Understanding HPV Vaccine Decision-Making Among Women in Georgia

By Victoria Churchill, PhD, MPH

Despite the availability of a safe and effective vaccine that can prevent most cases of cervical cancer, HPV vaccination rates remain below national goals. In Georgia, only about 65% of adolescents are up-to-date on HPV vaccination as shown in the state HPV data profile with even lower rates in rural communities. These disparities are particularly concerning because Black women experience higher mortality from cervical cancer than their White counterparts.

During my postdoctoral role at Morehouse School of Medicine, I applied for funding through the Health Disparities Research and Education Program, a component of the Morehouse School of Medicine, Tuskegee University, and O'Neal Comprehensive Cancer Center at the University of Alabama at Birmingham Partnership supported by the National Institutes of Health National Cancer Institute. After developing a community-informed video about clinical trial participation, I shifted my focus to cancer prevention, specifically HPV vaccination. I aimed to gain a better understanding of factors influencing HPV vaccination decision-making through in-depth interviews with women in Georgia, focusing on populations disproportionately affected by HPV cancers. I wanted to create a theory- and community-informed video promoting HPV vaccination. Fourteen women participated in virtual interviews, including eight women who identified as Black and three women from rural communities. They discussed their HPV knowledge, perceptions of and experiences with the vaccine, and sources of health information. They also shared how they would talk to someone considering HPV vaccination for their children.

The findings revealed that trusted sources of information, particularly health care providers and members of the community, play an important role in attitudes towards the vaccine. Participants highlighted the value of women sharing information with other women and identified community-based education as a way to increase awareness of the vaccine. At the same time, limited knowledge about HPV and HPV cancers and uncertainty about who is eligible for the vaccine, were identified as persistent barriers, consistent with the literature.

A key theme was the potential for women to serve as trusted messengers within their own families and communities. Women often play a primary role in making health care decisions for their children and may also influence other parents in their familial and social circles by sharing personal experiences and information about vaccines. This has practical implications for health educators, clinicians, and community organizations. Outreach may be more effective when it pairs a strong provider recommendation with relatable stories, plain-language educational materials, and opportunities to ask questions.

Insights from these interviews informed the development of a narrative-based video designed to address common concerns and provide culturally-relevant information about HPV vaccination. The video is a brief, freely accessible resource that can be shared during outreach activities or linked through social media and other websites. It can also be used in medical settings as a tool to initiate conversations between families and health care providers about the vaccine. Rather than relying only on statistics or other basic facts, the narrative format helps viewers see how common questions about HPV vaccination can be discussed in common terms.