Awareness and Attitude Relating to the Human Papilloma Virus and its Vaccines Among Pediatrics,Obstetrics and Gynecology Specialists in Turkey

Background: To determine the level of knowledge on human papillomavirus (HPV) infection and vaccination,and the attitude towards HPV vaccination in pediatricians, obstetricians and gynecologists (OBG). Materialsand Methods: Participants were administered a 40-question survey, investigating the demographic properties,the knowledge on the HPV infection-vaccination and attitudes towards vaccination. Results: The study enrolleda total of 228 participants (131 pediatricians and 97 OBGs). At a rate of 99.6%, the participants agreed with thefact that the HPV infection was the most common sexually transmitted disease and 33.8% of the participants hadthe opinion that the HPV vaccination should be administered only in women. The lowest level of HPV vaccinerecommendation was among the pediatrics specialists (59.4%, p=0.012). When asked whether they would havetheir daughters receive HPV vaccination, 79.5% of the participants answered favorably; this rate was 36.7%for the sons. At a rate of 59.5% of the participants thought that the HPV vaccine needed to be included in thenational vaccine schedule. Most of the participants (91.6%) had the idea that reduction of the vaccine costswould increase the vaccination frequency. Conclusions: We observed that the consideration of the costs and theprejudices relating to the inefficacy of vaccination as well as the inadequate level of knowledge were involved inthe physicians’ resistance to HPV vaccination. We believe that the healthcare professionals should be informedadequately to overcome false beliefs, thereby ensuring success of the HPV vaccine upon inclusion in the nationalvaccine schedule in the future.     

Human papillomavirus Infection and its Vaccines Knowledge and Attitudes of Primary Health Clinic Nurses in Kelantan,Malaysia

Background Cervical cancer though preventable is still the leading cause of cancer death among women secondary to breast cancer. Persistent infection with HPV has been causally linked to the disease. A school based HPV vaccination program was introduced in late 2010 in Malaysia and nurse support is essential for its success. Objectives To determine nurses knowledge and attitudes about HPV infection and its vaccines, and factors associated with their knowledge. Materials and Methods This cross-sectional study was conducted among nurses working at primary health clinics in Kelantan from mid-June till the end of July 2014. Its involved 330 nurses selected through multistage random sampling. A validated self-administered questionnaire consisting of 11 items for the knowledge domain and eight items for the attitude domain was used. Results The response rate of the study was 93.7%. The mean knowledge and mean attitude (SD) scores were 5.37 (1.76) and 29.8 (3.51) respectively. Only 24% knew that HPV is the most common sexually transmitted infection and 67% correctly answered that Gardasil vaccine can protect against four types of HPV. Nearly 60% of participants wrongly answered that HPV vaccines cannot be offered to sexually active women. Likewise, 70.9% participants were not aware that HPV vaccine may be appropriate for females aged 9 through 26 years. Though 90% of participants believed that the vaccine is safe, nearly half of them were unsure about efficacy. From multiple linear regression analysis, among the factors tested only participant's level of education showed a statistically significant association with the HPV knowledge score (<0.001). Conclusions This study indicates nurses have favorable attitudes towards HPV vaccination; however they have significant knowledge deficit and major misunderstanding in critical knowledge items. Among the factors tested, nursing qualification is the only factor that is significantly associated with the nurses knowledge score.     

Knowledge, attitude and practice of malaysian medical and pharmacy students towards human papillomavirus vaccination

Human Papillomavirus (HPV) infection is one of the most common sexually transmitted infections and oncogenic HPV is the main cause of cervical cancer. However, HPV vaccination is already available as the primary preventive method against cervical cancer. The objective of this study was to determine the level of knowledge, attitude and practice of HPV vaccination among Universiti Kebangsaan Malaysia (UKM) and Universiti Malaya (UM) students. This study was conducted from March until August 2009. Pre-tested and validated questionnaires were filled by the third year UKM (n=156) and UM (n=149) students from medical, dentistry and pharmacy faculties. The results showed that the overall level of knowledge on HPV infection, cervical cancer and its prevention among respondents was high and the majority of them had positive attitude towards HPV vaccination. Medical students had the highest level of knowledge (p<0.05). Very few students (3.6%) had already taken the vaccine with no significant difference between the two Universities (p=0.399). In conclusion, the knowledge and attitude of the respondents were high and positive, respectively. Only few students took HPV vaccination. Thus, more awareness campaigns and HPV vaccination services should be provided at universities' campuses with the price of the HPV vaccine reduced for the students.     

Incomplete knowledge--unclarified roles in sex education: results of a national survey about human papillomavirus infections

The purpose of this study was to evaluate the awareness of human papillomavirus (HPV) infections both in male and female adults in Hungary. A self-administered, anonymous questionnaire was completed by 785 college students and parents between January and May, 2009. The results were analysed by gender and age. Participants' knowledge about HPV and HPV-associated conditions was relatively incomplete. One-third of the respondents had never heard about HPV prior to the survey. Almost half of the respondents (42%) thought that the only sexual way of spreading HPV was vaginal intercourse, while the role of skin-to-skin contact was disregarded (6%). More than one-third of the participants (38%) believed that condoms give full protection from HPV infection. Encouragingly, the majority of respondents (64%) were open to further information about sexually transmitted diseases. The most trusted sources of information were health professionals. When talking about children, parents attributed the major role in delivering information about sexually transmitted diseases to schools. Primary prevention through carefully planned educational programmes may further raise the awareness about HPV-associated conditions, thus reducing the comparatively high mortality of cervical carcinoma in Hungary.     

HPV vaccination and the effects on rates of HPV-related cancers

Globally, human papillomavirus (HPV) infection is one of the most common sexually transmitted infection. HPV is linked to at least five malignancies including vulvar, vaginal, anal penile, oropharyngeal, and cervical cancer. Three HPV vaccines are currently available: bivalent (HPV 16,18), quadrivalent (HPV 6,11,16,18), and nonavalent (6,11,16,18,31,33,45,52,58) targeting between 2 and 7 oncogenic HPV serotypes. This review highlights the currently epidemiologic burden of HPV-related cancers, efficacy of current HPV vaccines, and speculates about the benefits of widespread HPV vaccination. At present, all three vaccines are effective in reducing cervical disease and anogenital dysplasia in industry sponsored clinical trials and in limited study of clinical effectiveness. Models predict elimination of HPV infection with global vaccination rates of 80% and benefits in reducing malignancy at 20% global coverage. Large population-based clinical efficacy studies of these vaccines will be necessary to assess the true impact of vaccination. HPV vaccines provide a promising primary approach to preventing malignancy and barriers to vaccine access must be addressed to meet vaccination goals.     

Evaluating knowledge about human papillomavirus infection among Brazilian health professionals

Human papillomavirus (HPV) infection is one of the most common sexually transmitted diseases worldwide. Although two safe and clinically effective vaccines against HPV have been developed, they are not available to the public health network in Brazil. This study was performed to assess knowledge about HPV among seventy-nine professionals who completed a questionnaire about diagnosis, transmission, symptoms, prevention and general information. General knowledge about HPV was high, as most of them recognized that HPV is transmitted sexually (98.7%), the disease can be asymptomatic (82.3%) or warts can be present on the genitals (84.8 ) and the Pap smear is the screening method to identify cellular changes on the cervix (88.6%). However, many professionals did not know that there are now vaccines available for many HPV variants (38.0%) and that not all of them are oncogenic (44.3%). These data show that further educational programs, especially about HPV prevention, are needed in Brazil.     

Journey of the Human Papillomavirus (HPV) in a Developing Country over 5 Years (2010 - 2015)

Human papillomavirus (HPV) is a prevalent sexually transmitted infection with serious medical, sexual, and relationship consequences. HPV vaccine protection is available globally but unfortunately vaccine uptake is inconsistent everywhere. From this study, it was observed that the awareness of cervical cancer, HPV virus and HPV vaccination in Malaysia is high, at 83.1%, 73.9% and 73.3% of respondents, respectively. However, a considerably low percentage had undergone HPV vaccination (8.6%) compared to those who had experienced a Pap smear (32.9%). Awareness between cervical cancer and HPV virus and vaccination was low. Health care providers and the governing bodies have to play a vital role in disseminating holistic information on the vaccine and the importance of getting vaccinated to the public more vigorously in Malaysia.     

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 2013to March 2014, in a public university, a convenient sampling method was used. A total of 716 respondents wererecruited and interviewed with a set of standard questionnaires for assessment of knowledge, perception andattitudes 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 withthe score of 11 and above. Only 142 (20%) students perceived themselves to be vulnerable to HPV infectionthough 560 (78.2%) students thought that HPV infection is a serious disease. Perceived benefits and desire tobe vaccinated were significantly associated with gender (p=0.000) and knowledge of HPV vaccine and cervicalcancer (p=0.000). Conclusions: The level of knowledge regarding HPV among the pre-university students waslow. However, student intention for vaccination increased with increasing level of knowledge. Thus, efforts toimprove knowledge and awareness should be prioritised to increase uptake of the HPV vaccination programmeand hence reduce morbidity and mortality from consequences of HPV infection, including cervical carcinoma.     

Awareness and Knowledge Levels of Turkish College Students about Human Papilloma Virus Infection and Vaccine Acceptance

Awareness of HPV by the target population is an important determinant of vaccine acceptance. The aim of this study is to evaluate the awareness of HPV infection and acceptability of the HPV vaccines among Turkish college students. College students aged 18–30 who were attending a large public university in Ankara participated in this study. The participants were asked to complete a questionnaire to elicit demographic characteristics, awareness level of HPV and HPV vaccine, and willingness to be vaccinated. One thousand one hundred sixty students responded to the invitation email and completed the questionnaire. The mean scores of female students about HPV and HPV vaccine were 7.1/15 and 3.6/9, respectively, while these scores were 7.9/15 and 3.4/9 among male students, respectively. While 51 % percent of female and 33.5 % of male students had heard of HPV and 32.8 % and 18 % of them had heard of HPV vaccine, respectively, only 1.5 % of female and 0.4 % of male students had been vaccinated against HPV. A total of 507 students (43.7 %) had previously heard of HPV. Only 309 (26.6 %) of the participants had previously heard of the HPV vaccine, and 45.1 % of the students were willing to receive HPV vaccination. The main predictors for willingness to be vaccinated were the following: sexual experience, sexual behavior, past history of sexually transmitted infection (STI), and knowledge about HPV and HPV vaccine. Higher awareness levels of HPV and HPV vaccine are significantly related to greater willingness to be vaccinated, and the main reasons for rejecting the vaccine were insufficient information about the vaccine and possible unknown side effects.     

Awareness of Human Papilloma Virus and Its Association with Cervical Cancer among Female University Students: A Study from United Arab Emirates

Cervical cancer is the neoplasm of the uterine cervix in women, which is highly preventable. With the advent of vaccination against HPV infection, a gradual decline in the incidence of cervical cancer cases has been observed in developing countries. The developing nations bear the brunt of cervical cancer incidence due to low acceptance of vaccination. This survey-based study was designed to assess the awareness and opinions of female university students regarding human papilloma virus, vaccination and cervical cancer. A survey questionnaire was distributed among female expatriate students (18 to 26 years of age) of a private university. The survey sought information on socio-demographic characteristics, family and personal health history, knowledge of cervical cancer, its association with HPV, preventive care and their opinions on vaccination. GraphPad was used for statistical calculations. Of the 269 respondents, only 6% had attended awareness programs and 11% reported having read any information leaflet. 78% of the respondents did not know how HPV infection occurs and less than 40% of the participants believed that cervical cancer is preventable. 75% of the respondents had not heard about the PAP smear test. 20% of the participants stated that they were uninterested in taking the vaccination and only 5% of the survey respondents had received vaccination. Majority of the respondents (78%) demonstrated positive attitude towards practices related to influence of nutrition in having a disease-free life. The present study indicates low levels of awareness regarding HPV and its role in cervical cancer among female university-going students. It was found that the awareness of HPV, their role in cervical cancer development and the availability of information regarding vaccination was very low. The authors recommend that educational institutions and government health authorities must offer a well-designed comprehensive awareness cum vaccination camp in order to educate young women about HPV infection and risk of developing cervical cancer. This will help ensure future economic and health benefits for all.     

Knowledge and Awareness of Human Papillomavirus Vaccination and Cervical Cancer among Men and Women in Japan: A Questionnaire Survey

Background: In many advanced countries other than Japan, the incidence and mortality rates of cervical cancer, which is mainly caused by the human papillomavirus (HPV) infection, are decreasing probably due to the high rate of HPV vaccination and cervical cancer screening. In Japan, these rates are on the rise owing to the stagnation of vaccination and low screening rate. To improve these situations, active promotion of HPV vaccination and screening is required. As a preliminary stage, we investigated perceptions regarding cervical cancer and HPV vaccines among Japanese men and women and examined the difference in perceptions by sex. Methods: This was a prospective cross-sectional questionnaire survey targeting Sojo University students and working adults. University students were targeted before learning about cervical cancer. Working adults were recruited on the basis of information from the Health Promotion of Health and Welfare Department of Kumamoto Prefectural Government in Japan and from companies via student organizations promoting cancer prevention. We surveyed respondents’ knowledge and awareness about HPV vaccination and cervical cancer and performed logistic regression analysis to compare the results between men and women. Result: A total of 557 completed questionnaires (205 men and 352 women) were analyzed. Women had high levels of knowledge and awareness about HPV vaccination and cervical cancer compared with men. However, 70% of women surveyed had never been screened for cervical cancer. Conclusion: A total of 557 completed questionnaires (205 men and 352 women) were analyzed. Women had high levels of knowledge and awareness about HPV vaccination and cervical cancer compared with men. However, among surveyed women, the degree of knowledge and awareness was lower than that among women in other countries with established HPV vaccination programs. Furthermore, 70% of women surveyed had never been screened for cervical cancer.     

Knowledge about Human Papillomavirus and Cervical Cancer: Predictors of HPV Vaccination among Dental Students

Background: The objective of this study is to determine the influence of dental students’ knowledge and attitude regarding human papillomavirus infection of cervical cancer on willingness to pay for vaccination. Basic research design: A convenience sampling method was used. The minimal sample size of 136 was calculated using the Raosoft calculator with a 5 % margin of error and 95% confidence level. Participants: The study population were all final year dental students from the School of Dentistry. Methods: A self-administered questionnaire was used to measure knowledge levels and attitudes regarding human papillomavirus vaccination. Contingent valuation was conducted for willingness to pay for vaccination. Main outcome measures: The Center for Disease Control and Prevention has stated that human papillomavirus are associated with oropharynx cancer and the American Dental Association insist on expanding public awareness of the oncogenic potential of some HPV infections. Thus, as future dental practitioners, dental students should be aware of human papillomavirus and their links with cancer and the benefits of vaccination. Results: Knowledge on HPV and cervical cancer did not impact on attitudes towards vaccines. However, significant correlation existed between knowledge and willingness to pay for vaccination. Conclusions: Dental students’ knowledge on HPV and cervical cancer has no influence on their attitude towards HPV vaccines. However, their willingness to pay for HPV vaccination is influenced by their knowledge of cervical cancer and HPV vaccination.     

Knowledge,Attitudes and Practices of Sudanese Women Regarding the Pap Smear Test and Cervical Cancer

Background: Despite the established role of the Pap smear test (PST) in prevention and early detection of cervical cancer, it is still rarely practiced in Sudan. Many challenges hinder the establishment of an effective cervical cancer screening program, including socio-cultural factors. Therefore, this study aimed to investigate the knowledge, attitudes and practices (KAP) of Sudanese women with regard to the Pap smear test and cervical cancer. Materials and Methods: A total of 500 married women aged 14 to 58 years were recruited from obstetric clinics, hospitals and universities in Khartoum in 2014. Data were collected using a standardized, pretested questionnaire that inquired socio-demographic characteristics and their KAP about cervical cancer and the PST. Results: More than 52% of participating women were above 30 years of age, and the majority (78.8%) were university degree holders. A total of 486 (97.2 %) of participants were resident in urban areas of Khartoum State. However about 48% of the respondents had never heard about PST, and only 15.8% of the participants had undergone a Pap smear test previously; 46.6% (233/500) knew that the human papilloma virus (HPV) was the causative agent, but only 39.2% (196/500) had heard about HPV vaccination, and only 11.4% (57/500) had received the vaccine. However 68% of the respondents agreed to do Pap smear if properly informed about the test and 75.4% of the respondents agreed to participate in a cervical cancer screening program. Conclusions: Despite a high educational level, less than half of our participants had accurate knowledge about cervical cancer, HPV, and cervical cancer screening. Health education about cervical cancer, HPV and sexually transmitted infections and the role of PST in cervical cancer prevention are crucial when designing interventions aimed at improving cervical cancer screening for Sudanese women.     

Parental Knowledge and Attitudes about Human Papilloma Virus in Iran

Infection by human papillomavirus (HPV) is one of common sexually transmitted diseases leading to cervicalcancer. Evaluation of parental knowledge and attitudes toward HPV were aims of present study to provide anappropriate method to decrease burden of this infection on society. During this study, 358 parents were assessedfor knowledge about HPV and its related disorders. Some 76% of parents had no information about HPVinfection and among the informed parents 36% had obtained their information via internet and others fromstudying medical resources. The average score of mothers information about HPV infection was higher thanthat of fathers, and also educational level and age had significant impact on knowledge of parents about HPV.Parent knowledge about the hazards of HPV was higher than their knowledge about modes of transmission.Lack of awareness about HPV infection was high in this study, underlining the urgency of education among alladult people in our society.     

Knowledge,Behaviors, and Attitudes About Human Papilloma Virus Among Nursing Students in Izmir,Turkey

Human papillomavirus (HPV) is transmitted through sexual contact and can cause cervical cancer. The aim of this study was to determine knowledge, behaviors, and attitudes about human papillomavirus (HPV) in nursing students in a baccalaureate program. This study was conducted with a sample of 624 students. Data were collected via questionnaires administered during the first class time. Students’ knowledge about HPV was high; 90.5% knew HPV can cause cervical cancer; 94.6% recognized it as a sexually transmitted disease. Although; 87.7% stated a vaccine is available to protect women from HPV, nearly all participants (98.1%) had not received HPV vaccination. Findings show students’ level of knowledge about HPV’s risk factors and modes of transmission were high. However, this knowledge did not translate into engagement in health related behaviors such as being vaccinated against HPV.     

Knowledge,Decision-Making and Acceptance of Human Papilloma Virus Vaccination among Parents of Primary School Students in Kota Bharu,Kelantan, Malaysia

Background: The incidence of cervical cancer in younger women remains high. This is worrisome as it affectsfuture generations. Therefore Malaysia implements human papilloma virus (HPV) vaccination as a national vaccinationprogram. Parents play an important role in determining the success of this HPV vaccination program among schoolagedgirls by their compliance. Objective: To assess parental knowledge, decision-making and acceptance of HPVvaccination. Methods: This cross sectional study was conducted among 280 randomly selected parents of primaryschool students aged 11 in Kota Bharu using a pre-validated self-administered questionnaire to assess knowledge anddecision-making with regard to HPV vaccination. Results: Most parents (62%) were shown to have poor knowledgewhile most decision-making was shared. Age of respondents (adjusted odds ratio ‘AOR’= 1.09; 95% confidence interval‘CI’= 1.04-1.14; p <0.001) and good knowledge of HPV vaccination (AOR= 16.32; 95% CI= 7.32-36.4; p <0.001) weresignificantly associated with HPV vaccine acceptance. Conclusion: The majority of parents exhibited poor knowledgewhich may affect their decision-making and uptake of HPV vaccination among their children. This highlights the needto better educate parents on HPV vaccination.     

Knowledge and Attitudes of Medical and Non-Medical Turkish University Students about Cervical Cancer and HPV Vaccination

Background: This study was conducted to determine knowledge, attitudes and practices about cervical cancer and HPV vaccination of students studying in various faculties of Erciyes University. Materials and Methods: The study was performed among the first and fourth grade students of Medicine, Theology, Education and Economics and Administrative Sciences (FEAS) faculties of Erciyes University. It was aimed to reach 1,073 students and 718 were evaluated. A questionnaire consisting of 48 questions related to the socio-demographic characteristics, knowledge, attitude and practices about cervical cancer and HPV vaccination was administered to the students. The chi-square test and logistic regression were used for the statistical analyses. Results: Of the students, 78.3% were aware of cervical cancer, while 36.1% of them were aware of the HPV vaccine. The percentage hearing about cervical cancer and HPV vaccination was significantly higher among the students of the medical faculty than the others and among fourth grade students comparing with the first grade. The marital status and the presence of a health worker in the family had no significant impact on the knowledge level of the students. The acceptability of the HPV vaccination was low among all students. Conclusions: The knowledge levels of the university students about cervical cancer and HPV vaccination are inadequate. This deficiency is more pronounced among the non-medical students and there is no significant increase during the faculty years. Non-medical students must be provided with information about important public health issues by elective courses. HPV vaccination could provide many benefits for men and women by decreasing the morbidity and mortality of cervical, anal, and penile cancers.     

Influence of risk‐taking health behaviours of adolescents on cervical cancer prevention: a Hungarian survey

An anonymous questionnaire survey was conducted among the Hungarian adolescents to establish their use of tobacco, alcohol and drugs in relation to sexual behaviours, knowledge of human papillomavirus (HPV) and cervical cancer, and beliefs and attitudes towards screening and vaccination. Results indicated that adolescent risk‐taking health behaviours correlate with risky sexual behaviours. As risk‐taking behaviours do not correlate with a better awareness of the risk associated with HPV infection, it is of crucial importance that HPV/cervical cancer preventing educational programmes shall be sensitive to this ‘vulnerable’ population and draw the attention of these adolescents to their increased risk of sexually transmitted diseases and undesired pregnancies. Well‐designed behavioural change interventions may be effective when in addition to providing adolescents (both men and women) with clear information about the implications of an HPV infection, they also aim to improve safer sex behaviours: consistent condom usage, limiting the number of sex partners, as well as encouraging regular participation in gynaecological screenings and uptake of the HPV vaccine. As this study population demonstrated positive attitudes towards the primary and secondary prevention of cervical cancer, the free HPV vaccination for the 12–13‐year‐old girls in Autumn 2014 will hopefully increase the currently low uptake of the vaccine in Hungary.     

Acceptability of Human Papilloma Virus Vaccination among Women in the United Arab Emirates

Background: Human papilloma virus (HPV) is a common sexually transmitted infectious agent. It is estimatedthat 10% of all women worldwide are infected with HPV, that is some 660 million each year. HPV vaccination hasa reported efficacy of more than 98% for protection against infection in females. In 2008 the Abu Dhabi HealthAuthority in the United Arab Emirates (UAE) introduced free HPV vaccination for all eligible schoolgirls in bothpublic and private schools. Methods: A cross-sectional study of 640 women aged 18-50 years in the Emirate ofAbu Dhabi in UAE from April 2012 to October 2012 was conducted. Results: Thirty-seven percent of the womenin our sample had heard about HPV vaccination, and 80% of these would consider getting vaccinated themselves,and 87% would recommend vaccination to relatives or friends. Most women in the study (69%) had a favorableopinion about the vaccine. Only 17% of the women felt it might not be culturally acceptable, and 1% felt thatthere might be religious objections to HPV vaccination. Vaccine safety and recommendation by a doctor (36%each) were the factors identified most frequently by our sample of women which would enhance the uptake ofthe HPV vaccination. Conclusions: Knowledge about HPV vaccination among women in our sample was belowaverage (37%); however, 80% of those who had heard about HPV vaccination were willing to be vaccinatedthemselves, and 87% would recommend vaccination to relatives and friends.