A human rights approach to understanding provider knowledge and attitudes toward the human papillomavirus vaccine in São Paulo, Brazil

• Type of Material: Article
• Authors: Meredith H. Kruse, Emory University; Robert Bednarczyk, Emory University; Dabney Evans, Emory University
• Language: English
• Date: 2020-06-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pvr.2020.100197
• Title of Journal or Parent Work: Papillomavirus Research
• Volume: 9
• Start Page: 100197
• End Page: 100197
• Grant/Funding Information: This research was funded in part by the Emory University Global Field Experience Award.
• Keywords: Brazil; Human rights; HPV vaccine; Access; Immunization program; Cancer
• Research Categories: Health Sciences, Oncology; Health Sciences, Immunology; Health Sciences, Public Health

Abstract

Objective: To determine the extent to which human rights considerations influence the attitudes of healthcare providers in Brazil with regard to access to the human papillomavirus (HPV) vaccine for females over 13 and males of all ages. Methods: From May to August 2015, we conducted a cross-sectional study among healthcare providers in eight public health clinics in the city of Mauá, Brazil. Frequency analysis was conducted across three subject areas: access, knowledge, and attitudes. Results: A total of 154 surveys were analyzed. Providers reported their perception that Brazilians do not have equal access to health (80%) and the vaccine exclusions limit an individual's right to health (72%). Providers stated it is medically effective to vaccinate females over the age of 13 (77%), these females should be vaccinated (84%), and they would vaccinate them (82%). Similar responses were reported for males. Conclusion: Cervical cancer is the 4th leading cause of cancer among females in Brazil. Most cervical cancer cases are caused by persistent HPV infection, preventable through HPV vaccination. Limiting access to the HPV vaccine when medically efficacious is a perceived infringement of an individual's right to health. Brazil has a constitutional responsibility to reduce these access barriers.