Contextualizing HPV vaccination intention among Haitian immigrant and migrant women through exploring cultural worldviews and affective risk perception: a qualitative study

Background: Haitian women experience high rates of cervical cancer and are more likely to be diagnosed at advanced stages. Although the HPV vaccine is effective in preventing cervical cancer, limited data exists regarding factors influencing HPV vaccine uptake among Haitian women. Our study explored HPV vaccination knowledge, awareness, and intentions through the domains of cultural worldviews and risk perception among Haitian immigrant and migrant women who recently arrived to the United States. Methods: These qualitative data are from a larger exploratory sequential mixed-methods study evaluating HPV vaccination intention among Haitian immigrant and migrant women. Semi-structured in-depth interviews were conducted with N = 25 participants. Interviews contained questions exploring health beliefs and knowledge, women’s cervical cancer experiences, cultural worldviews, affective evaluations of cervical cancer risk perception, and HPV vaccination intention. Qualitative descriptive methodology using thematic analysis was employed for data analysis on Atlas.ti software. Results: HPV vaccination knowledge and awareness were exceptionally low in our sample. Women endorsed maintaining cultural practices and beliefs upon migrating to the U.S. which shaped their decision to engage in health promotion behaviors. In response to affective risk perception, women believed that the unpredictability of cervical cancer increased their susceptibility to the disease. Participants endorsed cervical cancer as a fatal illness, with this perception being partly driven by superstitious beliefs toward cervical cancer, along with women’s prior experience with the health system in Haiti. These factors demonstrated potential relevance toward women’s decision making to engage in HPV vaccination behaviors. Conclusion: Culture, affective risk perception, and past experiences may be relevant toward Haitian women’s decision making to engage in HPV vaccination practices. Our results underscore the importance of using alternative methods in understanding HPV vaccination intention and scaling up HPV vaccination efforts for Haitian women both in the U.S. and in Haiti.