Ethnically diverse female university students’ knowledge and attitudes toward human papillomavirus (HPV), HPV vaccination and cervical cancer

Prevalence and determinants of vaccination intention towards routine immunizations in university students: a systematic review and meta-analysis

BACKGROUND

It is well known that, to be effective, vaccination programs require a high and consistent population uptake. Nevertheless, vaccine coverage is often insufficient. University students occupy a unique position within the broader population: they are highly mobile and socially active individuals who serve as influential figures among their peers and younger age groups, making them an ideal target for educational campaigns.

METHODS

This review (CRD42022309724) quantified the vaccination intention rates for routine immunizations in university students and systematically examined the determinants of vaccination acceptance. Cross-sectional studies that analyzed vaccination intention for at least one routine immunization using multivariable logistic regression were included. We used random-effects models to calculate the pooled proportions of vaccination intention. Determinants were categorized into contextual factors (such as socio-demographic, economic and cultural factors), individual/group factors (such as knowledge, awareness, peer opinions, infection risk perceptions) and vaccine-specific issues (such as vaccine effectiveness and vaccination policies).

RESULTS

Thirty-six articles were included: 29 on the human papilloma virus (HPV) vaccine and seven on the influenza vaccine. The pooled proportion of students intending to get vaccinated was 54% (95% CI: 47-60%) for HPV and 43% (95% CI: 26-61%) for influenza. The strongest positive determinants were individual/group factors, such as higher knowledge and awareness, pro-vaccine peer opinions, positive personal experience with vaccinations, and higher risk perception for HPV infection, and higher risk perception for infection and previous vaccination history for influenza. By contrast, contextual influences played a minor role in both vaccinations, while vaccine-specific concerns, particularly about costs and availability, negatively influenced intention for both vaccines.

CONCLUSIONS

Given the suboptimal rates of vaccination intention towards HPV and influenza vaccine that we found, addressing key determinants, such as awareness of infection risks and perception of vaccination benefits, is essential to increase vaccination acceptance in university students and to achieve high vaccination coverage.

Assessment of health literacy and HPV knowledge among university students: An observational study

Health literacy (HL) level is related to promotion of health, improved health behaviors, and early diagnosis of diseases, as well as the appropriate use of health services. Human papillomavirus (HPV) vaccination is the primary method of protection against cervical cancer and recommended for women aged 9 to 27. This study aims to assess the university students' knowledge about HPV and the association between HL and HPV vaccination. In this cross-sectional and descriptive study, an electronic survey was used. Demographic characteristics and anthropometric measurements of the participants were questioned. HPV Knowledge Scale (HPV-KS) and Turkish Health Literacy Scale (THLS-32) were used to evaluate HPV knowledge and HL. Statistical analyzes were performed with SPSS version 26. A total of 361 university students (74% women), aged 21.98 ± 4.72 years, were included in the study. About 52% of the participants were health sciences students. The total THLS-32 score was 34.68 ± 9.37 (95% CI = 33.71-35.65), and the total adequate/excellent HL level was 51%. The mean HPV-KS score of the participants was 10.28 ± 8.15 (95% CI = 9.44-11.12) of a possible 35. Health sciences students had higher rates of HPV awareness (78% vs 65%; P = .007). General HPV knowledge level was significantly better among women (P < .001), >20 years (P = .002), and those with a family history of cancer (P < .001) and significantly lower among students at prep or first year of school (P < .001). There was a weak, positive relation between THLS-32 and HPV-KS score (R = 0.136; P = .01). Participants with higher levels of HPV knowledge (P = .034) and total HPV-KS score (P = .025) were statistically significantly higher in students with adequate/excellent HL. Our results reveal that knowledge about HPV vaccination is closely related to HL levels. Educational interventions on HL may be considered to increase HPV vaccination rates.

Human papillomavirus (HPV) vaccination intent and its associated factors: a study of ethnically diverse married women aged 27 to 45 in Malaysia, a Southeast Asian country

INTRODUCTION

This study aimed to investigate HPV vaccination intention among adult married women aged 27 to 45 years and its associated factors, and their spouse/partner's influence on HPV vaccination decision-making.

METHODS

This is a cross-sectional, questionnaire-based study. Study participants were recruited through simple random sampling of patients attending obstetrics and gynecology outpatient clinics in a university teaching hospital. Participants were selected based on a computer-generated list of a random list of patients attending the clinic.

RESULTS

A total of 794 complete responses were received (response rate 88.2%). The mean age of the respondents was 32.2 years with a standard deviation (SD) of ±3.9 years.The vast majority (85.3%) would communicate with their spouse/partner with regard to HPV vaccination decision-making. Nearly 30% (over half were of the Malay ethnic group) perceived their spouse/partner would not consent to their HPV vaccination. Over half (54.9%) reported joint decision-making, and 9.1% (the majority of whom were Malay) reported that HPV vaccination was dependent on their spouse/partner's decision. Intention to vaccinate against HPV was high (74.5%). Factors influencing HPV vaccination intention were spouse/partner's consent to HPV vaccination (odds ratio [OR] = 4.51; 95% confidence interval [CI], 3.08-6.62), being a postgraduate student (OR = 4.55; 95% CI, 2.13-9.72 vs. unemployed/housewife), average household income MYR2000-4000 (OR = 2.09; 95%CI, 1.16-3.78 vs. below MYR2000), and an HPV-related knowledge score of 9-20 (OR = 1.60; 95% CI, 1.10-2.32 vs. score 0-8).

CONCLUSION

Findings highlight the importance of culture-centered interventions to enhance male partner's awareness and support for the HPV vaccination of married women.

Awareness and knowledge associated to Human papillomavirus infection among university students in Morocco: A cross-sectional study

Worldwide, cervical cancer is a real health issue, however, gaps exist in the public’s awareness of the causal role of Human papillomavirus (HPV) in the development of this disease. This study aims to determine the level of awareness, knowledge and the associated factors on HPV among university students in Morocco. A cross-sectional study was conducted with a descriptive and analytical aim, among students attending Ibn Zohr University, in Agadir, Morocco. An interview questionnaire was used to collect information about the participants: demographic data, awareness and level of knowledge on HPV infection, and awareness of cervical cancer. Logistic regression analyses were used to determine the associated factors with awareness and level of knowledge on HPV. A total of 479 students participated in this study (mean age 21.82 ± 2.091). Most participants n = 391 (81.6%) were aware of cervical cancer, while only n = 7 (1.5%) identified HPV as a sexually transmitted infection. Among students, 10.0% (n = 48) were aware of HPV but only half of them n = 23 (47.9%) confirmed that HPV is associated with cervical cancer, and n = 29 (60.4%) showed low knowledge on HPV. Multivariate analysis revealed that HPV awareness has a strong association with a higher level of education (OR 4.04; 95% CI: 1.92–8.52), and with being a biology student (OR 5.20; 95% CI: 2.12–12.73), while high HPV knowledge was only associated with the female gender (OR 3.76; 95% CI: 1.01–13.92). The data suggest that university students in Morocco did not show sufficient knowledge of HPV infection and its consequences. This supports that earlier incorporation of sexual health education programs, especially related to HPV and cervical cancer, must be implemented in the university to reduce the burden of HPV-associated diseases among the population at risk.

Knowledge, attitudes, and practices among Indonesian urban communities regarding HPV infection, cervical cancer, and HPV vaccination

Background

Few studies explored Indonesian understanding of cervical cancer (CC) and the human papillomavirus (HPV) vaccination. We aimed to investigate the association between knowledge, attitudes, and practices (KAP) and socio-demographical influences related to HPV, CC, and vaccination among Indonesian urban citizens.

Methods

We conducted an online survey during March 2020-August 2021 using the Snowball sampling technique. The socio-demographic characteristic and KAP responses were collected via Google Forms from 400 respondents in Jakarta. The knowledge and attitudes were divided into HPV and CC (aspect 1) and HPV vaccination (aspect 2). Correlation between KAP scores was performed using Spearman’s test, and multiple logistic regression analyses were conducted to determine KAP predictors.

Results

Indonesian urban citizens in Jakarta were found to have poor knowledge in individual aspects of the inquiry but moderate knowledge overall, good attitude in inquiry both in each aspect and overall, and unsatisfying practices. Overall, in the general population, men, and women respectively: 50.8%, 32.4%, and 53.6% had good knowledge; 82.0%, 75.2%, and 84.4% expressed positive attitude; and 30.3%, 15.2%, and 35.6% applied favorable practice regarding questions inquired. Knowledge was weakly correlated towards attitude (ρ = 0.385) but moderately correlated with practice (ρ = 0.485); attitude was moderately correlated with practice (ρ = 0.577), all results: p<0.001. Significant odds ratio (OR) for predictors to good knowledge were female sex (OR = 2.99), higher education (OR = 2.91), and higher mother’s education (OR = 2.15). Factors related to positive attitudes were higher mother’s education (OR = 4.13), younger age (OR = 1.86), and better results in the knowledge inquiries (OR = 2.96). Factors that suggested better practices were female sex (OR = 2.33), being employed (OR = 1.68), excellent knowledge scores (OR = 4.56), and positive attitudes expressions (OR = 8.05). Having done one vaccination dose and intention to receive vaccines were significantly influenced by good KAP.

Conclusions

KAP had inter-association to successful CC and HPV prevention programs, and socio-demographical characteristics are critical to influencing better KAP.

Acceptability of Human Papilloma Virus Self-Sampling for Cervical Cancer Screening in a Cohort of Patients from Romania (Stage 2)

(1) Background: Low patient’s adherence to conventional cervical cancer screening methods determined the need to take into consideration alternative approaches, and vaginal HPV self-sampling is one of them. We aimed to evaluate, using an online survey, the Romanian women’s acceptability of vaginal HPV self-sampling. (2) Methods: A 13-questions online survey was distributed on three Facebook groups, and the results were summarized. (3) Results: Despite of good educational background, 10.8% (n = 60) of the respondents did not know what a Pap smear is, and 33% (n = 183) were not informed about the free national cervical cancer screening program. Multivariate analysis revealed an increased likelihood of vaginal self-sampling acceptance among respondents who did not know about Pap test (OR: 7.80; 95%CI: 1.062−57.431; p = 0.021), national cervical cancer screening program (OR: 1.96; 95%CI: 1.010−3.806; p = 0.02), HPV infection (OR: 7.35; 95%CI: 3.099−17.449; p< 0.001) or HPV test (OR: 1.67; 95%CI: 0.950−2.948; p = 0.03). Moreover, women who did not previously undergo a cervical cancer screening program were more likely to accept the new screening method (OR: 1.62; 95%CI: 0.878−3.015; p = 0.04). (4) Conclusions: Our results showed high acceptability rates of vaginal HPV self-sampling among participants.

Knowledge, attitudes, and perception toward human papillomavirus among health profession students: A cross-sectional study in King Saud Bin Abdulaziz University for Health Sciences

BACKGROUND

Human papillomavirus (HPV) infection is the major risk factor for cervical cancer (CC) in women of reproductive age. Despite advances in treatment and prevention of CC by HPV vaccination, very few women utilize them because of a lack of awareness about HPV.

MATERIALS AND METHODS

We conducted this cross-sectional study among Health Professions Students (HPS) at King Saud Bin Abdul Aziz University for Health Sciences, Jeddah. Data were collected using a predesigned and validated study questionnaire to assess the knowledge, attitude, and perception of HPS toward HPV.

RESULTS

A total of 580 HPS responded to the survey; 128 (22.1%) were male, while 452 (77.9%) were female with the mean age ± standard deviation 20.36 ± 1.74 years. There was no significant difference between males and females related to screening of HPV and CC (82.8%; 82.3%). A minority (30.3%) of participants thought that HPV infection leads to CC, while 38.3% did not know about it. Furthermore, knowledge about HPV screening and vaccination was poor.

CONCLUSIONS

Students from the college of medicine had more knowledge and awareness about HPV (34.9%, P < 0.001). Thus, it is important to implement effective education programs, curricular activities, and awareness campaigns for health professions to augment the learning process effectively.

Awareness, attitudes and acceptability of the HPV vaccine among female university students in Morocco

Background

In Morocco, cervical cancer is the second most common cancer affecting women behind breast cancer. The Human PapillomaVirus (HPV) vaccine has been available in Morocco since 2008 but its introduction in the national immunization program is still under discussion. There is limited data regarding acceptability and predictors of HPV vaccine acceptability among Moroccan young women. This study aimed to evaluate the awareness of female university students of HPV and the vaccine and to identify predictors of HPV vaccine acceptability.

Methods

We conducted a structured interviewer-administered questionnaire with 1087 participants in six Moroccan universities between May 2019 and June 2020.

Results

The awareness of HPV infection was 14.7% and of HPV vaccine was 7.8%. The rate of immunization coverage against HPV was less than 1%. Over 67% of participants were willing to receive the HPV vaccine. Awareness of cervical cancer (p-Value = 0.04) and the HPV vaccine (p-Value = 0.01), and acceptability of Pap smear test (p-Value <0.01) were significant predictors of HPV vaccine acceptability.

Conclusions

This study revealed an insufficient amounts of awareness of HPV and of HPV vaccine uptake in a sample of Moroccan university young women. This lack of awareness needs intervention, and it is important to develop an awareness program for young female population either within or outside universities in order to promote vaccination uptake and ultimately lower the cervical cancer rate in Morocco.

Perception and knowledge of human papillomavirus (HPV) vaccine for cervical cancer prevention among fully vaccinated female university students in the era of HPV vaccination: a cross-sectional study

OBJECTIVE

To assess the perception and knowledge of cervical cancer prevention among fully vaccinated female university students in the era of human papillomavirus (HPV) vaccination.

DESIGN

Cross-sectional using a validated questionnaire.

SETTING

Face-to-face interview at a public university in Malaysia.

PARTICIPANTS

384 fully vaccinated female students were included in the study.

RESULTS

The total knowledge score in the questionnaire was 18 and was ranked according to score level into three groups: poor (score ≤5), moderate (score 6-10) and good (score ≥11). Mean score for knowledge of cervical cancer prevention was 8.24 (SD ±3.85), with 170 respondents (44.3%) scoring moderate knowledge level. The mean score for knowledge of HPV infection and its association with cervical cancer was 4.56±2.47, while the mean score for knowledge of HPV vaccination for cervical cancer prevention was 3.68 (SD ±1.98). A total of 186 (48.4%) respondents perceived that regular Pap smear was unnecessary after HPV vaccination. Respondents' perceived seriousness and susceptibility of HPV infection correlated well with knowledge of cervical cancer prevention. Two main reasons for their acceptance of HPV vaccine were self-health awareness and free vaccination.

CONCLUSION

The knowledge of HPV vaccination for cervical cancer prevention was average among vaccinated university students. Many of them had poor knowledge about Pap smear and did not consider regular Pap smear as an important cervical cancer screening tool following HPV vaccination. There is still a need for continued health education to improve the perception and knowledge about HPV infection and cervical cancer prevention among young adults in the community.

Psychological Variables Associated with HPV Vaccination Intent in Romanian Academic Settings

The aim of this study was to evaluate (1) the female medical students’ knowledge about HPV infection; (2) the associations between the HPV vaccination intent and coping strategies, health locus of control (HLOC), and sense of coherence; and (3) the specific differences between preclinical and clinical students in terms of the vaccination intent. Participants included 1243 female medicine students (mean age = 21.526, SD = 2.007), who completed The Multidimensional Health Locus of Control (MHLC)—Form A, the Brief COPE Scale, the Sense of Coherence Scale (SOC-13), and two questionnaires measuring the knowledge about the HPV infection and the HPV vaccination intent. Results show a good knowledge about HPV, which progressively increased during the study cycles. Still, the main contributors to vaccination intent are represented by coping strategies and health locus of control. Refusal of vaccination is associated to behavioral disengagement and the use of religion, precontemplation and contemplation to denial, and preparation to planning, positive reframing, and the powerful others component of HLOC. Sense of coherence did not predict vaccination intent. In clinical years, active coping outweighs HLOC in making the decision to get vaccinated. These results could be helpful in designing personalized strategies for addressing vaccine hesitancy in academic communities.

No longer recommended for cervical screening: How women aged 18-24 feel about the renewed National Cervical Screening Program

BACKGROUND

Since December 2017, the Australian National Cervical Screening Program no longer recommends screening for women under 25 years of age.

AIM

To explore the attitudes of women under 25 years toward the changes.

METHODS

In December 2019, women aged 18-24, residing in Australia, were recruited via the social media platform Instagram and Facebook. Descriptive analysis, t-tests, χ² tests and multivariable regressions were used to analyse the data.

RESULTS

Five hundred and twelve women completed a cross-sectional web-based survey. Women who were older (22-24: 3.1 vs 18-21: 2.8, P < 0.001), sexually active (3.1 vs 2.7, P = 0.003), vaccinated against human papillomavirus (mean = 3.2 vs 2.7, P = 0.005) or who had screened previously (mean = 3.5 vs 2.8, P < 0.001) had significantly greater knowledge about the current cervical screening practices. Older women (odds ratio (OR) = 0.85, 95% CI 0.80-0.95) or those who had screened previously (OR = 0.51, 95% CI 0.31-0.83) were less positive about the delayed start age of screening and five-yearly screening (OR = 0.54, 95% CI 0.35-0.85). A significant association was determined between being sexually active (χ² (4) = 32.71, P < 0.001) and women who had screened previously (χ² (4) = 34.43, P < 0.001), with a greater intention to screen in the future. Regarding health information, 64.6% of women had never heard of the 'National Cervical Screening Program' website and 38.9% of the sample (n = 199/512) reported they had 'rarely' noticed any health information regarding cervical screening in the past 12 months.

CONCLUSION

Further work is required to rectify women's knowledge of cervical screening to ensure women under 25 are aware of the screening guidelines and reduce the potential for over-testing and overtreatment in this age group.

Vaccine attitudes among young adults in Asia: a systematic review

Introduction: Young adults may be facing growing threats from vaccine-preventable diseases (VPDs). However, vaccination of young adults may not have drawn adequate attention. In Asia, adensely populated region with ahigh proportion of low-income countries, VPDs impose more of an economic and social burden than in western countries. However, knowledge about attitudes toward vaccines among young Asians is limited. This study aims to fill that gap by describing attitudes toward vaccines and how well they are accepted among young Asian adults through asystematic review of relevant Chinese and English publications.Methods: A three-stage searching strategy was adopted to identify eligible studies published during 2009-2019 according to the selection criteria, resulting in 68 articles being included.Results: The review finds that vaccination coverage among young Asians is generally lower than among their western peers, and there is a lack of relevant study in many Asian countries. Factors influencing young Asians' attitudes toward vaccines are categorized into contextual level, individual and social level, and vaccine-specific level.Conclusion: These suggest that there is a need to strengthen young adults' vaccination programs and to promote vaccine-related information and government.

Knowledge of Human Papillomavirus (HPV) and Oropharyngeal Cancer and Acceptability of the HPV Vaccine among Dental Students

Objectives:

To assess knowledge about human papillomavirus (HPV), vaccination, and HPV-related oropharyngeal cancer (OPC) and to evaluate HPV vaccine acceptability among a sample of undergraduate dental students.

Methods:

All third- and fourth-year dental students enrolled in any of the dental schools in Jeddah, Saudi Arabia, were invited to participate in this cross-sectional study. In total, 500 students completed a self-administered questionnaire on HPV, HPV vaccines, and HPV-related OPC knowledge. HPV, HPV vaccine and HPV-related OPC knowledge scores were calculated. Associations of participants characteristics with the knowledge scores and with willingness to take the HPV vaccine were assessed.

Results:

Of the participants, 62% had heard of HPV infections, and 57% of HPV vaccines. Average knowledge scores were low: HPV knowledge score 3.8±4.5 out of 16, HPV vaccination knowledge score 0.9±1.6 out of 7, OPC knowledge score 0.9±1.2 out of 5. Clinical-year students had better knowledge and were more willing to take the HPV vaccine than were preclinical-year students, as were those vaccinated for hepatitis B versus those not vaccinated for hepatitis B. Students with higher HPV knowledge scores were more willing to take the HPV vaccine (66%) than were those with lower scores (43%) (p=0.018). Only 4% of males and 12% of females reported taking the HPV vaccine. Of those who refused it, 51% cited lack of knowledge as the primary reason.

Conclusions:

Knowledge about HPV, its vaccine, and HPV-related OPC is low among this sample of Saudi undergraduate dental students. Improving knowledge among them may increase their awareness, which could affect the care provided to patients.

Knowledge of Cervical Cancer, Human Papilloma Virus (HPV) and HPV Vaccination Among Women in Northeast China

This study aimed to research the understanding and knowledge of cervical cancer, human papilloma virus (HPV), and HPV vaccination, and the acceptance of HPV vaccination, among a population of women in northeastern China. A cross-sectional survey was carried out by questionnaire to investigate knowledge of cervical cancer, HPV, and HPV vaccination. The 230 female participants were native residents of northeastern China, and their ages ranged between 18 and 65 years. Questionnaires were randomly acquired by the respondents from online and paper questionnaire distribution. The questionnaire included questions on three major aspects to record people's perceptions of cervical cancer, HPV, and vaccines. Of the sample of 230 women surveyed, 80.9% had heard of cervical cancer, but understanding was only 15.7%; 38.3% knew about HPV; 20% knew about HPV vaccine; 39.6% agreed to receive HPV vaccination, and the remainder were mainly concerned about its safety and effectiveness. Data analysis showed that age, family income, and whether there was experience of screening all influenced knowledge of cervical cancer, but this was not statistically significant. The level of education had no obvious effect on the degree of knowledge about cervical cancer; however, with an improvement in education, women's awareness of HPV vaccine improved significantly (p < 0.05). Women who have received cervical cancer screening had significantly greater knowledge about cervical cancer and HPV than those with no screening (p < 0.05). Women in northeastern China have little knowledge of cervical cancer, HPV, and HPV vaccine, lack disease knowledge, and hold a skeptical attitude about HPV vaccination. Medical institutions are the main channel providing information to these women.

A review of vaccine effects on women in light of the COVID-19 pandemic

The pandemic situation triggered by the spread of COVID-19 has caused great harm worldwide. More than six million people have been infected, and more than 360,000 of them have died. This is the worst catastrophe suffered by mankind in recent history. In the face of this severe disaster, people all over the world are frightened of the prospect of facing an outbreak or an annual recurrence. However, the development of a vaccine will help control the impact of COVID-19. Women in particular have been more seriously affected by the pandemic. Since the pressure and physical load they suffer are often greater than what men endure, women are more threatened by COVID-19. Though women have a poorer quality of life and work and face worse economic conditions, they also tend to have better physiological immunity than men, which can ease the effect of COVID-19. The early development of a vaccine against COVID-19 is an important issue that must take into consideration women's better immune response to the virus along with the technique of hormone regulation. Relevant research has been conducted on female-specific vaccines in the past, and women's issues were considered during those clinical trials to ensure that complications and antibody responses were positive and effective in women. National policies should also propose good strategies for women to be vaccinated. This could improve consciousness, give women a better vaccination experience, enhance their willingness to vaccinate, and protect them from COVID-19 infection.

Knowledge of Cervical Cancer and Human Papillomavirus Vaccines among Child-Bearing Aged Women in Hanoi, Vietnam

Objectives:

The study sought to examine knowledge of cervical cancer and human papillomavirus (HPV) vaccines among child-bearing aged women in Hanoi, Vietnam.

Methods:

In 2016, 807 women aged 18 to 49 years were recruited from one urban area and one rural area in 2016 and were examined through face-to-face paper-based interviews. Pearson’s chi-square test and an independent t-test were utilized to compare awareness of cervical cancer and HPV vaccination among women according residential status.

Results:

Overall, 83.8% and 71.3% women had heard about cervical cancer and HPV vaccination, respectively. Mean knowledge scores for cervical cancer and HPV vaccination were 4.60±1.43 out of 7 and 1.53±1.35 out of 5, respectively. Women living in an urban area were more likely to be aware of cervical cancer and to be more knowledgeable of HPV vaccination than women in a rural area.

Conclusions:

Despite strong awareness, we found knowledge on cervical cancer and HPV vaccination to be alarmingly insufficient among Vietnamese women.

Knowledge of Cervical Cancer and Adherence to Pap Smear Screening Test Among Female University Students in a Multiethnic Institution, USA

BACKGROUND/PURPOSE

This study assessed cervical cancer knowledge and examined its correlation with adherence to Pap smear guidelines.

METHODS

We carried out a cross-sectional survey in 141 undergraduate female college students. The response rate of the survey was 91.5%. Knowledge scores (0 - 4) were calculated based on students' answers to four items.

RESULTS

About 61.7% of the participants did not have annual checkups within a year, and 69% have never received Pap-test. Students who never received Pap-test mentioned procrastination (82%), lack of interest and fear as reasons for not practicing the behavior. About 92.9% of the students were not aware that the university student health service provides free Pap tests. More than double of annual checkup recipients undergone Pap test (33%) compared with those who did not have annual checkups (14.3%). Students who knew multi-partners sexual activity as a risk factor for cervical cancer had higher odds of receiving Pap test than those who didn't know the correlation between the number of sexual partner and the risk of cervical cancer [aOR= 2.87; 95% CI 1.07- 8.90]. Students with knowledge scores about cervical cancer risk factors and prevention methods at least a median had higher odds of receiving Pap test than those with knowledge scores lower than the median [aOR=6.49; 95% CI 2.8 - 14.7]. The increase in receipt of Pap test was associated with an increase in the level of knowledge about risk factors of cervical cancer.

CONCLUSIONS

This study confirmed a correlation of the receipt of Pap test with knowing the causes and prevention mechanisms of cervical cancer. Adequate knowledge about cervical cancer causes, and prevention/control strategies may help to improve adherence to Pap smear testing in college students.

Pamukkale University Medical Faculty Students' Knowledge Level of Human Papilloma Virus Infection and Vaccine

Aim: The aim of this study was to evaluate the knowledge level of Human Papilloma Virus infection and Human Papilloma Virus vaccine among medical students. Methods: This descriptive study was conducted among Pamukkale University Medical Faculty students between May and June 2019. The universe of our study consisted of 1129 students in the 1-5th grades. A questionnaire with 17 questions consisting of questions determining the level of knowledge about Human Papilloma Virus infection and vaccine developed by scanning the literature and socio-demographic data was applied to the students. Results: Of the 780 medical students who participated in the study, 91% knew Human Papilloma Virus and 85.6% knew about the Human Papilloma Virus vaccine. Knowing the Human Papilloma Virus vaccination of female students, getting vaccinated if possible, recommending them to their relatives and thinking that they should be included in the national vaccination schedule were significantly higher than male students. Also significant differences were found between the classes knowing the Human Papilloma Virus vaccine, having the vaccine if possible, recommending it to their relatives and thinking about taking part in the national vaccination schedule, especially with being in the 2nd grade and above. The rate of students vaccinated with Human Papilloma Virus was 2.1% and the most common reasons for not being vaccinated were not being at risk, not having enough information about the vaccine and its cost. Conclusion: We determined that knowledge of Human Papilloma Virus infection and Human Papilloma Virus vaccine, was high among medical students but the rate of vaccination was low. The reasons for not receiving vaccination included not feeling at risk, not having enough information and high cost. Keywords: HPV vaccines, medical students, knowledge

Sociodemographic determinants of knowledge and attitude in the primary prevention of cervical cancer among University Tunku Abdul Rahman (UTAR) students in Malaysia: preliminary study of HPV vaccination

BACKGROUND

Cervical cancer is the third most common cancer affecting women around the world in which the Human Papillomavirus (HPV) is the one of the recognized causative agent affecting women health. In response to this health issue, the Malaysian government had officially implemented the HPV immunisation programme for secondary schoolchildren in 2010 at the age of 13 years old and above. The purpose of this study is to investigate the sociodemographic determinants of knowledge and attitude among students of Universiti Tunku Abdul Rahman (UTAR) towards the HPV vaccination programme.

METHODS

A cross-sectional study was conducted using self-administered questionnaires, recruiting 374 UTAR's students as the respondents by using convenience sampling method. Respondents were categorized as having good/poor level of knowledge and positive/negative attitude towards HPV vaccination.

RESULTS

Over half of the respondents were females (64.5%) and the majority were aged 20 years old and below (55.8%). Generally, 54.7% of the total respondents had a high level of knowledge towards HPV vaccine while 57.5% of the total respondents showed a negative attitude towards HPV vaccine. Female respondents aged 20 years old and below showed good knowledge (56.4%) and a more positive attitude (55.8%) towards HPV vaccine. Students from the Faculty of Medicine and Health Sciences (FMHS) exhibited higher knowledge (67.3%) and positive attitude (62.4%) as compared to the Faculty of Accountancy and Management (FAM) which showed only 32.7% of knowledge and 37.6% of positive attitude towards the HPV vaccination.

CONCLUSION

The majority of UTAR students possess good knowledge regarding HPV vaccination. Nonetheless, they demonstrated a negative attitude towards HPV vaccination, depicting the necessity to impart and further intensify the sense of health awareness among all students, especially among male students. The judicious use of social media apart from the conventional mass media should be an advantage as to enhance the practice of HPV vaccination among them and thereafter minimize the health and economic burdens of cervical cancer.

Awareness, Knowledge and Attitudes of Human Papillomavirus (HPV) among Private University Students- Malaysia Perspective

Objective: Assess and analyse the awareness, knowledge, and attitudes of university students regarding HPV and its vaccine. Methods: A cross-sectional study was designed with questionnaire serving as the research instrument. A total of 425 university students were recruited voluntarily. Thirteen assessable questions were analysed to reveal the mean total knowledge score of HPV and its vaccine. Both descriptive and statistical approach were employed to analyse the research outcomes. Results: Students were moderately aware as 59.8% and 49.6% have heard about HPV and its vaccine, respectively. The mean total knowledge score was 5.26 ± 3.10 out of 13 which was found to be moderately knowledgeable. Female (N= 235) have a significantly higher mean knowledge score in comparison to male (N= 190) at 5.58 ± 2.80 versus 4.87 ± 3.40, respectively (p<0.05), likely due to the disease profiles favouring female. As hypothesised, health-related school students (N= 171) outperformed other schools (N= 254) at 7.00 ± 2.95 versus 4.10 ± 2.62, respectively (p<0.001). In general, the score depends on participant’s gender and educational background (χ2= 25.426, p<0.01 and χ2= 105.337, p<0.001, respectively). Despite low vaccination uptakes (28.5%), students accept the vaccine following physician’s recommendation and reject due to its cost. A positive attitude was seen as majority (88.7%) wished to know more about HPV. Conclusion: Moderation in awareness, knowledge and attitudes reflect the lifestyle of an urbanised population where information is accessible. Healthcare professionals, media campaign, and educational talk refinement are therefore essential in controlling the disease by spreading awareness.

Knowledge on the HPV vaccine among university students

The objective is to evaluate knowledge on HPV vaccine and its use among university students. This is a cross-sectional study with 301 participants, of which 202 medical students from UERJ and UNIFESO (101 freshmen = M1 and 101 from the 6th year = M2) and 99 UERJ literature students (50 freshmen = L1 and 49 of the last year = L2). Information was obtained by questionnaires. Input and statistical analysis were carried out with the EPI-INFO 3.5.2 Program. Results showed that, among medical students, 21% of M1 and 16% of M2 used the HPV vaccine (p=0.35), mostly adopted by women (M1=29.7% and M2=21.3%) than men (M1=5.4% and M2=7.5%). Similarly, female students showed more interest in using the vaccine (M1=85.1% and M2=80%) than male (M1=56.2% and M2=20.5%). Among literature students, only women received the vaccine (L1=6.5% and L2=22.2%) and no men were vaccinated (p=0.04). More women expressed interest in receiving the vaccine than men (♀ L1=76%, L2=65% and ♂, L1=47%, L2=40%). Comparison among genders regardless of the course showed that the vaccination rate is higher among women (p<0.001), as is the interest in being vaccinated (p=0.004). We concluded that the majority of male university students know less about the HPV vaccine than the female ones, use less and are less interested in being vaccinated, in all the groups interviewed. Vaccination coverage is low among the university population and is higher among medical students.

Gender and Sexual Orientation Differences in Human Papillomavirus (HPV) Vaccine Uptake among Chinese Young Adults

To date, empirical studies on HPV vaccine uptake are still limited in Chinese populations and mainly conducted in female cohorts. In order to inform health services planning and health promotion programmes for HPV vaccination, this cross-sectional study aimed to report the prevalence of self-reported HPV vaccination status and to examine gender and sexual orientation differences in the uptake of HPV vaccine in Chinese college students. The overall prevalence of HPV vaccine uptake was 27.6% (n = 242), with a significantly higher prevalence in females (39.7%) than in males (4.7%). 91.4% of subjects heard about HPV vaccination, with a significantly higher prevalence in females (93.8%) than in males (86.8%). The prevalence of HPV vaccine uptake was only 2.6% for bisexual/ homosexual males and 5.0% for heterosexual males. Only 45.8% of the overall subjects knew HPV vaccination is not for females only, with a significantly higher prevalence in females (49.7%) than in males (38.6%). The low prevalence of male HPV vaccine uptake and awareness called for the need to have more male-specific HPV campaigns to promote HPV vaccination awareness and uptake in males to reduce the overall prevalence of HPV infection.

Knowledge and Acceptance of Human Papillomavirus Vaccine for Cervical Cancer Prevention Among Urban Professional Women in Bangladesh: A Mixed Method Study

Prophylactic human papillomavirus (HPV) vaccination is the most effective preventive method against invasive cervical cancer, the second leading cause of cancer-related deaths among women in Bangladesh. Evidence on women's knowledge and perception about cervical cancer and HPV vaccination are needed for effective implementation of national cervical cancer prevention programs. The objective of this study was to assess the knowledge, attitude, and acceptance of cervical cancer, HPV, and HPV vaccination among urban professional women in Bangladesh. We recruited 160 female professionals employed at selected private banks in Bangladesh. Participants were selected using nonprobability-based convenience sampling for interviews through a self-administered questionnaire. Later, in-depth interviews were conducted with nine of these women. Quantitative data were analyzed utilizing descriptive statistics, whereas qualitative data were analyzed using a thematic approach. Ninety-eight percent of participants reported that they had previously heard of cervical cancer, however, only half (51%) reported to have heard of HPV as a cause of the disease. Less than 1% of the 160 participants had previously undergone a pap smear, and only 2% were vaccinated with at least one dose of HPV vaccination. Although knowledge was low, intention for acceptance of vaccination was moderate for women and high for their children. Although the majority of women had heard of cervical cancer, few women had in-depth knowledge of HPV and the etiology of invasive disease. This study draws attention to the urgent need of educational interventions on cervical cancer and its prevention to improve uptake of available HPV vaccination in Bangladesh.

Low rate of human papillomavirus vaccination among schoolgirls in Lebanon: barriers to vaccination with a focus on mothers' knowledge about available vaccines

Background

Human papillomavirus (HPV) infection is an established predisposing factor of cervical cancer. In this study, we assessed the awareness about genital warts, cervical cancer, and HPV vaccine among mothers having girls who are at the age of primary HPV vaccination attending a group of schools in Lebanon. We also assessed the rate of HPV vaccination among these girls and the barriers to vaccination in this community.

Subjects and methods

This is a cross-sectional, school-based survey. A 23-item, self-administered, anonymous, pretested, structured questionnaire with closed-ended questions was used to obtain data. The questionnaire was sent to the mothers through their student girls, and they were asked to return it within a week. Data were analyzed using the Statistical Package for Social Sciences version 21.0. Bivariate analysis was performed using the chi-square test to compare categorical variables, whereas continuous variables were compared using the Student's t-test. Fisher's exact test was used when chi-square test could not be employed.

Results

The response rate in our survey was 39.4%. Among the responders, the rate of awareness about HPV infection was 34%, where 72% of the mothers had heard about cervical cancer, and 34% knew that a vaccine is available to prevent cervical cancer. HPV vaccination uptake rate was 2.5%. This lack of vaccination was primarily attributed to the low rate of mothers' awareness about the vaccine (34%). Factors significantly affecting awareness about the vaccine were the mothers' marital age, nationality, level of education, employment, and family income. Barriers to HPV vaccination, other than awareness, were uncertainty about safety or efficacy of the vaccine, conservative ideas of mothers regarding their girls' future sexual life, and relatively high price of the vaccine.

Conclusion

Vaccine uptake is low among eligible girls attending this group of schools. The barriers to vaccination are multiple; the most important one is the mothers' lack of knowledge about HPV, cervical cancer, and the modes of prevention. Awareness campaigns along with a multimodal strategy that targets the identified barriers would be recommended to achieve higher rates of HPV vaccination.

Factors involved in human papillomavirus (HPV) vaccine hesitancy among women in the South-East Asian Region (SEAR) and Western Pacific Region (WPR): A scoping review

A scoping review was performed to identify factors that may lead to human papillomavirus (HPV) vaccine hesitancy among women in low- and middle-income countries in South East Asian Region (SEAR) and Western Pacific Region (WPR). A systematic search of English and non-English articles using Pubmed, EMBASE, PsycINFO, Cochrane, MEDLINE, and CINAHL plus was conducted. Only 63 studies conducted in SEAR and WPR were included from inception until December 2016. Results of these studies have shown that poor awareness and knowledge of practices on cervical cancer prevention was evident in both SEAR and WPR. Concerns on safety and efficacy of the vaccine, and costs in getting vaccinated were significant barriers. Most women stated that they needed more information, and strongly welcomed a physician's recommendation in both geographical regions. Women also felt they have a low risk of acquiring HPV infection and cervical cancer. Most women in SEAR and WPR were unable to decide on whether to accept HPV vaccination.

High trait shame undermines the protective effects of prevalence knowledge on state shame following HPV/CIN diagnosis in women

Human papillomavirus (HPV), and the related, cervical intraepithelial neoplasia (CIN), are common yet poorly understood physical conditions. The diagnosis of HPV often elicits shame and guilt, which in turn may undermine psychological and physical health. The current study compared shame and guilt responses to diagnosis among two groups: women diagnosed with HPV/CIN and women diagnosed with Epstein-Barr Virus (EBV/IM). Eighty women recently diagnosed with HPV/CIN or EBV/IM completed measures of shame- and guilt-proneness, shame and guilt following diagnosis, and disease knowledge including prevalence estimates (HPV and EBV, respectively). HPV/CIN (vs. EBV/IM) predicted more diagnosis-related shame and guilt. Estimates of high prevalence interacted with diagnosis and shame-proneness to predict diagnosis-related shame. Simple slope analyses indicated that in women with HPV/CIN reporting low-to-average shame-proneness, high prevalence estimates reduced diagnosis-related shame; however, women high in shame-proneness experienced high diagnosis-related shame regardless of more accurate prevalence estimates. Women high in shame-proneness appear to be particularly vulnerable to HPV-related shame even when they are aware that it is very common.

Cervical Cancer Prevention in Malaysia: Knowledge and Attitude of Undergraduate Pharmacy Students Towards Human Papillomavirus Infection, Screening and Vaccination in Malaysia

This study was conducted to evaluate knowledge of undergraduate pharmacy students about human papillomavirus infection and their attitude towards its prevention. A cross-sectional survey was conducted in 270 undergraduate pharmacy students using a validated questionnaire to assess knowledge about human papillomavirus infection and cervical cancer and their attitudes towards human papillomavirus vaccines. Eighty-one percent of the respondents knew that human papillomavirus is a cause of cervical cancer, and 87.8 % knew that this infection is preventable. The gender of the respondents showed the strongest correlations with human papillomavirus knowledge. There were no significant correlations between the ethnic group of the respondents and their human papillomavirus-related knowledge. Higher perceptions of risk were associated with relationship status, and respondents who were in a relationship showed greater interest in vaccinating themselves; relationship status emerged as a unique predictor. The results indicated a moderately high level of knowledge and positive attitude towards human papillomavirus vaccination with few disagreements. The results of this study will help to develop and plan appropriate education campaigns for pharmacy students that aim to reduce human papillomavirus infection and, consequently, the incidence of and mortality caused by cervical cancer in Malaysia.

Knowledge, perceptions and acceptability of HPV vaccination among medical students in Chongqing, China

OBJECTIVES

To evaluate medical students' knowledge of HPV and HPV related diseases and assess their attitudes towards HPV vaccination.

METHODS

A total of 605 medical undergraduates from Chongqing Medical University in China were surveyed using a structured and pretested questionnaire on HPV related knowledge.

RESULTS

Some 68.9% of the medical students were females, and mean age was 21.6 (±1.00) years. Only 10.6% correctly answered more than 11 out of 14 questions on HPV related knowledge, 71.8% being willing to receive/ advise on HPV vaccination. Female students (OR: 2.69; 95% CI: 1.53-4.72) and students desiring more HPV education (OR: 4.24; 95% CI: 1.67-10.8) were more willing to accept HPV vaccination. HPV vaccination acceptability was observed to show a positive association with HPV related knowledge.

CONCLUSIONS

Our survey found low levels of HPV related knowledge and HPV vaccination acceptability among participating medical students. HPV education should be systematically incorporated into medical education to increase awareness of HPV vaccination.

A brief information-motivation-behavioral skills intervention to promote human papillomavirus vaccination among college-aged women

Background

Human papillomavirus (HPV) is prevalent among college-aged women. Although HPV vaccines decrease women’s risk for cervical cancer, the vaccination rates remain inadequate.

Objective

This study explored the utility of an information–motivation–behavioral skills (IMB) intervention in promoting HPV vaccination knowledge, motivation, and intentions among college-aged women.

Methods

In Spring/Fall 2012, 62 participants were randomly assigned to a single-session intervention or attention control and were assessed baseline, post-intervention, and at 1 month.

Results

The participants demonstrated adequate baseline vaccine knowledge, low HPV/cancer knowledge, and ambivalence about the vaccination. Post-intervention, the IMB arm demonstrated increased HPV/cancer and vaccination knowledge, motivation, and intentions. There were no group differences in vaccination at 1 month; however, the odds of wanting to get vaccinated increased sevenfold in the IMB arm.

Conclusion

These results provide preliminary support for an IMB-based intervention in increasing vaccination knowledge, motivation, and intentions among at-risk women. Future research examining the efficacy of longer trials with larger, diverse populations is warranted.

Knowledge, Attitude and Practices Regarding HPV Vaccination Among Medical and Para Medical in Students, India a Cross Sectional Study

BACKGROUND

High risk human papilloma virus (HPV) types 16 and 18 have been proven as central causes of cervical cancer and safety and immunogenicity of HPV vaccines are sufficiently established. Knowledge and practices of HPV vaccination among medical and paramedical students is vital as these may strongly determine intention to recommend vaccination to others in the future. The present study was therefore undertaken to assess the knowledge, attitude and practices regarding cervical cancer screening and HPV vaccination among medical and paramedical students and to analyze factors influencing them.

MATERIALS AND METHODS

The present cross sectional study, conducted in a tertiary care teaching hospital in south India, included undergraduate students aged 18 years and above, belonging to medical, dental and nursing streams, after informed written consent.

RESULTS

Out of 957 participants, only 430 (44.9%) displayed good knowledge and only 65 (6.8%) had received HPV vaccination. Among the unvaccinated, 433 (48.54%), were not willing to take the vaccine. Concerns regarding the efficacy (30.5%), safety (26.1%) and cost of the vaccine (21.7%) were responsible for this. Age, gender, family history of malignancy and mother's education had no influence on knowledge. Compared to medical students, nursing students had better knowledge (OR-1.49, 95% CI 0.96 to 2.3, p = 0.072) and students of dentistry had poor knowledge (OR-0.50 95% CI 0.36 to 0.70, p <0.001).

CONCLUSIONS

The knowledge and uptake of HPV vaccination among medical and paramedical students in India is poor. Targeted health education interventions may have huge positive impact not only on the acceptance of vaccination among them, but also on their intention to recommend the vaccine in future.

A study on the predictors of Korean male students' intention to receive human papillomavirus vaccination

AIMS AND OBJECTIVES

The objective was to survey the current state of human papillomavirus (HPV) vaccination and the predictors of vaccination intention among Korean male students of high school (ages 15-19) and university (ages 17-27).

BACKGROUND

Human papillomavirus is a sexually transmitted infectious agent causing uterine cervical, anal, and/or penile cancer and genital warts in males and females. Infection rate of human papillomavirus increases from the age when sexual intercourse first occurs. Therefore, motivation to receive human papillomavirus vaccination is needed to protect infection.

DESIGN

Cross-sectional descriptive survey was performed only in male students. They are less aware of human papillomavirus than females, because human papillomavirus vaccination has been targeted on females for preventing cervical cancer in Korea.

METHODS

Data were collected using a self-reporting questionnaire for male high school and university students sampled from a city in Korea. Human papillomavirus vaccine-related knowledge, health beliefs, demographic, and sexual history information variables relating to intentions to vaccinate were assessed.

RESULTS

The human papillomavirus vaccination rate was very low and the levels of knowledge and health beliefs were low. The significant predictors that raised the intention of human papillomavirus vaccination were a university student, experience of sexual intercourse and perceiving the benefits of human papillomavirus vaccination.

CONCLUSIONS

To promote human papillomavirus vaccination, educational programming targeting males should include health beliefs and knowledge, emphasising that vaccination is important to prevent uterine cervical cancer and to role as a preventative measure against common male diseases.

RELEVANCE TO CLINICAL PRACTICE

Male high school students should be included as a major target population for school human papillomavirus education programmes, as they are at the age of commencing sexual intercourse. In addition, public health policies including human papillomavirus vaccination in the national immunisation programme are warranted.

Knowledge level of working and student nurses on cervical cancer and human papilloma virus vaccines

PURPOSE

To determine knowledge levels of working and student nurses about cervical cancer and prophylactic cancer vaccines.

MATERIALS AND METHODS

This study was performed on 259 nursing students in the Department of Nursing and 137 nurses working in Health Research and Practice Center, approved to participate in the study between April-June 2012. The study was performed universally without selecting a sample. A questionnaire that was prepared for evaluating participants' knowledge and attitudes about human papilloma virus (HPV) vaccine was distributed to the nurses and data obtained from the forms were transferred to SPSS 15.00 program and statistically analyzed.

RESULTS

It was found that 54.8% of the student nurses were between 21-24 years old and 13.1% of working students were between 25-28 years old. When student nurses and working nurses were compared in terms of their knowledge about the causes of cervical cancer, their ideas about prevention from cervical cancer with HPV vaccine, their ideas about possible risks of HPV vaccine and conservation ratios of HPV vaccine, it was observed that there were no statistically significant differences (p>0.05). When student nurses and working nurses were compared in terms of the information-source about HPV, ways of HPV contamination, awareness about people who are susceptible to HPV contamination and age of HPV vaccination, it was determined that there was a statistically significant difference (p<0.05).

CONCLUSIONS

It was found that all nurses had some knowledge about cervical cancer and HPV vaccine, but this was not sufficient. Therefore; it is recommended to use verbal, written and visual communication tools intensively in order to have topics on cervical cancer, early diagnosis and prevention in bachelor and master programs for nurses, to inform society about cervical cancer and HPV vaccine for public health and to teach precautions for its prevention.

Knowledge of Cervical Cancer Screening among Women across Different Socio-Economic Regions of China

Background and Objective

China has a high burden of cervical cancer (CC) and wide disparities in CC burden exist among different socio-economic regions. In order to reduce these disparities, China’s government launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Understanding the factors associated with underutilization of CC screening among target populations is important to improve the screening participation rate, and a high participation rate is key to achieving the goals of a screening program. However, data on the knowledge of CC among target populations in program areas is lacking in China. This study will investigate the knowledge of CC prevention and control among women in specific project counties to develop a better understanding of factors that might influence CC screening participation in order to improve the implementation of the NCCSPRA.

Materials and Methods

A cross-sectional survey was conducted and face-to-face interview questionnaires were completed by 308 women who received CC screening services in 6 project counties of NCCSPRA across different socio-economic regions of China. ANOVA and Chi-square tests were used to compare the knowledge rates and scores across the different subgroups. Logistic regression was conducted to examine factors associated with knowledge level.

Results

The overall CC knowledge rate of the target population was only 19.5%. Regional socio-economic level, advice from doctors, age, and educational status were strong predictors of knowledge level of CC screening. Significantly lower knowledge rates and scores were identified in older women (55–64 years old), less educated women (with primary school or illiterate), women in less developed regions and women who did not receive any advice about screening results from doctors.

Conclusion

The knowledge of CC screening among women in the project counties of NCCSPRA was found to be very poor. Given the importance of knowledge in encouraging women to participate in screening is key to reducing CC burden in rural women in China, it is urgent that a targeted health promotion intervention is developed and implemented in project counties, especially targeting older women, women with less education and women in less developed regions, and focus on improving their CC knowledge and encouraging them to communicate with health care providers. The health promotion intervention targeting health care providers is also important to improve their knowledge of CC and provide best advice to women.

Awareness and acceptance of human papillomavirus vaccination among health sciences students in Malaysia

The major cause of cervical cancer is human papillomavirus (HPV) for which vaccination is available. The success HPV vaccination programme largely depend on the degree of knowledge of the healthcare providers who can recommend to the public. Health sciences students as future healthcare providers play a major role in HPV vaccination initiatives. The objective of this study was to evaluate the knowledge, attitude, practice and to find out the willingness to pay for HPV vaccination among the health sciences students in a private university. The cross-sectional study was conducted among the university students studying health sciences program using a validated questionnaire to measure their awareness and acceptance of HPV vaccination. The students demonstrated moderate knowledge about HPV infection and vaccination with mean knowledge scores of 9.3 out of 17. Students were showing positive attitude towards HPV vaccination with mean scores of 3.80 out of 5. However, low HPV vaccination uptake rate was reported among the students. Most of the students were willing to recommend HPV vaccine. The participants felt that the cost is the major barrier towards HPV vaccination and they felt the government should cover the cost of vaccination for all. The results of this study may be helpful in establishing educational policies on cervical cancer-related topics in the universities.

Human papillomavirus vaccine acceptability among female undergraduate students in China: the role of knowledge and psychosocial factors

AIMS AND OBJECTIVES

To examine young women's perceptions and acceptability of human papillomavirus vaccination and factors influencing acceptability in mainland China.

BACKGROUND

In the light of current concepts, human papillomavirus vaccines serve as new paradigms in cervical cancer prevention programme for young women. However, knowledge and acceptability of human papillomavirus vaccination and factors influencing acceptability among young Chinese women are not known.

DESIGN

We implemented a cross-sectional descriptive study in the Hunan province of China.

METHODS

One hundred and seventeen female undergraduate students completed confidential surveys in 2012. The questionnaire included five parts: background information, awareness and knowledge of human papillomavirus vaccine and cervical cancer, attitudes towards the vaccine and intentions to be vaccinated, psychosocial burden of human papillomavirus infection, and human papillomavirus-related sexual stigma.

RESULTS

Only 44% of the participants were willing to be vaccinated in the future. Young women demonstrated low awareness and knowledge about human papillomavirus vaccine and cervical cancer. Their intention to receive future vaccination was associated with the high levels of knowledge about risk factors for cervical cancer and perceptions that infected women are responsible for their own infection of human papillomavirus.

CONCLUSION

The results of this study suggest low awareness and knowledge among young Chinese women about the preventive nature and value of human papillomavirus vaccination. Social and cultural factors including moral obligation and STD-related stigma may influence young women's intention to future vaccination.

RELEVANCE TO CLINICAL PRACTICE

Educational interventions are necessary to promote public awareness and deliver information about human papillomavirus vaccination and cervical cancer prevention. Results of this study can help health care practitioners develop appropriate programmes for the promotion of human papillomavirus vaccination among this population.

Knowledge of human papillomavirus (HPV) infection, cervical cancer, and HPV vaccine and its correlates among medical students in Southwest China: a multi-center cross-sectional survey

BACKGROUND

Since cervical cancer can be prevented and controlled through human papillomavirus (HPV) vaccination, it is important to train health care providers and provide them with appropriate knowledge. This study aimed to understand the level of HPV related knowledge among medical students and correlates in Southwest China in order to address any potential gap in their knowledge base.

METHODS

We conducted a cross-sectional survey among medical students in six selected universities across Southwest China based on a pretested questionnaire regarding HPV infection, cervical cancer, and HPV vaccines.

RESULTS

We successfully surveyed 1, 878 medical students, of whom 32.1% were males and 67.9% were females. Their mean age was 20.8 (standard deviation: 1.3) years. 91.8% of them were ethnic Han Chinese, and 43.8% were students in clinical medicine. While 76.5% had heard of HPV only 48.8% knew that the prevention of cervical cancer was possible through HPV vaccination. Only 42.9% of the male and 49.2% of the female students correctly answered over 10 out of 22 questions on HPV related knowledge. Female students appeared to know more about HPV and HPV vaccination (OR: 1.39; 95% CI: 1.11-1.75). In addition, the student knowledge improved with the grade (p<0.001). University courses were the most selected source of knowledge about HPV vaccination (66.4%). 83.6% of males and 91.4% of females were willing to have more HPV related education by experts (p<0.001). Only 10.1% of the students acknowledged that people had asked for their advice regarding HPV vaccination.

CONCLUSIONS

Our survey indicates that medical students from Southwest China have poor knowledge of HPV and HPV vaccination, but are willing to receive more relevant information. Targeted education should be incorporated into school courses to inform these future health care providers and ensure success of programs for cervical cancer control and prevention.

Young Singaporean women's knowledge of cervical cancer and pap smear screening: a descriptive study

AIMS AND OBJECTIVES

To assess the knowledge of young female Singaporeans regarding cervical cancer and pap smear, the intention to participate in pap smear and whether there is any relationship between knowledge and intention to participate in pap smear screening.

BACKGROUND

While cervical cancer has poor prognosis in the later stages, pap smear is effective in identifying precancerous lesions, which are more treatable. Pap smear screening is available to women in Singapore, but its uptake is opportunistic. Research has shown that knowledge about pap smear and cervical cancer is important determinant of screening behaviour in Singaporean women.

DESIGN

Cross-sectional descriptive correlational design was used.

METHODS

Three hundred and ninety-three young Singaporean undergraduates, aged 18-25 years, were recruited via convenience sampling from a local university over a four-month period. Data were collected through self-administered questionnaires.

RESULTS

Majority of the participants knew the term 'pap smear' and its function. However, knowledge of the risk factors for cervical cancer was lacking among the young women. Knowledge of pap smear and cervical cancer had a weak correlation with the intention to go for the future uptake of pap smear.

CONCLUSIONS

Educational efforts among younger Singaporean women on the knowledge of pap smear and risk factors for cervical cancer are needed. Improving knowledge will enable them to understand the importance of reducing exposure to risk factors and regular pap smear screening.

RELEVANCE TO CLINICAL PRACTICE

All health professionals working with young Asian women should be prepared to educate and counsel young women to participate in pap smear screening according to current guidelines. In particular, knowledge of the age to attend the first pap smear and the recommended frequency for screening need to be targeted for health education.

Human papillomavirus vaccines and cervical cancer: awareness, knowledge, and risk perception among Turkish undergraduate students

The aim of this study was to evaluate awareness, knowledge, and risk perception about human papillomavirus (HPV), cervical cancer, and HPV vaccines among undergraduate students in Turkey. The convenience sample of this descriptive cross-sectional study consisted of 605 undergraduate students in Istanbul University during a semester. Demographic characteristics of students, their reproductive health and lifestyle behaviors, and knowledge of HPV and HPV vaccine were questioned using self-administered forms. The overall proportion of students who had heard about HPV infection was 48.8%, while the proportion of students who had heard of the HPV vaccine was 44.5%. Forty eight percent of females and 60% of males reported never having heard of the HPV. Only 45.7% of females had knowledge about HPV as a cause of genital warts, and 58.1% correctly indicated that HPV caused cervical cancer. The majority of students in both genders (>80%) knew that the infection is primarily transmitted through sexual intercourse. Females were more concerned than males about having cervical/penile cancer associated with HPV in the future. Only 46.4% of females and 39% of males reported having heard of the HPV vaccine. The majority of the female and male students did not know who should get the HPV vaccine and when to get vaccinated. Among males, 25.8% reported that they would consider getting vaccinated (if available) and 38.4% intended to vaccinate their children. Turkish undergraduate students had a low to moderate level of knowledge regarding HPV infection and HPV vaccine. In order to increase awareness about HPV and develop positive behaviors, young people should be provided with accurate information through educational activities in the community and health care services.

Knowledge, attitudes and beliefs about cervical cancer and human papilloma virus vaccination with related factors in Turkish university students

BACKGROUND

This study aimed to determine knowledge, attitudes and believes about cervical cancer and human papilloma virus (HPV) vaccination with related factors in Turkish university students.

MATERIALS AND METHODS

This descriptive and cross sectional study was conducted between June-July 2013 in Hitit University located in Corum, a rural area to the East of Ankara. The population consisted of 550 university students who were training in first and last year from Faculties of Economics, Theology and Health. We reached 463 volunteer students without selection. The study of data was collected with a 44 item questionaire covering socio-demographic features, knowledge, attitudes and beliefs about cervical cancer, HPV and vaccination. Also for this study ethic committee report was taken from Bozok University. Data were evaluated with the SPSS 17.0 programme using the Ki kare test with P<0.05 accepted as statistically significant.

RESULTS

It was seen that there was a statistically significant variation between classrooms and departments of students with knowledge about cervical cancer and human papilloma virus and vaccine (p<0.001; p<0.01; p<0.05). Also we found low attitudes to thinking about taking HPV vaccination of girls and their children in the future.

CONCLUSIONS

In light of the study findings; it was concluded that knowledge levels, beliefs and attitudes of the university students about cervical cancer, HPV infection and HPV vaccination were low.

Knowledge, perception and attitude towards human papillomavirus among pre-university students in Malaysia

BACKGROUND

To evaluate the knowledge, perception and attitudes towards human papilloma virus (HPV) among pre-university students in Malaysia.

STUDY DESIGN

In this cross sectional study, between November 2013 to March 2014, in a public university, a convenient sampling method was used. A total of 716 respondents were recruited and interviewed with a set of standard questionnaires for assessment of knowledge, perception and attitudes towards HPV and predictor variables associated with level of knowledge.

RESULTS

Almost half (48.9%) of the respondents scored less than 5 and were categorised as having poor knowledge. Three hundred and twelve (43.6%) respondents had moderate knowledge and only 54 (7.5%) respondents exhibited good knowledge with the score of 11 and above. Only 142 (20%) students perceived themselves to be vulnerable to HPV infection though 560 (78.2%) students thought that HPV infection is a serious disease. Perceived benefits and desire to be vaccinated were significantly associated with gender (p=0.000) and knowledge of HPV vaccine and cervical cancer (p=0.000).

CONCLUSIONS

The level of knowledge regarding HPV among the pre-university students was low. However, student intention for vaccination increased with increasing level of knowledge. Thus, efforts to improve knowledge and awareness should be prioritised to increase uptake of the HPV vaccination programme and hence reduce morbidity and mortality from consequences of HPV infection, including cervical carcinoma.

University students' knowledge and attitudes regarding cervical cancer, human papillomavirus, and human papillomavirus vaccines in Turkey

OBJECTIVES

The current descriptive study aimed to determine university students' knowledge and attitudes regarding cervical cancer, human papillomavirus (HPV), and HPV vaccines in Turkey.

PARTICIPANTS

A total of 800 students participated.

METHODS

This study was carried out between September 1, 2012, and October 30, 2012, in 8 female dormitories.

RESULTS

In response to the question "What are cervical cancer risk factors?" 10.0% of students said HPV; 90.9% were unaware of how to protect themselves from HPV. Of the students, 99.7% had not had an HPV vaccination, only 32.6% wanted to get an HPV vaccination, and 20.7% did not want to be vaccinated, as they believe it "might have adverse effects."

CONCLUSIONS

The results of the present study show that female university students have low levels of awareness and knowledge toward cervical cancer risk factors, HPV, and HPV vaccination.

Female students receiving post-secondary education in Greece: the results of a collaborative human papillomavirus knowledge survey

OBJECTIVES

Contrary to the optimistic forecasts, existing until 2008 and despite the incorporation of the vaccine into the Greek National Immunization Program, six years later, the percentage of HPV vaccination coverage in Greece remains disappointingly low. The aim of this extended study was to investigate the knowledge, behaviour and attitude of a representative sample of the initial target group; young female students of Greek higher education institutions to Pap cervical screening, biology of HPV infection and principles of HPV vaccination.

STUDY DESIGN

Cross-sectional study.

METHODS

One thousand two hundred ten (1210) questionnaires were completed by young female students aged 17-24 years. The survey questionnaire sought data relating to sociodemographic characteristics, health behaviour and knowledge about HPV, as well as vaccination status.

RESULTS

79.6% of the sample reported at least one annual gynaecologic examination and 92.6% were familiar with the rationale of cervical screening; however only 52.9% had undergone a Pap smear. 69.7% reported adequate knowledge about HPV and 89.3% were aware of the possible course of HPV infection. Despite most (95.9%) were aware of vaccine availability, vaccinated students represented only 33.1%. According to the multivariate analysis, vaccination status was associated with university studies (OR 1.96; 95% CI: 1.19-3.20), parental area of expertise (OR 2.77; 95% CI: 1.18-6.53, OR 2.03; 95% CI: 1.05-3.94), and adequate knowledge of the reasons for which women should undergo regular cervical screening (OR 4.23; 85% CI: 1.55-11.55). Fear of side-effects and equivocal information were the main reasons of non-vaccination (52.2% and 33.1% respectively). Finally, the majority of unvaccinated individuals showed a positive attitude towards prospective HPV vaccination, providing they received well-documented advising.

CONCLUSIONS

Young women attending Greek higher education exhibit a good level of knowledge about HPV and its correlation with cervical cancer. These data highlight the need for further sensitization of the general population.

Human Papillomavirus vaccination acceptability among female university students in South Africa

BACKGROUND

The objectives of this present study were to assess the awareness of cervical cancer and its risk factors among female undergraduates in South Africa, and to determine the their level of acceptability of Human Papillomavirus (HPV) vaccination.

MATERIALS AND METHODS

This cross-sectional study was conducted in March 2013 among 440 full time undergraduate female students.

RESULTS

Of those students who never had sex (n=163), 96 (58.9%) had ever heard of cervical cancer and only 12 students (12.5%) knew that HPV causes cervical cancer. More than a third (35.4%) of the students correctly said that sexual intercourse before age of 18 years is a risk factor for cervical cancer and 55.2% of the students knew about the Pap smear test which is used for screening cervical cancer. The majority (77.3%) were willing to accept HPV vaccination. Results revealed that students who knew about the Pap smear test, and were aware that having multiple sex partners, sexual intercourse before the age of 18 years, smoking and having contracted any STDs are risk factors for cervical cancer were more likely to accept HPV vaccination compared to other groups.

CONCLUSIONS

The general knowledge of South African female university students about cervical cancer is not sufficient but they have positive attitudes toward getting vaccinated with the HPV vaccine.