"This Is Something Every Woman Needs. . .So Why Is It That Expensive?": Examining Privileges and Inequities in Access...

The age-standardized incidence and mortality rates for cervical cancer in Ghana is 27.4 and 17.8 per 100,000 women, respectively. Currently, HPV vaccination is available only through privately funded programs, leading to inequitable access and uptake. This study examined how intersecting identities, and social locations contribute to inequities in the privately-funded HPV vaccination program in Ghana. We used an intersectionality-guided qualitative case study design. Data collection included non-participant observation of the clinic context and semi-structured interviews with HPV vaccine recipients (N = 13). We found that participants' access to HPV vaccination was shaped by socioeconomic privileges, including the ability to afford the vaccine. Their narratives revealed significant challenges in accessing HPV vaccination and highlighted how intersecting identities contribute to inequities in the privately funded program. Participants reported a general lack of HPV vaccination information in Ghana and often learned about the vaccine through incidental means. Conservative sociocultural norms surrounding sex, sexuality, and reproductive health were significant barriers, particularly in facilitating adolescent-parent discussions about HPV vaccination. Given the inequities reported by vaccine recipients, there is a critical need for education campaigns that raise awareness of the benefits of HPV vaccination, alongside strategies to support socioeconomic empowerment. Addressing these barriers through an inclusive public health policy will help prevent replicating the inequities seen in the privately-funded program and reduce HPV-related diseases, particularly cervical cancer.