Gaining insights into the understanding and acceptability of ‘gender-neutral’ human papillomavirus (HPV) vaccination in northwest Tanzania: social sciences in the Add-Vacc Trial

Background

Human papillomavirus (HPV) infection and its related conditions affects both men/boys and women/girls. The Tanzania national vaccination programme introduced HPV vaccination for girls only in 2018. Gender neutral or HPV vaccination of both girls and boys is offered in some, mainly high-income, countries. There are few studies on the acceptability of male HPV vaccination in Africa. The Add-Vacc trial presents a unique opportunity to examine the acceptability and barriers to a gender-neutral HPV vaccination approach in Tanzania in the context of a study that provides a single HPV dose to boys. Gaining insight into community understanding of HPV, HPV vaccination and its health implications on boys through this study will provide essential information for future vaccination strategies both nationally and internationally.

Primary objective

To explore community HPV knowledge, HPV vaccine acceptability and potential barriers to vaccination, including vaccine hesitancy and rumours related to the delivery of single dose HPV vaccination of boys alongside the Tanzania national HPV vaccination programme of girls.

Methods

This qualitative study uses multiple approaches to gain insight into the acceptability of HPV vaccination in boys. It is piloting an electronic (tablet-based) rumours tracking tool to collect trial-related rumours in study communities. This information is analysed and used to enhance study team communications and trial-related community engagement. Similarly, acceptability and barriers to male HPV vaccination are explored through rapid ethnography (field observations and informal study-related discussions) at vaccination and community engagement events and qualitative interviews (focus group discussions and in-depth interviews) with parents, boys, health workers, teachers and community leaders.

Collaborators

London School of Hygiene & Tropical Medicine (LSHTM), UK: Richard Hayes, Hilary Whitworth, Mark Jit; MITU, Tanzania/LSHTM, UK: Saidi Kapiga, Deborah Watson-Jones, Jackton Indangasi; MITU, Tanzania: John Changalucha, Ramadhan Hashim; University of York, UK: Charles Lacey; University of Cambridge, UK: Margaret Stanley; Institut Català d' Oncologia, Spain: Miquel Angel Pavón Rabas; Karolinska Institute, Sweden: Joakim Dillner