Parent perceptions of dentists’ role in HPV vaccination

IntroductionOffering HPV vaccine in settings beyond the traditional medical home holds promise for increasing the currently low levels of coverage. As adolescents frequently visit dentists, dental practices may be one such alternative vaccination setting. This study assessed parent attitudes about the roles dental providers could play in HPV prevention, including vaccine provision.MethodsIn September 2016, we conducted an online survey using a national sample (n = 1209) of U.S. parents of adolescent children aged 11–17. Adolescents’ mean age was 14; 53% were male and 62% were non-Hispanic white. We identified correlates of parents’ comfort with dentists as HPV vaccinators using multivariable logistic regression.ResultsOverall, 23% of parents reported that they would feel comfortable with their child receiving HPV vaccine from a dentist. In multivariable analyses, parents had greater odds of being comfortable if they had higher trust in their child’s primary care provider (OR = 1.27, 95% CI: 0.96–1.68) and lower odds if their child was female (OR = 0.65, 95% CI: 0.50–0.86). Convenience (20%) and oral health expertise (20%) were the most commonly cited benefits of dentists administering the vaccine. Wanting their child’s regular provider to administer and track vaccinations (61% and 58%, respectively), and lack of insurance coverage (30%) were the most commonly cited concerns. Parents expressed somewhat greater comfort with roles dentists might play in promoting HPV vaccination other than vaccine delivery, such as providing education.ConclusionsParents in this sample had low comfort with dentists as HPV vaccinators. Findings from this study highlight potential concerns to be addressed before dental practices consider offering HPV vaccination in the future. Further research should assess dentists’ perspectives and explore alternative roles for dental providers in HPV prevention efforts.     

HPV、宫颈癌及HPV疫苗接种

众所周知,HPV即人乳头瘤病毒,是诱发宫颈癌的主要因素。那么,关于HPV与宫颈癌及HPV疫苗接种的相关知识,你了解多少呢?     

HPV感染及预防性HPV疫苗研究

子宫颈癌是引起女性死亡的第二大癌症,全球每年新发病例约50万,死亡例数约25万,在一些发展中国家甚至已居于女性癌症死亡率首位.分子流行病学的研究已经证实:人乳头瘤病毒(HPV)感染与子宫颈癌有着十分密切的关系,有96.6%的子宫颈癌患者的标本中检出HPV[1].     

女性HPV感染情况及对HPV和HPV疫苗的认知情况调查

目的了解女性人群人乳头瘤病毒(HPV)的感染情况,调查女性人群对HPV及HPV疫苗的认知情况。方法选取2017年9月-2018年3月就诊的20~60岁女性患者804例,对其进行HPV及HPV疫苗相关知识调查并进行HPV检测。结果人群HPV阳性检测率为15.67%,人群高危型HPV(HR-HPV)阳性检测率为13.60%,低危型HPV(LR-HPV)阳性检测率为4.73%,同时感染HR-HPV及LR-HPV的阳性检出率为2.66%。低年龄组的HPV感染率高于高年龄组的感染率;在HPV、宫颈癌及HPV疫苗的认知水平调查中发现:70.02%的人知道HPV,67.91%的人知道HPV与宫颈癌有关,40.92%的人知道HPV疫苗,并有23.13%的人表示有意愿接种疫苗;单因素结果显示:年龄、户籍类型、文化程度及家庭月平均收入均对HPV认知产生影响(P<0.05)。对于影响HPV疫苗认知程度的因素赋值,引入Logistic多因素回归模型进行分析,结果显示:年龄、户籍及文化程度会对HPV疫苗认知程度产生影响。结论女性HPV感染情况及对HPV和HPV疫苗的认知情况仍不容乐观,政府和及医疗卫生机构应积极在各个层面有针对性地开展健康教育活动。     

Adolescent Participation in HPV Vaccine Clinical Trials: Are Parents Willing?

Approximately one-quarter of human papillomavirus (HPV) infections are acquired by adolescents, with a higher burden among racial/ethnic minorities. However, racial/ethnic minorities have been underrepresented in previous HPV vaccine trials. Ongoing and future HPV vaccine optimization trials would benefit from racially- and ethnically-diverse sample of adolescent trial participants. This study examined factors influencing parental willingness to consent to their adolescents’ participation in HPV vaccine clinical trials and tested for possible racial differences. A convenience sample of parents of adolescents (N?=?256) completed a cross-sectional survey. Chi square analyses were used to assess racial differences in parental HPV vaccine awareness and intentions and willingness to consent to their child participating in an HPV vaccine clinical trial. Ordinal logistic regression was used to identify factors associated with willingness. Approximately 47% of parents were willing to allow their adolescent to participate in HPV vaccine clinical trials (30.7% African American and 48.3% Caucasian, p?=?.081). African Americans had lower HPV vaccine awareness (p?=?.006) but not lower intentions to vaccinate (p?=?.086). Parental willingness was positively associated with the following variables: Child’s age (p?<?.039), Perceived Advantages of HPV Vaccination for Adolescents (p?=?.002), Parental Trust in Medical Researchers (p?<?.001), and Level of Ease in Understanding Clinical Trial Information (p?=?.010). Educating parents about the advantages of HPV vaccines for younger adolescents using low-literacy educational materials and building trust between parents and researchers may increase parental willingness to consent to adolescent participation in HPV vaccine clinical trials.     

浅淡HPV与宫颈癌及HPV疫苗的接种

目的:初步认识了解HPV与HPV疫苗以及与宫颈癌的关系,达到预防为主,远离宫颈癌的目的。方法:根据HPV病毒各基因型别的致病性危害性大小不同,将HPV病毒分类,举例说明:分别为高危型、低危型两种。结果:只有持续感染高危型HPV病毒才能导致宫颈癌前病变或宫颈癌。结论:HPV感染已具有普遍性及社会环境因素引起的必然性,注射HPV疫苗是必要的,也是应该全面推广的。     

HPV疫苗研究进展

作为流行最广的性传播疾病之一，ＨＰＶ感染的防治已成为研究热点。近年来，利用ＨＰＶ疫苗对ＨＰＶ感染相关疾病进行防治取得了可喜的进展。本文对不同类型ＨＰＶ疫苗的特点及设计原理进行了介绍。     

HPV疫苗研究进展

作为流行最广的性传播疾病之一 ,HPV感染的防治已成为研究热点。近年来 ,利用 HPV疫苗对 HPV感染相关疾病进行防治取得了可喜的进展。本文对不同类型 HPV疫苗的特点及设计原理进行了介绍。     

HPV致女性生殖道疾病及HPV疫苗现况

人乳头瘤病毒(human papillomavirus,HPV)是最常见的性传播病毒之一,在感染女性生殖道后可引起多种病理改变,其较高的感染率和高致病性严重危害了女性的生殖健康,其导致的常见临床表现主要包括一过性感染、生殖道疣、外阴上皮内瘤变、外阴癌、宫颈上皮内瘤变及宫颈癌。近年随着HPV预防性疫苗的投入使用,HPV感染率及相关疾病的发生率大幅度降低,对于HPV16/18型所致的宫颈病变,2价和4价疫苗的预防率可达到100%,仅少部分人群在接种后出现头晕、头痛、恶心及接种部位不良反应等情况,疫苗的安全性和有效性均已得到证实。现就HPV感染所致女性生殖道病理改变、HPV疫苗现况及HPV筛查的重要意义等方面进行简要综述。     

宫颈癌与HPV

目的 :揭示宫颈癌与HPV之间的相互关系。方法 :从HPV病毒的形态学特征、传播途径、增强宫颈上皮癌变的因素、HPV的量、HPV与免疫系统、HPV的致病机制等多个角度揭示它们之间关系。结果 :宫颈癌的发生与HPV的量、机体的免疫状态等多种因素有关。结论 :HPV可作为检测的重要指标,HPV是宫颈癌发生的重要的原因之一。     

女性HPV感染

问：我今年31岁,体检发现“HPV阳性”,我平时没有不适症状,怎么会感染了HPV？     

HPV致女性生殖道疾病及HPV疫苗现况

人乳头瘤病毒（human papillomavirus，HPV）是最常见的性传播病毒之一，在感染女性生殖道后可引起多种病理改变，其较高的感染率和高致病性严重危害了女性的生殖健康，其导致的常见临床表现主要包括一过性感染、生殖道疣、外阴上皮内瘤变、外阴癌、宫颈上皮内瘤变及宫颈癌。近年随着HPV预防性疫苗的投入使用，HPV感染率及相关疾病的发生率大幅度降低，对于HPV16/18型所致的宫颈病变，2价和4价疫苗的预防率可达到100%，仅少部分人群在接种后出现头晕、头痛、恶心及接种部位不良反应等情况，疫苗的安全性和有效性均已得到证实。现就HPV感染所致女性生殖道病理改变、HPV疫苗现况及HPV筛查的重要意义等方面进行简要综述。     

Actions improving HPV vaccination uptake – Results from a national survey in Italy

BackgroundIn Italy, HPV vaccination is offered to 11-year-old girls since 2007. In 2012 coverage was 69%. Strategies for offering and promoting HPV vaccination and coverage rates (26–85%) vary among Regions and Local Health Authorities (LHAs). We conducted a national study to identify strategies to improve HPV vaccination uptake.MethodsIn 2011–2012 we invited the 178 LHAs to fill a web-questionnaire, inquiring implementation of HPV vaccination campaigns (immunization practices, logistics of vaccine delivery, training, activities to promote vaccination, barriers, local context). We described type of offer and vaccination promotion in each LHA and studied the association of these factors with vaccination coverage rates.ResultsWe analyzed 133 questionnaires. The communication tools more frequently used to promote vaccination were: brochures/leaflets (92% of LHAs), fliers/posters (72%). Television (24%) and radio (15%) were less used. Using ≥3 communication channels was associated to a coverage ≥70% (OR_adj = 5.9, 95%CI 2.0–17.4). The probability to reach a coverage ≥70% was higher if the invitation letter indicated a pre-assigned date for HPV vaccination (OR_adj = 7.0, 95%CI 1.2–39.8) and >1 recall for non-respondents was planned (OR_adj = 4.1, 95%CI 1.8–9.3). Immunization services and paediatricians were involved in informative and training activities in most LHAs (80–90%), instead general practitioners, women and family's healthcare services and public gynaecologists in 60–70%, cervical cancer screening services and private gynaecologists in 20–40%. The main factors that negatively affected vaccination uptake were: poor participation to training events of professional profiles different from personnel of immunization services (reported by 58% LHAs), their mistrust towards HPV vaccination (55%) and insufficient resources (56%).ConclusionThe synergy of multiple interventions is necessary for a successful vaccination programme. Practices such as pre-assigning vaccination date and repeatedly recalling non-respondents could improve vaccination uptake. Efforts are required to strengthen the training of different professional profiles and services and encourage their collaboration. Economical resources are needed to promote vaccination.     

西安市妇科门诊患者HPV和HPV疫苗的认知调查

目的 了解西安市妇科门诊患者对人乳头瘤病毒(HPV)的认知情况及其接种HPV疫苗的态度,为推广HPV疫苗的接种提供依据. 方法 在西安市第四医院妇科门诊单纯随机抽取前来就诊的患者1 000人,采用自行设计的问卷,进行调查.问卷内容主要包括患者的基本资料(年龄、婚姻、学历、职业)、对HPV的认知、对HPV疫苗的认知及态度. 结果 32.5％患者知晓HPV,不同年龄、教育程度、职业的女性在HPV知晓率上差异均有统计学意义.30＜年龄≤40岁年龄段的女性对HPV的知晓率(49％)明显高于21≤年龄≤30岁(34.4％)和60＜年龄≤71岁(17.6％)年龄段的女性,大学及以上学历的女性对HPV的知晓率(44.3％)明显高于初高中组,未受过教育的女性对HPV的知晓率(29.7％)最低;干部/职员/技术人员对HPV的知晓率(41.7％)最高,而工人、农民、个体户/服务人员对HPV的知晓率普遍偏低.76.0％患者愿意接种HPV疫苗,担心会感染HPV(32.1％)或患宫颈癌(26.1％)的女性有较强的接种意愿.56.6％的患者能接受的疫苗价格在50 ～ 100元,有49.9％的患者更愿意接受政府提供的疫苗,40.8％的患者更愿意接受医疗机构提供的疫苗. 结论 西安市门诊患者对HPV及其疫苗的知晓率较低,应加强公众健康教育宣传力度,普及HPV疫苗相关知识.     

HPV病毒与宫颈癌

HPV是人乳头瘤病毒英文缩写,因发现HPV感染与妇女的宫颈癌有关,现在常常被人们认为是洪水猛兽.面对HPV感染不知该如何应对?别着急,让我们一步一步揭开HPV神秘面纱. HPV家族庞大,高危型危害大 HPV的家族非常庞大,现已查明的有200多种,根据致病力或致癌危险性的大小可分为高危型和低危型.     

控制HPV感染刻不容缓

我国每年子宫颈癌新发病例13．15万，每年约有3万女性死于宫颈癌。     

多管齐下 防治HPV感染

一、加强预防HPV感染健康教育 对HPV感染疾病的控制，预防HPV感染是首要措施，健康教育尤为重要，可以达到从源头杜绝HPV传染。     

细说HPV与宫颈癌

宫颈癌是女性生殖道常见的恶性肿瘤之一,居全球女性恶性肿瘤发病率第二位,仅次于乳腺癌。幸运的是,宫颈癌病因较为明确,可以进行有效的预防。HPV(人乳头瘤病毒)是一种主要通过性传播的病原体,该病毒“家族”非常庞大,有200多种分型。其中大部分为低危型,有二三十种型别可引起生殖器疣等疾病,95%的宫颈癌与高危型HPV感染有关。     

HPV疫苗安全性研究进展

宫颈癌是女性第二常见的恶性肿瘤,严重威胁女性的健康,已有研究表明高危型人乳头瘤病毒(HPV)的持续感染是引起宫颈癌的重要因素。HPV疫苗是全球首个可预防癌症的疫苗,随着二价、四价及九价HPV疫苗在国内外相继获批上市,该疫苗的安全性也引起社会广泛关注。本文检索国内外药监网站及数据库,汇总该疫苗的安全性研究资料,分析该疫苗的安全性研究现状,为该疫苗在我国的推广接种,防控宫颈癌提供参考。