WHEP Scholar Karina Verma
Drexel University College of Medicine, Class of 2021

Attitudes regarding HPV vaccination vary globally and cross-culturally. Among South Asian American females, low rates of HPV vaccination may directly be influenced by cultural and religious expectations due to the vaccine’s misconceived association with sexual activity. The South Asian American population’s cultural beliefs include abstinence from premarital sexual behavior and a monogamous sexual relationship upon marriage. Parents often decline HPV vaccination for their teenage children based on the belief that they are too young to think about sexual activity, making the vaccine unnecessary. A concern that parents often raise is that vaccination may be interpreted by children as implied consent for sexual activity. Consequently, parental hesitancy to accept vaccination may stem from fear of sexual promiscuity and sexual disinhibition.

There is a lack of understanding of the HPV vaccine as a preventive health measure in children and young adults. In fact, an analysis of the National Health Interview Survey (NHIS), an annual survey of sociodemographic and health factors in the United States, that explored HPV vaccination rates in South Asian women ages 18-26 found that South Asian Americans were less likely to participate in preventive health behaviors in general, such as routine screening and vaccinations. This may in part be due to a cultural difference in seeking medical attention only when something is wrong, rather than practicing traditional preventive health care measures. These biases, preconceived notions, cultural standards and fears can serve as a barrier to vaccination.

With a rapidly growing immigrant South Asian population, it is necessary to understand culturally specific barriers to HPV vaccination in order to  tailor educational materials and help parents and young adults make a more informed and educated decision regarding vaccination. Since South Asian cultural and religious beliefs are stringent in relation to premarital sexual behavior, it is important to address the nature of HPV vaccination as cancer prevention rather than its sexualization. It is necessary to further educate parents on the purpose of vaccine initiation prior to HPV exposure and highlight that accepting the vaccine is not synonymous with endorsing sexual activity.  Rather, HPV vaccines should be presented to parents as a health measure and future protection against HPV-related clinical diseases. This can be achieved by increasing culturally tailored messaging and improving provider cultural competency in order to improve understanding of various barriers against vaccination.