Barriers,Attitudes and Clinical Approach of Lebanese Physicians Towards HPV Vaccination; A Cross- Sectional Study

Objectives: HPV infection is associated with the development of cervical and oropharyngeal cancer. HPV vaccination prevents cervical cancer, but is still not part of Lebanon’s routine vaccination schedule. As such, understanding physicians’ practice towards HPV vaccination is essential. Material and Methods: We conducted a cross-sectional study in Greater Beirut, Lebanon to assess the barriers, attitudes and clinical approach of Lebanese physicians towards HPV vaccination. We also aimed to analyze the factors associated with physicians’ barriers to HPV vaccination. Results: In total, 228 physicians completed the survey. Our results show that physicians and parents consider the cost of HPV vaccination to be a main barrier (58.9% and 80.7% respectively). Also, parents tend to have concerns about vaccine safety (78.1%), efficacy (68.6%), and lack education concerning HPV infection (81.8%). Furthermore, female physicians tend to have fewer barriers when compared to male physicians (aOR = 0.39; p-value = 0.007). Additionally, physicians who completed residency programs in the USA also showed fewer barriers when compared to physicians who completed Lebanese residency programs (aOR = 0.24; p-value = 0.040). Finally, physicians with higher knowledge score have fewer barriers when compared to those with lower knowledge scores (aOR = 0.42; p-value = 0.018). Conclusions: Physician gender, residency program and level of knowledge play a role in HPV vaccine barriers and recommendation in Lebanon. Future improvements in cost and awareness about HPV might improve vaccination rates. Creating uniform practices towards HPV vaccine is warranted to improve patient care.     

Knowledge and Attitudes about Human Papillomaviruses and Immunization among Turkish Pediatricians

Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infectious agents,and the effectiveness of vaccine delivery programs will depend largely upon whether providers recommendvaccines. The objectives of this study were to examine pediatrician characteristics, knowledge, and attitudesassociated with HPV and HPV immunization. Materials and Methods: Attendees of the national pediatricmeeting in 2011, were asked to complete a questionnaire that, aside from demographic information, elicited levelof agreement with statements regarding HPV, its related diseases, and HPV vaccination. It also documentedattitudes and beliefs about HPV vaccination. Results: Of the 480 attendees, 226 (47%) filled in the questionnaire.The level of pediatrician HPV-related knowledge varied. The majority (78%) were aware that HPV infection isthe most common sexually transmitted infection, while 51% were unaware that a condom is ineffective protectionagainst HPV infection. Between 60-80% of respondents were aware of the effectiveness of HPV vaccination forwomen. On the other hand, only 10% were aware of reasons why men should be vaccinated against HPV. Themajority (75%) of Turkish pediatricians were likely to recommend HPV vaccination to their daughter, if theyhad one. Seventy percent of pediatricians agreed that the HPV vaccination should be added to the NationalImmunization Program (NIP) in Turkey. However, the respondents documented concerns about the cost of thevaccination. Conclusions: Increasing pediatricians’ knowledge and awareness of HPV and HPV vaccinationmay assist with the implementation of an effective NIP.     

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.     

National HPV Immunisation Programme: Knowledge and Acceptance of Mothers Attending an Obstetrics Clinic at a Teaching Hospital,Kuala Lumpur

Background: Introduction of the HPV vaccine is a forefront primary prevention method in reducing theincidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government hasimplemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV,HPV vaccine and National HPV (NHPV) immunisation programme since its’ implementation. It also assessedacceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves. Materialsand Methods: A cross sectional study was conducted on 155 respondents using self-administered questionnaires;conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur.Respondents were selected using a multistage sampling technique. Results: A response rate of 100% was obtained.Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2%for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regressionanalyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education wasassociated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPVimmunisation programme; ethnicity (p=0.017), mothers’ education (p=0.0005) and number of children (p=0.020).The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by formothers themselves at 73.5%, and the least is for sons 62.6%. Conclusions: This study found that the overalllevel of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and theNational HPV immunisation programme should be provided to mothers in order to increase acceptance of theHPV vaccine which can reduce the disease burden in the future.     

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.     

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.     

HPV Vaccine Knowledge and Beliefs Among Cambodian American Parents and Community Leaders

Background: The cervical cancer incidence rate among Cambodian American women is 15.0 per 100,000,compared to 7.7 per 100,000 among non-Latina white women. HPV infection has been identified as a universalrisk factor for cervical cancer. The HPV vaccine was recently approved in the United States for females aged 9-26 years. There is little information about HPV vaccination knowledge and beliefs in Southeast Asian communities.Methods: We conducted 13 key informant interviews with Cambodian community leaders, as well as four focusgroups with Cambodian parents (37 participants). Two of the focus groups included fathers and two of the focusgroups included mothers. Interview and focus group questions addressed HPV vaccine barriers and facilitators.Results: Participants had limited knowledge about HPV infection and the HPV vaccine. Barriers to HPVvaccination included a lack of information about the vaccine, as well as concerns about vaccine safety, effectiveness,and financial costs. The most important facilitators were a health care provider recommendation for vaccinationand believing in the importance of disease prevention. Discussion: Future cervical cancer control educationalprograms for Cambodians should promote use of the HPV vaccine for age-eligible individuals. Health careproviders who serve Cambodian communities should be encouraged to recommend HPV vaccination.     

Provider factors associated with disparities in human papillomavirus vaccination among low‐income 9‐ to 17‐year‐old girls

BACKGROUND:

Many women who develop cervical cancer are eligible for or are participants of Medicaid. Providing human papillomavirus (HPV) vaccination to girls enrolled in Medicaid may reduce cervical cancer disparities in low‐income and minority women. This study evaluated provider characteristics associated with HPV vaccination among 9‐ to 17‐year‐old female Medicaid enrollees.

METHODS:

A random sample of 800 providers from the Florida Medicaid Master Provider File was mailed a survey in October 2009 that evaluated demographic and practice characteristics, HPV information and knowledge, barriers to HPV vaccination, vaccine practices, and vaccine recommendation practices. To measure HPV vaccination, Medicaid claims data were used to calculate the proportion of eligible patients who received at least 1 dose of the vaccine from participating providers within the study period. Provider factors associated with vaccination at the bivariate level were evaluated in a multiple linear regression model.

RESULTS:

The response rate was 68.3% (N = 485). After excluding ineligible respondents, the current analysis included 433 providers. HPV vaccination prevalence ranged from 0% to 61.9% (M = 20.4, standard deviation = 14.5). HPV vaccination rates were higher among providers who were pediatricians, had a private practice, practiced in a single specialty setting, were providers under the Vaccines for Children program, saw primarily non‐Hispanic white patients, used 2 or more strategies for vaccine series completion, and did not refer out for HPV vaccination.

CONCLUSIONS:

Despite financial coverage for Medicaid‐eligible girls, HPV vaccination rates are low. Study findings can be used to target health services interventions to providers least likely to administer HPV vaccine to female Medicaid enrollees. Cancer 2013. © 2012 American Cancer Society.     

Awareness of Turkish Female Adolescents and Young Women about HPV and their Attitudes Towards HPV Vaccination

Background: The aim of the study was to assess the knowledge about HPV and HPV vaccines and attitudestowards vaccination among the females aged 9-24 years in Turkey. Materials and Methods: Self-administeredquestionnaires were filled out individually by the participants covering demographic information, knowledgeabout HPV infection and HPV vaccines, attitudes towards vaccination, and the perceptions of them about theirparental attitudes about vaccination. Results: Of the 408 subjects participating in the study, 41.6% (n=170) hadheard of HPV. Thirty-three percent (n=136) knew the causal relationship between HPV and cervical cancer.Only 27.9% (n=114) of them knew that HPV vaccines can prevent cervical cancer. Eleven percent (n=46) of thefemales participating in the study were willing to be vaccinated, and only 1.4% (n=6) were already vaccinated atthe current time. The main reason listed among the participants who were not willing to be vaccinated was lackof information. Conclusions: Awareness and knowledge of Turkish female adolescents and young women aboutHPV, relation with cervical cancer and prevention of cervical cancer by Pap smear and vaccine are still limited.If the most important barrier to vaccination, which is reported as lack of information, were to be addressed, itwould greatly impact the decision-making and vaccine acceptance.     

Human papillomavirus and vaccination: knowledge, attitudes, and behavioural intention in adolescents and young women in Italy

This study assesses knowledge, attitudes, and behavioural intention towards human papillomavirus (HPV) infection and vaccination in a random sample of 1348 adolescents and young women aged 14-24 years in Italy. A self-administered anonymous questionnaire covered demographics; knowledge about HPV infection, cervical cancer, and HPV vaccine; the perceived risk for contracting HPV infection and/or for developing cervical cancer, the perceived benefits of a vaccination to prevent cervical cancer, and willingness to receive an HPV vaccine. Only 23.3% have heard that HPV is an infection of the genital mucosa and about cervical cancer. Those older, with at least one parent who is a health care professional, with personal, familiar, or friendly history of cervical cancer, and having underwent a health checkup in the last year with information about HPV vaccination were significantly more knowledgeable. Risk perception scores (range: 1-10) of contracting HPV infection and of developing cervical cancer were 5.8 and 6.5. Older age, not having a parent who is a health care professional, having had a personal, familiar, or friendly history of cervical cancer, and need of additional information were predictors of the perceived susceptibility of developing cervical cancer. The vast majority professed intent to receive an HPV vaccine and the significant predictors were having at least one parent who is a health care professional, a high perceived risk of contracting HPV infection and of developing cervical cancer, and a high belief towards the utility of a vaccination for preventing cervical cancer. Knowledge about HPV infection and cervical cancer should be improved with more attention to the benefit of HPV vaccination.     

A qualitative study on HPV vaccination from a nursing perspective in Hong Kong

Objective: To identify the perception on human papillomavirus (HPV) vaccination among female nursing students in Hong Kong. Data Sources: Data were collected through focus group discussions and semi-structured in-depth interviews. All participants (n=28) were female nursing students of a university in Hong Kong. Tape recordings of individual interviews and focus group discussions were transcribed verbatim in Chinese, translated into English, and analyzed according to Colaizzi’s phenomenological analysis. Study Design: Four major themes emerged from the data: nursing students’ understanding about HPV vaccine, nursing students’ attitude on HPV vaccine, nursing students’ perspective on HPV vaccination promotion, and nursing role on HPV vaccination. Conclusions: Government should take initiative in promotion with vaccine suppliers. The awareness and knowledge of HPV and HPV vaccination among women should be increased in order to raise the positive attitude of women towards HPV vaccination and prevention of cervical cancer. Health professionals should work together on HPV promotion among women and increase the HPV vaccination rates. Moreover, further studies regarding attitude and awareness of HPV vaccination among women in different age groups are needed in order to identify more associated factors affecting their perceptions towards HPV vaccination.     

A Cross Sectional Study on Knowledge,Attitude and Practice related to Human Papillomavirus Vaccination for Cervical Cancer Prevention between Medical and Non-Medical Students in Hong Kong

Background: One of the most important aetiologies of cervical cancer is Human Papillomavirus (HPV) infection. While vaccination is an effective way in preventing high risk HPV infection, HPV vaccine uptake rate in Hong Kong has been low. Considering the proven effectiveness of HPV vaccination and the low vaccination uptake rate in Hong Kong, this study was conducted to compare the knowledge, attitude and practice towards HPV vaccination for cervical cancer prevention between medical and non-medical students in the University of Hong Kong. Methods: A total of 420 full time undergraduates from the University of Hong Kong were recruited and evaluated. Questionnaires covering demographics, sexual risk profile, knowledge, attitude and practice towards HPV vaccination were applied, with the Chi-square test analysis. Results: Medical students had more comprehensive knowledge than their non-medical counterparts on HPV vaccination, including the carcinogenicity of HPV (P<0.001), available vaccines on the market (P<0.001) and the outcome of vaccination (P<0.001). In particular, senior medical students (Year 3 or above) were shown to be more knowledgeable than their juniors (below Year 3) with statistical significance (P<0.001). Positive attitudes toward HPV vaccination were observed more frequently among medical students when compared to non-medical students, especially regarding the usefulness of HPV vaccination in males (P<0.001). However, there was no significant difference in the vaccination rate between medical and non-medical students (P=0.671), suggesting an importance for factors other than knowledge, such as cost of vaccination and anxiety of side effects. Conclusions: Medical students in Hong Kong, especially those in senior years, had more comprehensive knowledge and positive attitudes towards HPV vaccination than non-medical students. Yet, there was no significant difference in the practice of HPV vaccination between medical and non-medical students. In addition to medical education, other factors such as health beliefs, risk perception and financial considerations, may have a role in determining HPV vaccination for cervical cancer prevention.     

Knowledge and Attitude Toward Human Papillomavirus Infection and Vaccination among Thai Women: A Nationwide Social Media Survey

Objectives: This study was performed first to assess Thai women’s knowledge and attitude toward Human papillomavirus (HPV) infection and vaccination and second to find out factors associated with knowledge in this regard. Methods: The survey announcement was advertised via Facebook from 17 May 2019 to 14 June 2019 to recruit women aged 18-26 years living in Thailand. A score below 5 out of total score of 10 on the survey was considered as a poor level of knowledge. Multivariate analysis was applied to identify factors associated with HPV infection and vaccination knowledge. Results: A total of 1,175 participants were recruited. The participants’ median age was 22 years. Approximately, 46% of the participants had poor level of knowledge regarding HPV infection and vaccination. Factors associated with poor knowledge included low educational level (adjusted OR, 1.35; 95% CI 1.04-1.77), low family income (adjusted OR, 2.14; 95% CI 1.65-2.78), being Christian (adjusted OR, 4.04; 95% CI 1.22-13.40), being engaged in sexual intercourse (adjusted OR, 0.75; 95%CI 0.58-0.97), and being unvaccinated against HPV infection (adjusted OR, 5.74; 95% CI 3.07-10.74). Conclusion: Nearly half of the Thai women who participated in the survey had poor level of knowledge regarding HPV infection and vaccination, indicating a need for more effective health education intervention. Factors associated with knowledge included socioeconomic status and sexual behavior.     

Knowledge of Human Papillomavirus Infection,Cervical Cancer and Willingness to pay for Cervical Cancer Vaccination among Ethnically Diverse Medical Students in Malaysia

The primary objective of this study was to assess the knowledge of medical students and determine variationbetween different cultural groups. A secondary aim was to find out the willingness to pay for cervical cancervaccination and the relationships between knowledge and attitudes towards Human Papillomavirus vaccination.A cross-sectional survey was conducted in a private medical university between June 2014 and November 2014using a convenient sampling method. A total of 305 respondents were recruited and interviewed with standardquestionnaires for assessment of knowledge, attitudes and practice towards human papilloma virus and theirwillingness to pay for HPV vaccination. Knowledge regarding human papilloma virus, human papilloma virusvaccination, cervical cancer screening and cervical cancer risk factors was good. Across the sample, a majority(90%) of the pupils demonstrated a high degree of knowledge about cervical cancer and its vaccination. Therewere no significant differences between ethnicity and the participants’ overall knowledge of HPV infection,Pap smear and cervical cancer vaccination. Some 88% of participants answered that HPV vaccine can preventcervical cancer, while 81.5% of medical students said they would recommend HPV vaccination to the publicalthough fewer expressed an intention to receive vaccination for themselves.     

Awareness of cervical cancer and HPV vaccination and its affordability among rural folks in Penang Malaysia

Introduction: As the second most common cancer in women worldwide, cervical cancer causes major health and economic burdens. Recent introduction of HPV immunization program locally has been encouraging but vaccine uptake remains poor. In addition, no study has been conducted to explore the people’s awareness and knowledge on cervical cancer, HPV and its vaccine in a rural setting in Malaysia after the inception of the HPV vaccination program. Objective: This study was conducted to determine the awareness of cervical cancer, HPV vaccination and its affordability among people in a rural area in Malaysia. Method: A cross-sectional study was conducted among 116 participants in a village in Penang. All consenting female villagers aged 13 years and above, and males who were married were interviewed using a questionnaire. Results: Most participants (88.8%) had heard of cervical cancer, however only 29.3% and 42.2% of them had heard of HPV and HPV vaccination respectively. Only 5.2% knew the actual market price for the vaccine. They were willing to pay an average of RM 96.7 (USD $27.7) for the full course of vaccination if it is not given to them for free, whereas the market price is RM1200 (USD $342.85). Conclusion: Awareness among the Malaysian population in a rural setting on HPV and HPV vaccination is low. Educating the public on the infection can help control the illness. Cost of the HPV vaccine is a serious barrier to the success of the vaccination program in Malaysia.     

Knowledge,Acceptance, and Willingness to Pay for Human Papilloma Virus (HPV) Vaccination among Female Parents in Thailand

Background: This study aimed to examine the level of knowledge, attitude, acceptance, and willingness to pay (WTP) for HPV vaccination among female parents of girls aged 12-15 years in Thailand. Materials and Methods: A cross-sectional survey was conducted in eight schools across Bangkok. Results: Of 1,200 questionnaires sent out, a total of 861 questionnaires were received. Knowledge regarding the HPV vaccine among parents was quite low. Only half of the parents knew about the link between HPV and cervical cancer while one-third of them knew that the vaccine should be administered to the children before they become sexually active. Nevertheless, vaccine acceptance was high if it was offered for free: 76.9% for the bivalent and 74.4% for the quadrivalent vaccine. The proportion of respondents who were willing to copay for the vaccine if it was not totally free was also high, ranging from 68.9% for the bivalent to 67.3% for the quadrivalent vaccine. No significant difference between bivalent and quadrivalent vaccines in terms of prevalence of acceptance and willingness to pay was found. About one-third of the participants, who were willing to copay for the vaccine if it was not offered for free, indicated that they would copay less than 500 baht (30 baht = approx US$1) for three doses of bivalent vaccine. Conclusions: Substantial effort should be made to educate parents prior to introduction of a national HPV vaccination program. In terms of acceptance, either bivalent or quadrivalent vaccines can be recommended.     

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.     

Practice of HPV Vaccine and Associated Factors among School Girls in Melaka,Malaysia

Objective: The objective of this study is to determine the practice and associated factors of HPV vaccineamong school girls in Melaka, Malaysia. Methodology: A total number of 612 secondary school girls participatedin this study. The questionnaire consists of 38 questions which included 3 sections. The first section is about sociodemography.The Second section is about knowledge and awareness of HPV vaccines. The third section is aboutpractices with associated barriers of HPV vaccination. Verbal consent was obtained from all participants, anddata were analyzed using SPSS 13. Results: A total number of 612 secondary school girl students participated inthis study. The mean age was 13.93±SD (1.09); minimum age was 13 years old and maximum was 17 years old.The majority of them was Malay, from rural areas and had a family monthly income of RM 3000 or less (91.8%,53.1%, 69.6%; respectively). The majority of the parents of the school girls were with secondary educationlevel (56.4%). The majority of the participants did not have a family history of cervical cancer (99.0%). Theprevalence of HPV vaccination was 77.9% among school girls in Melaka. The majority of the participants werevaccinated in their schools (77.0%). About 69% knew about cervical cancer and 77.6% had ever heard aboutHPV vaccine. Regarding the factors that influence the practice of uptake HPV vaccine, they were age, race,income, parents’ education, knowledge about cervical cancer, heard about HPV vaccine and place of getting thevaccine (p<0.001). Conclusion: The prevalence of HPV vaccine among school girls is high. Age, race, income,parents’ education, knowledge about cervical cancer, heard about HPV vaccine and place of getting the vaccinewere the significant factors that influence the practice of uptake HPV vaccine among school girls.     

Knowledge,Attitudes and Barriers for Human Papilloma Virus (HPV) Vaccines among Malaysian Women

A cross-sectional study was conducted among 300 Malaysian women in the obstetrics and gynecology outpatient clinic in a selected hospital in Bangi, Selangor to determine the level of knowledge of HPV and HPV vaccines, attitudes toward HPV vaccination and barriers of being vaccinated. Factors associated with knowledge and attitudes were also addressed with a questionnaire. Seventy eight women (26%) had heard about the HPV virus and 65 about HPV vaccines (21.7%). Marital status was associated significantly with awareness of HPV and HPV vaccine (p=0.002, p=0.002; respectively), in addition to level of education (p=0.042). The percentages of women who reported correct answers for the questions on knowledge of HPV and HPV vaccine ranged from 12% to 25%. One hundred fifty nine respondents (53%) had a positive attitude toward HPV vaccination. Age, marital status, and level of education were associated significantly with attitude (p<0.001, p<0.001, p=0.002; respectively). The most important barriers reported were ‘unawareness of the vaccine’ ‘concerned about side effects’ and ‘afraid of needles’. This study found a very low level of knowledge of HPV and HPV vaccine. Education of population is highly recommended and barriers to being vaccinated should be dealt with seriously.