Knowledge,attitudes, and practices among Saudi women regarding cervical cancer,human papillomavirus (HPV) and corresponding vaccine

AimTo our knowledge there are no studies exploring Saudi women’s understanding of the importance of the human papillomavirus (HPV) vaccine. In the present study, we examined the awareness of HPV and women’s attitudes toward the HPV vaccine.MethodNine focus groups were formed in Riyadh City, Saudi Arabia, including 77 women between the ages of 18 and 45 years old. Face-to-face interviews were conducted in 58 female healthcare providers to examine women’s awareness of cervical cancer, HPV, barriers, acceptance, beliefs, and attitudes towards the HPV vaccine.ResultsFocus group discussions revealed a lack of knowledge and awareness of cervical cancer, HPV, and the HPV vaccine. Cultural concerns regarding screening and vaccinating for a conventionally known sexually transmitted infection were an emerging theme in addition to not perceiving cervical cancer screening as necessary because women with no signs and symptoms considered themselves not at risk for developing cervical cancer. Approximately 30% of healthcare providers other than physicians were unaware of prevention methods, and 63.3% did not practice any screening methods for cervical cancer and attributed the lack of screening to “no specific reasons at all”.ConclusionBecause of the unfavorable knowledge and attitude of HPV infection and the associated vaccine from the women in the present study, emphasis should be directed to educate and promote awareness of women to the risk factors of cervical cancer and to the need for screening programs and the administration of the vaccine.     

Stages of HPV Vaccine Hesitancy Among Guardians of Female Secondary School Students in China

PurposeFemale secondary school students are the primary recommended population for human papillomavirus (HPV) vaccines. However, vaccine hesitancy may affect uptake. In this study, we assessed the vaccine hesitancy levels among the guardians of female secondary school students in China.MethodsWe developed a questionnaire and conducted cross-sectional surveys among guardians of secondary school girls aged 12–19 years in mainland China based on the Increasing Vaccination Model and the Precaution Adoption Process Model.ResultsWe collected 3,225 valid samples. Among the participating guardians, 53.9% were vaccine hesitant, although only 0.9% had refused HPV vaccines. Some individual characteristics of guardians (e.g. sex, education/income level) were associated with understanding HPV vaccines. Better knowledge of HPV vaccines and communication with reliable sources of information were associated with vaccine nonhesitancy. Practical barriers such as vaccine shortage and busy schedules prevented nonhesitant guardians from vaccinating their children.DiscussionA substantial proportion of the guardians surveyed were HPV vaccine hesitant. Promoting HPV knowledge and communication with reliable sources (e.g. clinical doctors) could help fight against vaccine hesitancy.     

Knowledge,attitudes and acceptance toward Human papillomavirus (HPV) vaccination: Perspectives of Muslim women and men

ObjectivesHuman papillomavirus (HPV) infection is the leading risk factor for the development of anogenital cancers. Most Arab countries lack both HPV education and national HPV vaccination programs. The objective of this study was to assess knowledge, attitudes, and acceptance toward HPV vaccination in men and women from Oman, a country in the Middle Eastern North Africa region.MethodsThis cross-sectional quantitative study used convenience sampling to recruit male and female participants, aged 18 years and above from all 11 governorates of Oman to complete a validated self-administered questionnaire online in the Arabic language. The questionnaire comprised five sections, with a total of 32 questions. The questionnaire, including Arabic and English versions, was content validated and piloted.ResultsA total of 1403 participants, including 952 parents and 369 healthcare providers, completed the survey. The results showed a lack of knowledge regarding HPV infection and vaccines, including among healthcare providers. Less than a quarter of the participants had heard of HPV infection, with digital sources of information being the most common. Factors such as being a woman or a healthcare provider or completing higher levels of education were independently and significantly positively association with HPV awareness (p < 0.001). The majority of the participants lacked vaccine safety knowledge, had concerns about the vaccine's side effects, and sought reassurance of its protection against HPV infection (62%, 71.5%, and 84.6%, respectively). Nevertheless, nearly two-thirds of the participants agreed to take the HPV vaccine, with support for both boys and girls being vaccinated. There was almost universal agreement among the participants regarding the need for parental and adolescent HPV educational programs.ConclusionOmani women and men showed a high level of acceptance and favorable attitude toward HPV vaccination. The study findings support future efforts to implement school and public-level HPV education and a national HPV vaccination program in Oman.     

Acceptability of vaccination against human papillomavirus among women aged 20 to 45 in rural Hunan Province,China: A cross-sectional study

ObjectiveThis study aimed to examine the intentions of and barriers to vaccination against human papillomavirus (HPV) among women aged 20 to 45 in rural areas, and to determine the popular sources to getting information about HPV vaccine and vaccination.MethodsThis cross-sectional study was conducted in 2018 with a sample of women aged 20 to 45 from rural areas of Hunan Province in China. Anonymous self-administered questionnaires were used to collect sociodemographic information and characteristics related to reproductive health of participants, and intentions of and barriers to HPV vaccination. All statistical analysis methods were performed with SPSS 18.0.ResultsA total of 2101 women participated in the study, with 58.55% intended to vaccinate against HPV. Increased intention of HPV vaccination was associated with higher age (adjusted odds ratio [AOR] = 1.35 and 1.50, respectively) and education level (AOR = 1.13 and 1.47, respectively). Women who have heard of HPV vaccine (AOR = 2.67, 95% confidence interval [CI]: 1.20–5.98) and have been aware of that cervical cancer could be prevented (AOR = 2.01, 95%CI: 1.44–2.82) were more willing to vaccinate. Having never heard of HPV vaccine and worry about efficacy and safety of vaccines were the most commonly cited reasons to refuse vaccination. The preferred source to get the knowledge was medical personnel (58.45%), followed by WeChat or Microblog, TV programs, and Internet.ConclusionWe found the intention of HPV vaccination among women aged 20 to 45 in rural China is low. Findings highlighted the importance of knowledge and trust in HPV vaccine, and suggested strengthening educational interventions on HPV vaccine and vaccination through multiple sources, including HPV vaccine coverage in health insurance to increase access.     

Application of the theoretical domains framework to identify factors influencing catch-up HPV vaccinations among male college students in the United States: A review of evidence and recommendations

BackgroundGenital human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection among young adults ages 15–25 years in the United States (US). Although HPV vaccines are recommended for individuals ages through 26 years, vaccine completion rates remain substantially low.MethodsAccordingly, our study utilized a comprehensive – Theoretical Domains Framework (TDF) of behavior change to systematically identify facilitators and barriers to catch-up HPV vaccinations. Five databases - Medline, Embase, CINAHL, ERIC, and PsycINFO were searched from January 2009 to July 2019 for empirical studies using quantitative and qualitative methods to assess HPV vaccine uptake among males ages 18–26 years within US college and university settings. The TDF analytic process included a content analysis using the mixed deductive-inductive approach to extract, analyze and categorize data into TDF domains/themes and sub-themes.ResultsOverall, 17 studies were selected for data extraction. We identified eleven key TDF domains that influenced HPV vaccination behavior among college male students: ‘knowledge’ (82% of included studies), ‘environmental context and resources’ (53%), ‘beliefs about consequences’ (53%), ‘unrealistic optimism’ (50%) and ‘pessimism’ (6%), ‘emotion’ (50%), ‘social influences’ (50%), ‘beliefs about capabilities’ (41%), ‘intention’ (24%), ‘reinforcement’ (18%), ‘social professional role and identity’(12%), and ‘behavioral regulation’ (12%). Barriers influencing HPV vaccine uptake included lack of knowledge and awareness regarding HPV infections, HPV vaccine safety, effectiveness, side effects, and costs; absence of health providers’ recommendations; lack of healthcare and health insurance; low levels of perceived susceptibility and severity for HPV infections; HPV vaccine misinformation; as well as social stigma and peer influences regarding HPV vaccinations. Enablers for HPV vaccine uptake included high levels of perceived benefits for HPV vaccines.DiscussionOur study theoretically identified factors influencing HPV vaccinations. This could inform the efficient planning, support, and implementation of interventions that facilitate catch-up HPV vaccination practices among high-risk males within college/university settings.     

HPV vaccine coverage and acceptability among a national sample of sexual minority women ages 18–45

BackgroundSexual minority women (lesbian, bisexual, and other women who have sex with women) are at risk for human papillomavirus (HPV) infection and HPV-related disease, demonstrating the importance of HPV vaccination for these women.MethodsWe conducted an online survey of sexual minority women ages 18–45 from the United States (n = 505) in October 2019, about two months after HPV vaccine recommendations were expanded to include ages 27–45. Multivariable Poisson regression identified correlates of HPV vaccine initiation (i.e., receipt of at least one HPV vaccine dose).ResultsOverall, 65% of participants ages 18–26 and 33% of participants ages 27–45 had initiated the HPV vaccine series. Among participants ages 18–26, initiation was more common among those who had received a healthcare provider recommendation (RR = 2.19, 95% CI: 1.64–2.93) or had disclosed their sexual orientation to their primary healthcare provider (RR = 1.33, 95% CI: 1.07–1.65). Among initiators ages 27–45, a large majority (89%) reported receiving their first dose before turning age 27. Initiation was more common among participants ages 27–45 who had received a healthcare provider recommendation (RR = 3.23, 95% CI: 2.31–4.53) or who reported greater perceived social support for HPV vaccination (RR = 1.22, 95% CI: 1.05–1.40). Several reasons for not yet getting HPV vaccine differed by age group (ages 18–26 vs. ages 27–45; all p < 0.05).ConclusionsMany sexual minority women, particularly those ages 27–45, remain unvaccinated against HPV. Findings provide early insight into HPV vaccine coverage among adult women and highlight key leverage points for increasing vaccination among this population.     

Parents' Internet use for information about HPV vaccine

Purpose

The Internet is an increasingly common source of health-related information. We sought to examine associations between parents’ Internet information-seeking and their knowledge, attitudes and beliefs about human papillomavirus (HPV) vaccine.

Methods

We interviewed parents within a year after approval of HPV vaccine for females and males. Participants were North Carolina parents with daughters ages 10–18 surveyed by telephone in Fall 2007 (n = 773); and a national sample of parents with sons ages 11–17 surveyed online in Fall 2010 (n = 115). We used multivariate regression to examine associations of past and intended Internet seeking for HPV vaccine information with knowledge and health belief model-related constructs.

Results

Among parents of daughters, having heard of HPV vaccine through the Internet (8%) was associated with higher HPV knowledge, perceived likelihood of HPV, and vaccination willingness, and with receiving a doctor's recommendation. It was also associated with lower perceived vaccine harms, uncertainty, and anticipated regret. Parents of sons who heard of HPV vaccine through the Internet (10%) perceived greater barriers to vaccination than parents who learned about HPV vaccine for males through other sources. Intended future Internet information-seeking among parents of daughters (69%) was more likely if they perceived a lower likelihood that their daughters would get HPV if they were vaccinated (all p < .05).

Conclusions

Our findings suggest a positive influence of accessing information on the Internet about HPV vaccine. It was associated with higher knowledge and mostly positive parental attitudes and beliefs.     

Human Papillomavirus Knowledge and Attitude among Homeless Women of New York City Shelters

BackgroundHuman papillomavirus (HPV) has not been studied among homeless women in the United States. We assessed knowledge and attitudes regarding HPV infection and the HPV vaccine among homeless women.MethodsWe enrolled 300 homeless women age 19 to 65 residing in multiple New York City shelters from 2012 to 2014. We used a national survey to collect HPV data.ResultsMean age was 44.7 ± 12.16 years. The majority were Black, heterosexual, and single; 50.6% were smokers. Almost all HPV knowledge and attitudes data were considerably below the national averages; 41.9% never heard of HPV. Only 36.5% knew that HPV is a sexually transmitted disease; 41.5% knew that HPV causes cervical cancer; and only 19.5% and 17.3% received provider counseling regarding HPV testing and vaccine, respectively. Among participants, 65.4% reported that they would vaccinate their eligible daughters for HPV. Lower rates of up-to-date Pap tests were associated with a lack of knowledge regarding relationship between HPV and abnormal Pap test (p < .01).ConclusionsWe recommend improved HPV counseling by providers during any clinical encounter to reduce missed opportunities, coupled with employing patient teaching coach or navigators to improve health literacy and to connect patients to services regarding HPV and cervical cancer.     

Introduction of a National HPV vaccination program into Bhutan

BackgroundCervical cancer is the most common cancer in Bhutanese women. To help prevent the disease, the Ministry of Health (MoH) developed a national human papillomavirus (HPV) vaccine program.MethodsMoH considerations included disease incidence, the limited reach of cervical screening, poor outcomes associated with late diagnosis of the disease, and Bhutan's ability to conduct the program. For national introduction, it was decided to implement routine immunization for 12 year-old girls with the quadrivalent HPV6/11/16/18 (QHPV) vaccine and a one-time catch-up campaign for 13–18 year-old girls in the first year of the program (2010). Health workers would administer the vaccine in schools, with out-of-school girls to receive the vaccine at health facilities. From 2011, HPV vaccination would enter into the routine immunization schedule using health-center delivery.ResultsDuring the initial campaign in 2010, over 130,000 doses of QHPV were administered and QHPV 3-dose vaccination coverage was estimated to be around 99% among 12 year-olds and 89% among 13–18 year-olds. QHPV vaccine was well tolerated and no severe adverse events were reported. In the three following years, QHPV vaccine was administered routinely to 12 year-olds primarily through health centers instead of schools, during which time the population-level 3-dose coverage decreased to 67–69%, an estimate which was confirmed by individual-level survey data in 2012 (73%). In 2014, when HPV delivery was switched back to schools, 3-dose coverage rose again above 90%.DiscussionThe rapid implementation and high coverage of the national HPV vaccine program in Bhutan were largely attributable to the strength of political commitment, primary healthcare and support from the education system. School-based delivery appeared clearly superior to health centers in achieving high-coverage among 12 year-olds.ConclusionsBhutan's lessons for other low/middle-income countries include the superiority of school-based vaccination and the feasibility of a broad catch-up campaign in the first year.     

Facilitators of and barriers to HPV vaccination among sexual and gender minority patients at a Boston community health center

BackgroundYoung sexual minority individuals have lower human papillomavirus (HPV) vaccine completion rates than the general population, and little is known about how gender minority people perceive HPV vaccination. The aim of this study was to qualitatively identify patient-, provider-, and systems-level barriers and facilitators for HPV vaccination among sexual and gender minority (SGM) people.MethodsFifteen SGM-identified individuals, ages 23–26, were recruited at an urban community health center in Boston, MA, that specializes in care for SGM. Participants were enrolled in a study that utilized surveys and in-person focus groups. During focus groups, participants were asked to describe their perceived barriers and facilitators for completion of HPV vaccination.ResultsFourteen participants reported having a sexual minority identity, and five participants reported having a gender minority identity. Participants described the following factors influencing HPV vaccination: (1) at the patient level, low HPV-related knowledge and lack of engagement in care were associated with less vaccination, whereas fear of HPV-related disease motivated vaccination; (2) at the provider level, knowledge and SGM cultural-competence related to HPV was associated with patient willingness to be vaccinated; (3) at the systems level, SGM identity-affirming healthcare settings were associated with increased vaccination, whereas historical trends in HPV vaccine marketing selectively for cisgender women and lack of public awareness of HPV-related disease among SGM were associated with decreased vaccincation.ConclusionOur study identified internal and external barriers for HPV vaccination related among SGM patients. These findings highlight the need to increase public awareness about the risks of HPV-related disease among SGM and educate SGM youth about HPV-related disease and vaccine importance. Finally, this study supports the need for future interventions to cultivate SGM-competent providers and SGM identity-affirming healthcare settings as a way to increase HPV vaccination.     

Effectiveness of HPV vaccines against genital warts in women from Valencia,Spain

ObjectivesTo assess the effectiveness of the HPV vaccines in preventing genital warts in young women.DesignPopulation-based study using health databases.SettingValencian Community (Spain).ParticipantsAll girls and women aged 14–19 years who were registered in the Valencian Community between January 2009 and December 2014 (n = 279,787).Main outcome measuresIncident cases of genital warts were defined as the first activation of diagnosis code ICD-9-CM 078.11 (Condyloma acuminatum) in primary care and outpatient clinics during the study period.ResultsThere were 612 cases of genital warts. The overall incidence rate was 75.8/100,000 person-years (95% CrI 69.7–81.8). There was a decrease in genital warts when female candidates to be vaccinated with quadrivalent HPV vaccine reached the age of 18 (in 2012), compared to previous years. Incidence of genital warts in unvaccinated women and those who received the bivalent vaccine was higher than in girls and women who received the quadrivalent HPV vaccine. The effectiveness of a three-dose regimen of the quadrivalent HPV vaccine was 77% (95 CrI: 66–85%), whereas that of a single dose was 61% (95 CrI: 20–87%). No effectiveness was seen with a full vaccination course with the bivalent HPV vaccine.ConclusionsThree doses of the quadrivalent HPV vaccine were effective against genital warts in our population. Moreover, with low vaccine coverage the incidence of genital warts decreased only in the vaccinated.     

Human papillomavirus vaccine series completion: Qualitative information from providers within an integrated healthcare organization

ObjectiveThis qualitative study aimed to identify doctors’ and nurses’ perceptions of patient-, provider-, and system-level factors associated with human papillomavirus (HPV) vaccine completion that may be targets for intervention.MethodsWe analyzed data from 61 qualitative interviews with pediatricians, family medicine physicians, and immunization nurses at medical centers that had the highest and lowest HPV vaccine completion rates within the same health care system.ResultsIn both groups, almost all providers reported strong support for the HPV vaccine. In detailing how they talk to parents and patients about the vaccine, more of the providers working at higher completion centers described using effective communication techniques, including engaging parents and patients in two-way conversation and demonstrating awareness of cultural and practical barriers to completion that families may face. Providers at higher completion centers were also more likely to depict a local medical culture supportive of and committed to HPV vaccine completion, with greater levels of proactivity and teamwork. In contrast, providers working at lower completion medical centers described a lack of proactivity, and the strategies they suggested to improve HPV vaccine completion tended to be approaches that someone other than medical providers would implement. The comments made by these providers sometimes reflected a level of negativity and judgment absent from the comments of providers at higher completion centers.ConclusionInterventions to improve HPV vaccination completion rates should address both individual- and system-level factors. Improving communication skills, encouraging a supportive medical culture, and addressing resource issues is likely to improve vaccine adherence.     

藏区育龄妇女生殖健康知识的认知与需求调查

目的了解甘南藏区已婚育龄妇女生殖健康的相关知识和需求，为进一步制定健康教育干预策略提供依据。方法采取分层整群抽样的方法对5667名已婚育龄妇女进行问卷调查和定性访谈。结果知晓4～5种避孕方法的妇女占29．6％；对艾滋病传播途径的知晓率为11．7％-29．4％。不同文化程度的妇女对避孕方法知晓率和艾滋病传播途径的正确回答率不同。妇女希望获得生殖健康知识的传播途径依次为专业人员面对面地咨询、朋友间交流和电视节目录像等。60％以上的妇女希望获得妇幼保健和生殖道感染方面的知识。结论已婚育龄妇女生殖健康知识缺乏，应采取灵活多样的、有针对性的健康教育形式，加强对育龄妇女的生殖健康教育。     

A model of health care provider decision making about HPV vaccination in adolescent males

IntroductionIn the U.S., HPV vaccination of adolescent males remains low, despite the recommendation for routine vaccination. Although research has highlighted that health care provider (HCP) recommendation is very influential in HPV vaccine uptake, research on this topic in the male population is lacking. Accordingly, we used a qualitative approach to identify HCP knowledge, attitudes, and behaviors regarding adolescent male HPV vaccination, one year, after routine vaccination of adolescent males was recommended.MethodA total of 20 U.S. pediatric HCPs participated in 20–30 min interviews about knowledge, attitudes, and practices regarding male HPV vaccination. Interviews were audio-recorded, transcribed and, analyzed using inductive content analysis.ResultsThe providers had been in practice for 1–35 years, 75% were female, and 75% were White. Opinions on HPV vaccination were shaped by knowledge/perception of the risks and benefits of vaccination. Although all providers frequently offered HPV vaccine to male patients, the strength and content of the offer varied greatly. Vaccination opinions determined what issues were emphasized in the vaccine offer (e.g., stressing herd immunity, discussing prevention of genital warts), while adolescent age influenced if and how they pitched their vaccine offer (e.g., HPV as a STI). Most providers agreed with the ACIP recommendations, however, several expressed that providers’ preexisting opinions might remain unchanged despite the recommendations. Consistent with the literature on determinants of HPV vaccination, providers believed that their own recommendation was a major factor in a family's decision to vaccinate. Barriers to vaccination included the “newness” and sexual nature of the vaccine, lack of insurance coverage, and the vaccine not being mandated.ConclusionsProviders’ opinions about, and approaches to offering, HPV vaccination to males were highly variable. Interventions designed to improve male HPV vaccination should focus on helping providers to routinely recommend the vaccine to all of their eligible patients, both males and females.     

Knowledge,Attitudes, and Beliefs Regarding HPV Vaccination: Ethnic and Cultural Differences Between African-American and Haitian Immigrant Women

BackgroundBlack women have higher rates of cervical cancer and lower rates of HPV vaccination than White women in the United States, and Haitians may be an especially vulnerable subgroup of Black women. To reduce these disparities, understanding differences among subgroups of Black women is crucial.MethodsThe objective of our study was to assess similarities and differences in the knowledge, attitudes, beliefs, and practices toward HPV vaccination and actual vaccination rates among African-American and Haitian immigrant women and their daughters. We used validated surveys of HPV knowledge, trust in physicians, acculturation, and constructs of the health belief model: Perceived susceptibility, severity, and barriers. We probed women's thought processes about vaccination using open-ended questions. We then reviewed medical records to determine vaccination rates.ResultsNineteen African Americans and 51 Haitians participated. Although 75% of Haitians and 63% of African Americans intended to vaccinate their daughters, only 47% of African-American and 31% of Haitian daughters were vaccinated. African Americans were more knowledgeable than Haitians and had more prior experience with HPV disease. Most African Americans felt that vaccination fell within the parental role, whereas many Haitians felt uncomfortable vaccinating against sexually transmitted infections because they felt children should not be having sex. Both ethnic groups wanted more information about HPV vaccines.ConclusionCultural differences between African-American and Haitian immigrant mothers revealed distinct barriers for vaccine acceptance. Improving HPV vaccine rates in Black women may require culturally competent and sensitive approaches that address ethnic-specific barriers.     

Facebook for Health Promotion: Female College Students' Perspectives on Sharing HPV Vaccine Information Through Facebook

Facebook, a social network site, has been widely used among young adults. However, its potential to be used as a health promotion medium has not been fully examined. This study explored Facebook''s potential for sharing human papillomavirus (HPV) vaccine information among female college students in Hawai‘i. Culturally tailored flyers and handouts were developed and distributed at one large university in Hawai‘i to recruit female college students between the age of 18 and 26 having an active Facebook account. Three focus group meetings were conducted to gather student perspectives about how information about HPV vaccine may be best shared via Facebook. We found that students believed Facebook is a good awareness tool but they needed more knowledge about the HPV vaccine to feel comfortable sharing the information. Participants preferred forwarding information to chatting about HPV. Some participants expressed concern that their Facebook friends would think the HPV vaccine information they forwarded on Facebook is spam. Participants suggested prefacing the posted HPV vaccine information with a personal note in their own words to make the message more interesting and relevant to their Facebook friends. Future interventions using Facebook to promote HPV vaccine could provide students with HPV vaccine information from credible sources and ask students to attach personal testimonials or endorsements while forwarding the information on Facebook.     

Ethnic and Gender Differences in HPV Knowledge,Awareness, and Vaccine Acceptability Among White and Hispanic Men and Women

The purpose of this study was to examine factors associated with human papillomavirus (HPV) knowledge and awareness, and HPV vaccination among White and Hispanic males and females. Differences in HPV knowledge, sources of information, vaccine awareness, vaccination status, and interest in vaccination were examined. A community sample was recruited from local health care clinics in a medium sized Midwestern city between May 2010 and December 2011. Participants (N = 507) were White (n = 243) and Hispanic, males (n = 202) and females between the ages of 15–30. Results indicate that White and female participants were significantly more likely to have heard of HPV, have higher levels of HPV knowledge, have been diagnosed with HPV, and be aware of the HPV vaccine for women. White and female participants were also more likely to have heard of HPV from their physician and were significantly more interested in receiving the HPV vaccine in the future. There was no effect of ethnicity on interest in the vaccine per a doctor’s recommendation, however. Findings suggest that Whites and females have greater levels of HPV awareness and knowledge and that, while Hispanic participants are less likely than White participants to be told about the HPV vaccine from their provider, they may be equally receptive to such a recommendation.     

An intervention for increasing HPV vaccination on a university campus

PurposeTo evaluate the effects of a human papillomavirus (HPV) vaccination intervention implemented on a large university campus in the United States.MethodsThe intervention consisted of student-directed campaign materials promoting HPV vaccination (e.g., posters, yard signs, social media posts) and provider recommendation for HPV vaccine to students attending university health services (UHS) from January through March of 2019.ResultsWe observed a 75% increase in HPV vaccine doses administered at UHS in the spring semester of 2019 vs. 2018. In both semesters a higher percentage of doses was given to females than males. Further, the increase from 2018 to 2019 was larger for females than males. Age at vaccine receipt did not differ by year.ConclusionsPartnering with college and university health centers to implement HPV vaccine interventions could be a promising strategy for increasing HPV vaccination coverage among young adult college students across the country.     

Assessing university students’ sexual risk behaviors as predictors of human papillomavirus (HPV) vaccine uptake behavior

ObjectivesThere exists a significant gap in vaccine coverage of the human papillomavirus (HPV) among college-aged students. This study assessed sexual risk-taking behavior among university students and analyzed predictors of HPV vaccine initiation and completion in this population.Materials and methodsData (n = 746) were from an anonymous online, cross-sectional survey distributed to university students, between the ages of 19–26 years, at a private Midwestern university. Both chi-square and multivariable logistics regression models estimated the association between sociodemographic characteristics and sexual risk factors (including number of vaginal sexual partners, number of oral sexual partners, initiation of oral sex, and initiation of vaginal sex), with HPV vaccine initiation and completion.ResultsA significant number of participants (40%) had not received a single dose of the HPV vaccine series. Of those who initiated the series, more than half (51%) did not achieve completion. Additionally, a greater number of participants have had multiple (4 or more) oral sexual partners than vaginal sexual partners (25.7% vs. 20.3%). After adjusting for covariates, it was found that sexual risk factors were not significantly associated with HPV vaccine initiation or completion.ConclusionHPV vaccine initiation and completion rates are suboptimal among university students. High levels of sexual-risk taking behaviors associated with HPV infection persist, yet are not significant predictors of HPV vaccine behaviors in this age group. To increase uptake among 18–26-year-old students, future public health interventions should focus on HPV vaccine education and uptake across the entire population, irrespective of sexual risk profile.