Factors that influence the uptake of human papillomavirus vaccine among preadolescent girls in South Africa: A Scoping Review

Human papillomavirus (HPV) infection is a sexually transmitted infection which causes cancer, especially cervical cancer. HPV infection and cervical cancer are a public health concern in South Africa. Primary prevention interventions, such as vaccination against cervical cancer, have been rolled out in the country. However, the uptake of the vaccine faces challenges due to various factors. The aim of the review was to identify factors which influence the uptake of the vaccine. A six-step framework developed by Levac, Colquhon and O'Brien was adopted to guide this scoping review. The articles were searched in the following databases: s: EBSCOhost, PubMed, CINAHL and Google scholar. The search, conducted from May to July 2023 was limited to articles published in English between 2008-2023 and those conducted in Africa. The results showed that most studies were conducted in sub-Saharan Africa, with majority of the studies being from Nigeria. Subthemes were extracted from the articles and categorised under the four themes of the Social Ecological Model. The four themes used from the Social Ecological Model were individual factors; interpersonal factors; community and societal factors, and organisational factors and public policy. The subthemes were socioeconomic and sociodemographic of parents, knowledge, fear and mistrust, family structure and proximity to cancer/STI, misinformation from social media, religion, culture and tradition, free vaccination programme and lack of engagement. The identified gap in literature was a lack of studies of factors which influence HPV vaccination uptake in South Africa and qualitative studies that explore and provide the factors influencing uptake. We conclude that in designing effective interventions for the uptake of HPV vaccines, it is important to consider influential factors that are tailor-made for specific demographics.