Health Beliefs and Perspectives of Parents Regarding Human Papillomavirus Vaccination in Kuwait: Qualitative Study

After breast cancer, cervical cancer (CC) is one of the leading causes of female mortality. CC accounts for more than 7.5% of female cancer deaths worldwide. Human papillomavirus (HPV) is the most common sexually transmitted disease in women and the leading cause of CC in almost 99% of all CC cases. HPV vaccination could prevent up to 70% of HPV-related CC and 90% of genital warts. HPV vaccination is the bedrock of primary prevention and helps reduce the incidence and death rates of HPV-associated CC.

The study aimed to understand the knowledge, health beliefs, and perspectives of Kuwaiti parents regarding HPV vaccination, with the goal of developing a health promotion policy and introducing a national immunization program in Kuwait.

A total of 37 participants were evaluated using purposive sampling to select 20 (54%) participants for one-on-one semistructured interviews. We wanted to include both participants (male and female parents) with primary education (diploma or below) or secondary and higher education (bachelor's degree and above). We had four categories (male parents/guardians with a diploma or below, male parents/guardians with a bachelor's degree or above, female parents/guardians with a diploma or below, and female parents/guardians with a bachelor's degree or above) with at least 5 participants in each category, which gave us 20 participants. Semistructured interviews were based on the Health Belief Model (HBM). The data were thematically analyzed using an inductive approach, generating themes through the theoretical framework of the HBM, and theme extraction analyses were managed on a semantic level.

We identified 7 main themes containing 20 subthemes. The seven themes were (1) knowledge and awareness about HPV infection and vaccination (3 subthemes); (2) perceived susceptibility, which is explained by the HPV infection effect based on sex (2 subthemes); (3) perceived barriers to HPV vaccination (8 subthemes); (4) perceived benefits (1 subtheme); (5) perceived severity (2 subthemes); (6) perceived efficacy (2 subthemes); and (7) cues to action (2 subthemes).

The HBM framework is beneficial for Kuwait's HPV vaccination campaign. The correlation between sexual intercourse and the HPV vaccine frequently adds complexity to the decision-making process about immunization. This study demonstrates that positive cues to action from health care practitioners and educational vaccination benefits can overcome perceived barriers among parents related to stigma and religion. It is essential to conduct more such research to guide the development of interventions aimed at promoting adoption of the HPV vaccine.