Social determinants of vaccination against human papillomavirus in Ecuador

Abstract

Identifying social factors associated with HPV vaccination prevalence is essential for informed decision making. Objectives: This study focuses on: (1) estimating the proportion of the target population vaccinated against HPV in the public sector, with one and two doses of the vaccine, and (2) identifying social factors related to the prevalence of HPV vaccination in Ecuador. Methods: Using public data on the number of first and second doses administered against HPV in public health centers, we estimated the proportion of girls aged 9 to 10 years vaccinated in the 24 provinces of Ecuador. In addition, using linear regression we evaluated associations between the following independent variables: illiteracy, poverty due to needs, indigenous population, Afro-Ecuadorian population, adequate employment and female violence with the prevalence of HPV vaccination (first and second dose). The analysis was performed in Epi Info V7.2.5. Results: The variables “illiteracy” and “need-based poverty” were inversely associated with vaccination prevalence (first dose) in the multivariate model. While, in the univariate model, a direct association was found between the indigenous population and vaccination prevalence (first dose). Conclusions: Illiteracy and poverty appear to negatively affect HPV vaccination coverage. These results suggest that policies aimed at eradicating cervical cancer must address these social problems.