"You Don't Know If It's the Truth or a Lie": Exploring Human Papillomavirus (HPV) Vaccine Hesitancy among Communities with Low HPV Vaccine Uptake in Northern California.

BACKGROUND: Vaccine hesitancy, delaying or refusing to vaccinate despite the availability of vaccines, impedes the progress of achieving optimal HPV vaccine coverage. Little is known about the sources of human papillomavirus (HPV) vaccine hesitancy among racially/ethnically and geographically diverse communities. The purpose of this paper is to explore HPV vaccine hesitancy among rural, Slavic, and Latino communities that reside in counties with low HPV vaccine uptake rates. METHODS: Key informant interviews and focus groups were conducted with rural, Slavic, and Latino communities that reside within counties in California that have low HPV vaccine up to date rates (16-25%). Qualitative data were transcribed verbatim and analyzed using inductive and deductive thematic analysis. RESULTS: A total of seven focus groups and 14 key informant interviews were conducted with 39 individuals from seven California counties. Salient themes that contributed to HPV vaccine hesitancy included the following: social media and the anti-vaccination movement; a strong belief in acquiring immunity naturally; prior vaccine experiences; and vaccine timing concerns. Participants suggested the provision of culturally appropriate, in-language, in-person easy to understand HPV vaccine education to mitigate HPV vaccine hesitancy. CONCLUSIONS: Our findings can inform future interventions to increase HPV vaccine uptake among hesitant communities.

Human papillomavirus self-sampling: A tool in cancer prevention and sexual health promotion.

This article examines human papillomavirus (HPV) self-sampling as an approach to cervical cancer prevention and the ways self-sampling kits are promoted directly to consumers in the United States. Public health, biomedicine and health tech have increasingly imagined self-sampling, which allows individuals to collect their own vaginal specimen, mail to a laboratory for testing and receive delivered results, as a component of cervical cancer prevention and sexual health promotion. This article examines the scientific and biomedical claims used to configure the problem in need of this solution and the ways persons, publics and markets are established. We analyse scientific literature, interviews with clinicians and other key actors, and websites of directly to consumers (DTC) companies. HPV self-sampling is constructed as both a solution to inequities and gaps in cervical cancer screening and a solution to the wants and needs of those already engaged in self-projects of body monitoring and risk reduction. These multidirectional biomedical tendencies also reveal how sexuality and sexual health and cervical cancer prevention and sexual health promotion are entangled objects. While we do not want to undermine the potential of HPV self-sampling, we encourage a focus on equity and care and not commodified markets that reinforce notions of 'good' patients monitoring their health.

Multilevel Factors Influencing Young Mothers' Breastfeeding: A Qualitative CBPR Study.

BACKGROUND: Young mothers (age 14-24 years), who are often low income, are less likely than other mothers to breastfeed for 6 months. They also are more likely to be diagnosed with aggressive forms of breast cancer; breastfeeding significantly reduces this risk. While adolescent breastfeeding has been investigated from the perspective of the individual, the social ecological model recognizes the influence of factors at multiple levels. RESEARCH AIM: The aim was to identify social and structural barriers to and motivators of breastfeeding that young mothers may encounter. METHODS: Using a cross-sectional prospective qualitative design with a community-based participatory research approach, we sought to identify influential factors at each social ecological level: individual, relationship, community, and societal/structural. We used purposeful sampling, and enlisted snowball sampling. We interviewed stakeholder experts ( n = 9) and dyads ( n = 6) consisting of a young mother and her decision-making partner. Groups of young mothers ( n = 6 groups) collectively created community maps while discussing their feelings about infant feeding in different locations. Using collaborative data analysis, we identified themes and categorized barriers and facilitators according to the social ecological levels. RESULTS: Four meta-themes emerged: roles, place, stigma, and support. While some barriers and facilitators were similar to those experienced by mothers of all ages, participants reported multiple overlapping stigmas, requiring more support. CONCLUSION: Young mothers who decide to breastfeed encounter barriers at multiple levels. Policies and programs aiming to increase breastfeeding rates in this group must address these barriers and enlist identified facilitators.