Influences on HPV vaccine acceptance among men in the Philippines

Background: The purpose of the study was to examine attitudes toward, and acceptability of, human papillomavirus (HPV) vaccination among Filipino men. Methods: Self-administered, theory-grounded surveys were completed by a community-based sample of 143 men (aged 18-31 years). Demographic, behavioral, attitudinal, and social influences on vaccine acceptance were examined and recommendations for vaccine administration were elicited. Intent to receive the vaccine was assessed at low, moderate, and high vaccine price. Results: At low vaccine price, 39% were accepting of HPV vaccination, while 22-26% were accepting at moderate and high price. Few (16%) believed they would be making their vaccination decision independently, expecting strong influence by their mothers (69%) and fathers (64%). In multivariate analysis for acceptance at low vaccine cost, men whose fathers were influential had 62% lesser odds of accepting vaccination than did men whose fathers were not influential (95% confidence intervals (CI) = 0.2-0.9). Protecting sexual partners and staying healthy for family were important. Most (81%) did not agree with a female-only vaccination strategy. Men were more willing to receive the vaccine from a male versus female provider, but were reluctant to see a physician. Transportation and time were barriers to vaccination for many. Conclusions: HPV vaccine acceptance among Filipino men is contingent on affordable pricing. A successful male vaccine initiative in the region must address the influence of family and friends in HPV vaccination decisions, minimize structural barriers to acceptance, and incorporate an extensive educational campaign. Any effective implementation strategies must work within cultural norms surrounding gender of vaccine recipients and providers.