The recommended HPV vaccination schedule is three doses administered over a six-month period [4
]. The 2009 National Immunization Survey–Teen found the proportions of females aged 13–17 years that had initiated (received at least one vaccine dose) the HPV vaccine series were 44% among all racial/ethnic groups in the US, 42% among all Asian Americans, and 60% among Washington State residents [12
]. However, our findings suggest that only 26% of Cambodian girls and adolescents in the 9–18 age group have initiated the HPV vaccine series.
Bastani and colleagues recently completed telephone interviews with 490 low-income mothers from multiple racial/ethnic groups. Survey respondents were all women who called a Los Angeles County Department of Public Health service referral hotline and had a daughter who was age-eligible for the HPV vaccine. Similar to our findings, only 25% of 98 Chinese participants and 24% of 66 Korean participants reported their daughters had initiated the HPV vaccination series [11
Previous research has shown that provider-patient communication variables are the most important correlates of Pap testing in Southeast Asian communities [13
]. For example, Nguyen and colleagues found that Vietnamese women who had requested a Pap test were nine times more likely to have been screened than women who had never requested the test, and women who had received a physician recommendation were eight times more likely to have been screened than those who had not received a recommendation [14
]. Our findings indicate that provider-patient communication variables are also important correlates of HPV vaccine uptake among Cambodian mothers. However, only 40% of the mothers who participated in our survey reported that a doctor had recommended HPV vaccination.
Our study has several strengths. Specifically, we used population-based sampling methods, administered the survey face-to-face, and had relatively high cooperation rates. However, there are also several limitations. Our survey was conducted in one metropolitan area, only households that were included in a database of telephone listings were eligible for the survey, respondents may have had different preventive behavior patterns than those who were unreachable or refused participation, and we did not attempt to verify vaccination self-reports with provider reports. Additionally, the sample size for this exploratory study of HPV vaccine uptake was relatively modest.
In conclusion, our findings suggest that HPV vaccine awareness and uptake are low among Cambodian American mothers. Linguistically appropriate cervical cancer and HPV vaccine educational initiatives should be developed and implemented in Cambodian and other Asian immigrant communities [11
]. Intervention programs should aim to improve provider-patient communication by encouraging health care providers who serve Cambodian families to recommend HPV vaccination, as well as by empowering Cambodian mothers to ask their daughters' doctors for HPV vaccination.