Sex differences among college students in awareness of the human papillomavirus vaccine and vaccine options

Knowledge and perceptions regarding Human Papillomavirus (HPV) and willingness to receive HPV vaccination among university students in a north-eastern city in Turkey

BACKGROUND

For a HPV vaccination program to be successful, it is important that the target population has sufficient knowledge about HPV and HPV vaccines. The aim of this study was to evaluate HPV-related knowledge levels among students at a university in northern Turkey, to assess vaccination willingness, and to determine factors associated with HPV-related knowledge.

METHODS

This cross-sectional study was conducted on 824 (93.1%) students studying at 16 different faculties. The study population was identified through the proportional stratified sampling method. Data were collected through a questionnaire including socio-demographic characteristics and the HPV Knowledge Scale. Multiple linear regression analysis was performed to identify factors that may be associated with knowledge scores.

RESULTS

43.6% of the students had never heard of HPV, 50.6% of them had never heard of HPV screening tests or HPV vaccination. Only 2.7% of the students were vaccinated against HPV and 15.7% were willing to receive HPV vaccination. Awareness of HPV and willingness to receive vaccination were found to be higher among women, while previous experience with sexual intercourse was higher in men (p < 0.05). The mean HPV knowledge score was quite low (6.74 ± 7.13 out of 29 points). The studying in a field related to health sciences, being a senior student, intending to be vaccinated, being a woman, having had sex were found to be associated with high knowledge levels (p < 0.05).

CONCLUSIONS

Educational programmes should be developed to increase university students' knowledge about HPV and the HPV vaccine.

Human papillomavirus (HPV) and HPV vaccine knowledge, the intention to vaccinate, and HPV vaccination uptake among male college students

ObjectiveThis systematic mixed studies review aims to summarize the results of available research on knowledge of the human papillomavirus (HPV) and HPV vaccine, the intention to vaccinate, and HPV vaccination uptake among male college students. Methods: PubMed, ProQuest, EBSCO, PsycINFO, JSTOR, MEDLINE, and Google Scholar searches were performed to identify studies. A total of 39 studies were included in this review. Results: Most studies were cross-sectional (n = 27) and used convenience samples (n = 18). Although many students were aware of HPV and the HPV vaccine, gaps in their knowledge about the mode of transmission, symptoms, risk factors, and HPV vaccine mechanism were evident. The cost of HPV vaccination and concerns about safety and side effects were the most frequently reported barriers to obtaining the vaccination. Conclusion: More effort to increase knowledge about HPV and the uptake of the HPV vaccination among college men in the United States is necessary.

Knowledge, Perceptions, and Uptake of the Human Papillomavirus Vaccine in a Sample of US High School Adolescents

OBJECTIVE

To assess high school students' knowledge and perceptions of human papillomavirus (HPV) and HPV vaccines and evaluate high school students' self-reported uptake of the HPV vaccine.

METHODS

This was an observational, descriptive study using a 44-question survey. Participants were ninth grade students in a Colorado public school district. The survey was administered as part of a health education course.

RESULTS

Ninety-two surveys were included in the analysis. Demographic characteristics included 64/92 (69.6%) male and 55/92 (59.8%) Hispanic/Latino students. There was no difference between males and females regarding self-reported vaccination status. Non-Hispanic students were 71.6% less likely to have received the HPV vaccine than Hispanic students (OR 0.284; 95% CI, 0.088–0.920; p = 0.036). The average score on the knowledge section was 42.7% with a standard deviation of 22.6%. When assessing students' perceptions, 71/92 (77.2%) disagreed or strongly disagreed that they felt at risk for getting an HPV infection. There was no significant difference between males and females regarding awareness of the HPV vaccine (p = 0.14). More than half of students (58.7%) did not know if they had received the HPV vaccine.

CONCLUSION

HPV vaccine awareness was low and many students did not know if they had received the HPV vaccine. Ninth grade students did not have accurate knowledge of HPV and HPV vaccines and this study presents opportunities for increased education.

Impact of school-based educational interventions in middle adolescent populations (15-17yrs) on human papillomavirus (HPV) vaccination uptake and perceptions/knowledge of HPV and its associated cancers: A systematic review

The American Academy of Paediatrics (AAP) divides adolescence into early (12-14 years), middle (15-17 years), and late (18-21 years) stages. School-based HPV educational interventions are largely directed at parents of early adolescents at the time of vaccination. As the average age of first sexual intercourse in high income countries is 15-17 years old, a second educational intervention for middle adolescents could have a strong impact on HPV prevention, providing an opportunity for self-consenting to HPV vaccination in many countries. This paper appraises literature exploring the impact of school-based educational interventions in 15-17 year olds, on HPV vaccination uptake and/or perceptions/knowledge of HPV and its associated cancers. Randomised controlled trials (RCTs) and quasi-experimental designs (QEDs) (2007-2019) were included if they delivered a school-based educational intervention for 15-17 year olds, and the outcome measures included HPV vaccination uptake, knowledge of HPV and associated cancers or perception/attitude regarding self-protection against HPV. Fifteen studies met the inclusion criteria and were assessed for quality using the Quality Assessment Tool for Quantitative Studies. All studies demonstrated a statistically significant improvement in at least one major outcome measure post-intervention, despite the wide range in design of interventions, though only three studies actually measured changes to HPV vaccination uptake. Stakeholder engagement was absent in most intervention designs and many were not grounded in evidenced theory. Content was largely focused on female cervical cancer, rarely discussing oropharyngeal cancer, the most pre-dominant HPV-associated cancer in men. An optimal mixed gender intervention remains to be established for middle adolescents.

Human papillomavirus vaccination among diverse college students in the state of Georgia: who receives recommendation, who initiates and what are the reasons?

Young adulthood is a critical time for catch-up HPV vaccination. We assessed predictors of vaccine recommendation and initiation among college students. We analysed cross-sectional surveys from 2397 students using multivariable logistic regressions. Guided by the Socio-ecological and Health Belief Models, measures included socio-demographic characteristics, intrapersonal measures (e.g. vaccine beliefs), interpersonal measures (e.g. doctor's recommendation) and institutional-level measures (e.g. college settings). The sample included students from private, public, technical and historically black colleges/universities. Of the sample, 64.5% were White; additionally, 48.3% of women (n = 750/1552) and 18.8% of men (n = 159/845) received a doctor's recommendation. Among women, predictors included older age, US-born, higher parental education and attending private schools. Among men, predictors included younger age, being homosexual and attending private schools. HPV vaccine series initiation was low-43.3% of women (n = 672) and 16.7% of men (n = 141). Doctor's recommendation predicted initiation for both sexes. Younger women, women attending technical colleges and men of 'multiple/other' race had lower odds of initiation. Common initiation barriers for both sexes included a lack of doctor recommendation and sexual inactivity. These barriers and the associations between nativity, race and socio-economic status with vaccine recommendation and initiation should be further investigated. Interventions should improve patient-provider communication around HPV vaccine.

HPV Vaccination in Correctional Care: Knowledge, Attitudes, and Barriers Among Incarcerated Women

Incarcerated women are at increased risk of developing cervical cancer and have high rates of human papillomavirus (HPV) infection, an important cause of cervical cancer. However, many correctional facilities do not offer HPV vaccination to female inmates. This pilot survey study, conducted with incarcerated women aged 18 to 26 at a facility that does not offer the vaccine, assessed attitudes and knowledge about HPV and the HPV vaccine, acceptability of and barriers to in-prison HPV vaccination, and self-reported HPV vaccination rates. Most participants reported that they had not received the HPV vaccine but had positive attitudes toward it and would be willing to get it in prison. Correctional facilities should consider offering this preventive service to this vulnerable population.

Knowledge and Behavior of University Students toward Human Papillomavirus and Vaccination

Objectives:

Human papillomavirus (HPV) causes cervical cancer. This study aimed to determine the knowledge and attitude of university students toward HPV infection and vaccine prevention in Turkey.

Methods:

A total of 1563 female and male university students participated in the study. The study design was descriptive and cross-sectional. The study included students enrolled in the departments of faculties and vocational schools.

Results:

In total, 16.8% of students stated that they had heard of HPV. There was a statistically significant relationship between the mean awareness of HPV and different variables, such as age, gender, marital status, family history of cancer, and conversation about sexual matters (P < 0.01). As the age of the students increased, the chance of hearing about HPV also increased. Of all the students, 1.5% took HPV vaccination. Furthermore, 87.7% of the female students stated that they had heard of cervical cancer.

Conclusions:

The depth of knowledge among Turkish university students toward cervical cancer, HPV infection, and vaccination was inadequate. It is important to provide educational and counseling services by nurses to make university students aware of HPV infection and vaccination.

Predictors of Adults' Knowledge and Awareness of HPV, HPV-Associated Cancers, and the HPV Vaccine: Implications for Health Education

High human papillomavirus (HPV) prevalence and low HPV vaccine uptake are significant public health concerns. Disparities in HPV-associated cancers and HPV vaccine uptake rates suggest the need for additional research examining factors associated with vaccine acceptance. This study assessed HPV awareness and knowledge and identified sociodemographic characteristics associated with HPV knowledge at the population level. Data from adult men ( n = 1,197) and women ( n = 1,906) who participated in the National Cancer Institute's 2014 Health Information National Trends Survey were analyzed. Multivariable regression was used to identify predictors of four HPV knowledge categories: (1) general knowledge, (2) cervical cancer knowledge, (3) "other" cancer knowledge (i.e., anal, oral, penile), and (4) vaccine knowledge. Significant gender differences in awareness and knowledge of HPV and the HPV vaccine were revealed. Most participants (>70%) knew that HPV could cause cervical cancer, but fewer (14.9% to 31.5%) knew of the association between HPV and "other" cancers. Women were more likely to report that a health care provider recommended vaccination. Significant predictors of general HPV and HPV vaccine knowledge included gender, education, income, race, and other sociodemographic characteristics. Age and income predicted cervical cancer knowledge. Knowledge of "other" HPV-associated cancers was predicted by having a child under 18 years in the household and relationship status. HPV knowledge appears to be socially patterned. Low HPV knowledge among men and some racial minorities suggests a need for further intervention. Health education should emphasize risks of noncervical HPV-associated cancers. Patient-provider communication that includes education, counseling, and clear recommendations favoring vaccination may improve uptake.

Using the Theory of Planned Behavior to predict HPV vaccination intentions of college men

OBJECTIVE

The purpose of this study was to test Theory of Planned Behavior (TPB) constructs in predicting human papillomavirus (HPV) vaccination behavioral intentions of vaccine-eligible college men.

PARTICIPANTS

Participants were unvaccinated college men aged 18-26 years attending a large public university in the southeastern United States during Spring 2015.

METHODS

A nonexperimental, cross-sectional study design was employed. Instrumentation comprised a qualitative elicitation study, expert panel review, pilot test, test-retest, and internal consistency, construct validity, and predictive validity assessments using data collected from an online self-report questionnaire.

RESULTS

The sample consisted of 256 college men, and the final structural model exhibited acceptable fit of the data. Attitude toward the behavior (β = .169) and subjective norm (β = 0.667) were significant predictors of behavioral intention, accounting for 58% of its variance.

CONCLUSIONS

Practitioners may utilize this instrument for the development and evaluation of TPB-based interventions to increase HPV vaccination intentions of undergraduate college men.

Intention of college students to receive the human papillomavirus vaccine

Purpose

– The purpose of this paper is to better understand what influences the intentions of college students to receive the human papillomavirus (HPV) vaccine. HPV is the most common sexually transmitted infection in the USA and cancers related to HPV are on the rise.

Design/methodology/approach

– A 2×2 experimental design was used to predict the intentions. Messages were created that manipulated the level of severity and vulnerability to determine which would increase intentions to receive the HPV vaccine. Each of the 278 participants viewed a message that contained one severity message (high or low) and one vulnerability message (high or low).

Findings

– Regression was used to determine that elements of the protection motivation theory such as vulnerability and fear, along with norms, and information seeking explained a significant portion of the variance in intent to be vaccinated (R2=0.40, F(4, 268)=44.47, p < 0.001). Norms had the most influence on intention (β=0.42, p < 0.001), next was vulnerability (β=0.21, p < 0.001) then fear (β=0.16, p=0.002), and finally information seeking (β=0.10, p=0.01).

Originality/value

– The current college age population did not have the opportunity to be vaccinated early and the recent (2011) recommendation that males get vaccinated makes this research valuable to those designing vaccination messages. The current study shows that norms were the most influential variable in regards to increasing intent to get vaccinated. This means that if the participant believed their friends would support or endorse their intent to get vaccinated they were more likely to say they would follow through and get vaccinated. This finding should be highlighted in any future campaign.