HPV knowledge and vaccine acceptability in Appalachian Tennessee and Kentucky, USA.

The Central and South-Central sub-regions of rural Appalachia have the highest cervical cancer rates in the USA.1 Low socioeconomic status, limited access to health care, geographic isolation, and fatalistic attitudes contribute to this disparity.2 Since 99% of cervical cancers are caused by oncogenic strains of human papillomavirus (HPV),3 the two Food and Drug Administration (FDA)-approved HPV vaccines4 have huge potential benefits for this region. However, information is limited about the acceptance and barriers to HPV vaccine uptake among rural Appalachian residents.5 We wish to inform Journal readers of the results of an HPV knowledge and acceptability survey conducted in rural Appalachia that has implications for future HPV vaccination and cervical prevention strategies. A questionnaire assessed HPV knowledge and vaccine acceptability from May to July 2008 at three family medicine clinics in eastern Tennessee and …