Factors associated with HPV vaccination uptake in Central Uganda

The burden of cervical cancer in Uganda is high yet uptake of HPV vaccination is low. Identification of child and mother factors associated with HPV vaccination are important for targeted interventions however, this problem has not been well investigated. The aim of the study was to determine the prevalence of HPV vaccine uptake and associated factors among the10 to 17-year-old girls in Central Uganda four years after rolling out the vaccine in the country. The cross-sectional survey was done in Wakiso and Nakasongola districts in Central Uganda. A total of 503 girls participated in the study. Logistic regression analyses were done to establish the relationship between vaccination status and socio-demographic characteristics of the girls and their mothers. HPV vaccination uptake was generally low (39.4%) in central Uganda and significantly associated with; mothers’ education attainment, HPV knowledge, mothers’ age, religion, wealth index, type of residence, birth order and schooling status. There were reduced odds of HPV vaccination among Pentecostal girls [OR=0.44; (95% CI: 0.21-0.90), p=0.025)] and rural dwelling girls [OR=0.24 (95% CI: 0.16-0.37), P=0.016)]. The likelihood of vaccination was higher among girls; of birth order three [OR=2.45 (95% CI: 1.25-4.82), P=0.029)], who were schooling  [OR=2.73 (95% CI: 1.12-6.63), P=0.027)], with high wealth index  [OR= 2.31 (95% CI: 1.12-4.76), P=0.024)], living with mothers with high HPV knowledge [OR= 2.26 (95% CI: 1.41-3.61), P=0.001)], and whose mothers were aged 30-39 years [OR= 2.44 (95% CI: 1.07-5.59), P=0.034)]. Both child and mother characteristics showed a marked impact on HPV vaccination. Strategies like creation of awareness should target girls: in rural areas, not schooling, with lower social economic status, living with women below 29 years, of lower birth orders, and living with less knowledgeable women; and involving religious leaders in programs should be embraced in order to achieve high vaccination uptake.