Effect of Human Papillomavirus (HPV) Education Intervention on HPV Knowledge and Awareness Among High School Learners in Eastern Cape Province of South Africa

The Effectiveness of Interventions Targeting Adolescents in HPV Vaccination-A Scoping Review

Adolescents are the target group for HPV vaccination. Studies that examine factors influencing acceptability among adolescents and interventions aimed at improving knowledge, attitudes, perceptions, intentions, and, most importantly, vaccination rates are less common than those addressing parents or healthcare professionals. The specialized literature was searched for studies evaluating the impact of various interventions on adolescents. In the final analysis, 41 studies were included (35 original studies and 6 reviews). Educational interventions increased adolescents' knowledge scores in the selected studies. Peer education proved highly effective in rapidly and significantly improving knowledge about HPV. Additionally, multicomponent interventions generated awareness and knowledge that persisted for months after the interventions. HPV vaccine uptake increased following educational interventions in 11 out of the 14 studies that evaluated this outcome; studies presenting multicomponent interventions also proved effective in improving vaccination rates. Higher HPV vaccine series completion was reported following a reminder system strategy. Interventions directed at adolescents, combined with strategies involving parents and healthcare professionals, can play an important role in improving HPV vaccination rates. Educated adolescents must be involved in decisions about their own health and can be a valuable source of information for their peers and parents.

The effect of education based on planned behavior theory on women's knowledge and attitudes about human papillomavirus

Human papillomavirus is the most common sexually transmitted infection in the world. Improving knowledge and attitude is the key to controlling and preventing, but women's knowledge about this virus is not enough. This study aimed to determine the effect of educational intervention based on planned behavior theory on knowledge and attitude toward HPV and its vaccination in women of reproductive age. The study was a single-blind, randomized clinical trial study with a control group was done in 2022, which was conducted on 85 women referred to selected comprehensive health centers in Shiraz, Iran. In this study, the sampling was performed is a multi-stage random way. Eighty-three women who met the inclusion criteria were randomly divided into two intervention and control groups. The data collection tool was the knowledge and attitude questionnaire about HPV and its vaccine, which was confirmed to be valid and reliable. Data analysis was performed with descriptive and analytic statistics at a significance level of P < 0.05 with SPSS (22) software. The results showed that the educational intervention has caused a significant increase in the components of knowledge, attitude, social norms, perceived behavior control, and willingness to receive the HPV vaccine in the intervention group. So that in both stages after the intervention, there was a significant difference between the intervention group and the control group in the studied components (P < 0.05). The educational intervention based on the planned behavior theory significantly affected the knowledge, attitude, social norms, and intention for HPV vaccination in women of reproductive age. Therefore, educational intervention recommended as awareness-raising programs and strategies for women.Trial registration: (RCT code: IRCT20220131053891N1). First Registration date: 28/04/2022.

Poor Cervical Cancer Knowledge and Awareness among Women and Men in the Eastern Cape Province Rural Community

Cervical cancer knowledge and awareness is low among South Africans despite high cervical cancer prevalence. This study aimed to investigate knowledge about the symptoms, signs, risk factors, and methods of prevention of cervical cancer among women and men in the rural Eastern Cape province, South Africa. This cross-sectional analytical study was conducted in the rural community of the OR Tambo municipality in the Eastern Cape province. 252 women and men aged ≥ 25 years were randomly recruited. Data were collected using semi-structured questionnaires. A knowledge score was categorized as "good" if it was ≥65%. The majority of participants (69.8%) were women. Only a proportion of 25.6% (51/199) of the participants had good overall knowledge about cervical cancer, and the majority of these (84.3%) were women. Women previously screened for cervical cancer had a significantly higher median cervical knowledge score than those who had never been screened (p = 0.002). Only among women, good knowledge about cervical cancer was associated with a tertiary education level (OR: 3.17, 95% CI: 1.08-9.57, p = 0.044) and high household income (OR: 3.40, 95% CI: 1.24-9.75, p = 0.027). Both women and men in rural Eastern Cape had limited knowledge about the risk factors and prevention methods of cervical cancer. Public health strategies to improve knowledge and awareness of cervical cancer among both men and women are necessary.

Knowledge on Cervical Cancer Services and Associated Risk Factors by Health Workers in the Eastern Cape Province

Globally, cancer is a leading cause of death, with cervical cancer ranking second among all cancers. Its adversity impacts not only individuals but also families, societies, and governments. The quality of services, as informed by the knowledge and adequacy of the health workers, plays an important role in both prevention, diagnosis, and management of the disease. A cross-sectional study among 108 purposively selected health workers in rural health facilities in the Eastern Cape province was conducted to assess knowledge on cervical cancer and associated risk factors through the use of validated structured questionnaires. The Statistical Package for Social Sciences was used for analysis, with a 95% confidence interval and a p-value of 0.05 considered significant. A total of 91.7% of the 108 participants were female, and 25% were over the age of 50. A total of 88% and 85.2% indicated sexually transmitted disease and human immunodeficiency virus as major risk factors, respectively. The HPV, pap smear, and vaccination age were known by 64.8%, and vaccine availability was known by 71.3%. Only 40.7% of workers were trained on cervical screening, and 35.2% were trained on the interpretation of pap smear results. An overall knowledge score of 53% was obtained, with more experienced clinicians scoring lower grades. This study identified inadequacies in essential knowledge for successful implementation of cervical cancer services and found that extensive training was needed.

Microbiological and behavioral determinants of genital HPV infections among adolescent girls and young women warrant the need for targeted policy interventions to reduce HPV risk

BACKGROUND

Genital human papillomavirus (HPV) is the most common sexually transmitted virus in most populations globally. Adolescent girls and young women (AGYW) remain a key population group at risk for HPV infection. However, the risk factors of HPV infection among AGYW, especially in sub-Saharan Africa, are a subject of little investigation in published literature. Here, we investigated the factors associated with HPV infection among unvaccinated South African AGYW with a high HPV burden (prevalence: 76.1%).

METHODS

We retrospectively recruited 213 AGYW learners (aged 15-25 years) from a previous cross-sectional study, the HPV Education Intervention Study, conducted in the Eastern Cape, South Africa. Sexually transmitted infections (STIs), bacterial pathobionts, genital ulcers (due to infectious causes), candidiasis, and bacterial vaginosis (BV) in the self-collected vaginal specimens were determined using the Allplex™ Panel Assays. Statistical analyses were performed using STATA v16.1. Continuous and categorical variables were computed by t-test /Wilcoxon rank-sum test and Chi-square/Fisher's exact tests, respectively. Logistic regression was used to determine the univariable predictors of HPV infection.

RESULTS

The overall detection rate of any viral STI, bacterial STI, pathobiont, genital ulcer, candidiasis, and BV among the AGYW was 75.0, 34.4, 90.7, 14.4, 26.9, and 43.6%, respectively. The main factors associated with HPV infection were alcohol consumption (p = 0.005), infection with any and multiple Candida species (p = 0.011 and 0.006, respectively), Candida albicans infection (p = 0.010), Ureaplasma urealyticum pathobiont infection (p = 0.044), BV-associated bacteria (specifically Atopobium vaginae: p = 0.039, BV-associated bacteria 2: p = 0.021, Gardnerella vaginalis: p = 0.021, Megasphaera type 1: p = 0.037), and BV (p = 0.011).

CONCLUSIONS

Our study, albeit not necessarily generalizable, found social behavior as well as specific vaginal microbes as correlates of HPV infection among AGYW in South Africa. There is a need to investigate HPV epidemiology in other AGYW populations. The factors associated with genital HPV infection among AGYW burdened with HPV infection necessitate the need to formulate and implement population-specific public health strategies for creating HPV awareness and reducing its risk.