in South Africa. Overall poor community knowledge of cervical cancer and the causal relationship between HPV and cervical cancer suggests the need for continued education around the importance of regular cervical screening. The optimal target populations for HPV vaccination was influenced by the perceived median age of sexual activity in South African girls (9-15 years), with an underlying concern that high levels of sexual abuse had significantly decreased the age of sexual exposure suggesting vaccination should commence as early as 9 years. Vaccination through schools with the involvement of other stakeholders such as sexual and reproductive health and the advanced programme on immunization (EPI) were suggested. Opposition to the HPV vaccine was not anticipated if the vaccine was marketed as preventing cervical cancer rather than a sexually transmitted infection. The findings assist in identifying potential barriers and facilitating factors towards HPV vaccines and will inform the development of policy and programs to support HPV vaccination introduction in South Africa and other African countries.
机译：本文报道了定性研究，调查了在南非西开普省引入人乳头瘤病毒（HPV）疫苗的主要挑战和障碍。在政策，卫生服务和社区调查级别共进行了50次深度访谈和6个焦点小组。受访者对HPV疫苗表示了总体支持，与目前的子宫颈筛查计划以及南非正在迅速发展的HIV / AIDS流行相关的困难突显了这一点。社区对子宫颈癌的整体了解不足，HPV与子宫颈癌之间的因果关系表明，需要继续接受定期子宫颈筛查的重要性的教育。 HPV疫苗接种的最佳目标人群受到南非女孩（9-15岁）的性活动中位数年龄的影响，潜在的担忧是高水平的性虐待已大大降低了性接触的年龄，建议应开始接种疫苗早在9年。建议在其他利益攸关方（如性健康和生殖健康）以及高级免疫规划（EPI）的参与下，通过学校进行疫苗接种。如果将HPV疫苗用于预防子宫颈癌而非性传播感染，则不会反对HPV疫苗。这些发现有助于确定HPV疫苗的潜在障碍和促进因素，并将为支持在南非和其他非洲国家引入HPV疫苗的政策和计划的制定提供信息。

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