1. Although Pap tests can detect changes in the cervix and early stage cervical cancer, women and girls who do not have access to routine PAPs are at significant risk for developing cervical cancer. Given that the vaccine that prevents cervical cancer is recommended for girls, 9 – 12 years, parents will determine if their children get the vaccine. The purpose of this formative study was to assess maternal-child (MC) communication, identify barriers to accessing the vaccine, willingness to vaccinate, and assess the role of parents and providers in cervical cancer prevention. Shelley A. Francis, DrPH, MPH, CHES; Joan Liverpool, EdD, CHES; Jenny A. Nelson, MPH; Roland H. Thorpe, PhD, MS; Soji Shogun, MBBS, FACHE; Nokuthula Mofammere, CHW Abstract Specific Aims Key Findings & Implications Limitations & Strengths Funder - Merck Pharmaceuticals Inc. The South Africa Women’s Health study is supported by an investigator initiated award from Merck Pharmaceuticals, Inc. The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official views of Merck Inc. 1.Moms report feeling comfortable/positive in their ability to talk to kids about sexual health issues 2.Almost 60%, have not talked about HIV in last year 3.Many moms are not talking to their kids about sex, HPV and cervical cancer and need more information on how to talk to them 4.Moms get prevention messages from multiple sources 5. Prevention strategies must be respectful of culture 6. Need to utilize media to get the message out 7. Need to increase availability and affordability of screening and vacci ne 1 2 3 6 Assess communication about sex, STDs, and HPV and cervical cancer prevention and Assess maternal attitudes about vaccinating their children Put Your Logo Here Maternal-child communication about cervical cancer, HPV, and sexual health among South Africa women Background Cervical cancer needs attention in the developing world & South Africa #1 cause of cancer related deaths; attributed to over 3400 deaths of South African women Strong association between HIV and HPV Women with limited access to routine PAP tests are at risk Pap tests and early detection are the KEY to prevention Key findings - MC communication about sexual health & HPV and cervical cancer Families play a significant role in sexual socialization Simply providing information to youth is insufficient Globally, 72-98% of parents report talking to kids about sex Parents expressed moderate to strong interest in vaccinating their kids against STDs Majority of existing studies focus on developed countries Gaps in the literature Further research is needed to assess vaccine acceptance and knowledge among women/parents in developing countries (-) Descriptive study, generalizability, small sample size (+) Explored an understudied area, used mixed methods (+) Provides better understanding of issues around maternal-child communication, knowledge and attitudes about HPV, and cervical cancer, and vaccine acceptance Methods 4 1.Women recruited from a private clinic in Alexandria Township for a larger study 2.All 88 participants invited; approximately 24 women participated 3.Local research assistant hired to assist with study recruitment and facilitation 4.Participants were asked a series of questions about communication about sexual activity, HIV/AIDS, their knowledge, beliefs, and perception of risk for HPV, cervical, and vaccine acceptance 5.Data transcribed and triangulated for common trends and themes 5 Results 7 “Special thanks to the study participants and Dr. Shogun’s clinic staff – Kojo, Sara, and Dr. Shola. We could not have done the study without all your help.” Maternal-child communication Talking to your kids and being open about sex is very important; Parents talked to children about sex, STDs, AIDS, pregnancy, condoms; Other topics included drugs, sexual abuse and peer pressure “Mom - I feel like everyone should learn, and talk to the children especially when it comes to sex. I believe there is no reason to hide, because if you hide the children won’t know the truth.” Ages to begin talking about sex ranged from 6-10 years old Premarital sex is frowned upon for religious and cultural regions Girls are more affected by this then boys because of pregnancy “Mom - We must teach our children that it is bad in our culture to go and stay with a boy without parent’s permission.” “Mom - We must always advise them that if you go and stay with a boyfriend, he will never marry you…what will make him go and pay for you?” Frequency of medical screenings Mothers take their children to the doctor when they are sick or once a year for screenings Most vaccines are given at a young age Barriers to accessing the vaccine Approval by doctors and government were important to mothers Cost was a large concern; most thought the government should pay for the vaccine “Mom - I think it will be very difficult for parents to have the money to pay for the vaccine- there are many disadvantaged communities” Other concerns included long-term effects and allergies Almost no mothers were aware of what HPV was, most had heard of cervical cancer “Mom - Our kids take things their own way. When you give your child the vaccine she thinks you are giving her permission to go and sleep around…the best thing is that you sit down with your child and give her the reasons why you are allowing them to take the vaccine.” “Mom-That doesn’t mean that we are against it. We are always going to try to talk with them.” “ Mothers’ willingness to vaccinate Mothers wanted to be educated on the vaccine before allowing their child to receive it “Mom - We feel ok because it’s a chance to be healthy…for the child’s sake” Role of parents in Cervical Cancer Prevention Mothers are more involved in their children’s health than fathers Permission from fathers to vaccinate their daughters was a concern for some mothers “Mom - Men, they do not take their role in parenting or in the child’s life. Men just go to work in the morning, come back later. Often they just eat and sleep…I leave him out of these decisions. Most of the time it is believed that it is the women’s job to raise the child.” Parents should educate their children and allow them to get the vaccine