Health beliefs and Responses of parents towards Human papillomavirus vaccination in the Middle East: a qualitative systematic review (Preprint)

BACKGROUND Human papillomavirus (HPV) is the most frequent sexually transmitted disease in women and the major cause of cervical cancer (CC). Several countries have significantly reduced CC deaths and rates by offering cervical screening and HPV vaccination programs. The number of CC screening and HPV vaccine programs in around 100 countries around the world has led to dramatic reductions in incidence and death rates for the disease. HPV vaccination could prevent up to 70% of HPV-related cervical cancer and 90% of genital warts. HPV vaccination plays an influential role in decreasing CC worldwide. Thus, it is essential to formulate a suitable vaccination program for each nation so that they can combat the life-threatening conditions caused by HPV infection. OBJECTIVE This study aimed to systematically synthesize the attitudes and health beliefs of Middle Eastern (ME) parents regarding HPV vaccination, and to examine parents' uptake of HPV vaccination in ME nations, as well as assess their children's HPV vaccine uptake. METHODS Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Since the first HPV vaccination was approved in 2006, PubMed/MEDLINE, Web of Science, CINAHL, and Google Scholar were searched for papers between January 1, 2006, and May 2025. RESULTS Out of the 33 included studies, 32 were quantitative observational (cross-sectional), while one was a qualitative study. The findings were synthesised according to the six components of the health belief model: perceived susceptibility and severity regarding HPV and vaccination, perceived barriers to HPV vaccination uptake, perceived benefits of HPV vaccination, self-efficacy as a measure of HPV vaccination, concerns surrounding HPV vaccination, modifying variables influencing HPV uptake, and parental attitudes towards HPV vaccination uptake. Parents expressed apprehension about their limited knowledge of the virus and vaccine, citing obstacles such as a shortage of healthcare providers, safety concerns, cost, and vaccine availability. CONCLUSIONS The knowledge of HPV and its possible carcinogenic consequences in Middle Eastern nations was insufficient. Strategies to improve HPV vaccination uptake included mass medical campaigns, healthcare professional involvement, educational interventions, health insurance coverage, and recommendations from the Ministry of Health. Self-efficacy played a crucial role in enhancing vaccine uptake.