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Agimas MC, Adugna DG, Derseh NM, Kassaw A, Kassie YT, Abate HK, Mekonnen CK. Uptake of human papilloma virus vaccine and its determinants among females in East Africa: a systematic review and meta-analysis. BMC Public Health 2024; 24:842. [PMID: 38500046 PMCID: PMC10949808 DOI: 10.1186/s12889-024-18141-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/17/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION Cervical cancer is the most common malignant tumor among women. It is the main cause of death among women in sub-Saharan African countries. Particularly, the incidence and mortality rates are highest in East Africa. Even though the burden of human papilloma virus-related cervical cancer is high in East Africa, there is no conclusive evidence about the prevalence of human papilloma virus vaccine uptake and its predictors. OBJECTIVE To assess the pooled prevalence of human papilloma virus vaccine uptake and its determinants in East Africa. METHOD Eligible articles were searched on PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and Google. Those articles incorporating the outcome of interest, both analytical and descriptive study designs, and published or unpublished articles at any time were included. Keywords and Medical Subjects Heading terms or synonyms of human papilloma virus vaccine and Boolean operators were used to retrieve the articles. To assure the quality of articles, Joana Brigg's Institute critical appraisal checklist for cross-sectional studies was used. Sensitivity analysis was conducted to assess the heterogeneity among the studies, and a random effect model was used to analyze the pooled effect size. RESULT A total of 29 articles were included, and the pooled prevalence of HPV vaccine uptake in East Africa was 35% (95% CI: 26-45%). Good knowledge (OR = 1.6, 95%CI; 1.43-1.8), positive attitude (OR = 2.54, 95% CI; 2.13-3.03), ever heard about HPV vaccine (OR = 1.41, 95% CI; 1.03-1.94), mother educational status above college (OR = 1.84, 95%CI; 1.03-3.31), middle wealth index (OR = 1.33, 95%CI; 1.04-1.7), ≥ 9 family size (OR = 0.76, 95%CI; 0.68-0.98), availability of promotion (OR = 2.53, 95%CI: 1.51-4.26), availability of adequate vaccine (OR = 4.84, 95%CI; 2.9-8.08), outreach vaccination practice (OR = 1.47, 95%CI; 1.02-2.12) and family support (OR = 4.3, 95% CI; 2.98-6.21) were the significant factors for the uptake of human papilloma virus vaccine. CONCLUSION As compared to the global strategic plan, the pooled prevalence of HPV vaccine uptake in east Africa was low. The uptake of the HPV vaccine was higher among adolescents than youths. Knowledge about the HPV vaccine, attitude towards the HPV vaccine, ever hearing about the HPV vaccine, residence, mother's educational status, mother's occupational status, wealth index, and family size were the significant determinants of HPV vaccine uptake. Therefore, we recommend focusing on awareness creation and behavioral change to expand the uptake of vaccines in East Africa.
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Affiliation(s)
- Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Dagnew Getnet Adugna
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Amare Kassaw
- Department of pediatric health nursing, college health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yohannes Tesfahun Kassie
- Department of Emergency and critical care nursing, college of health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Hailemichael Kindie Abate
- Department of medical nursing, school of Nursing, College of Medicine and health science, University of Gondar, Gondar, Ethiopia
| | - Chilot Kassa Mekonnen
- Department of medical nursing, school of Nursing, College of Medicine and health science, University of Gondar, Gondar, Ethiopia
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Esagoff A, Cohen SA, Chang G, Equils O, Van Orman S. Human papillomavirus and Chinese international students in the United States: attitudes, knowledge, vaccination trends, healthcare behaviors, and sexual activity. Hum Vaccin Immunother 2022; 18:1882283. [PMID: 33705223 PMCID: PMC8920154 DOI: 10.1080/21645515.2021.1882283] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the world, with the ability to cause external genital warts and cancers. The HPV vaccine, first released in the United States of America (USA) in 2006, has been shown to protect against the highest risk HPV strains responsible for the majority of HPV-related cancers. In mainland China, the HPV vaccine was only recently approved in 2016 and is therefore not readily available. As a result, Chinese international students (CIS) studying in the USA continue to have low HPV vaccination rates. This study completed in person and online surveying of 396 CIS at a large Southern California university, with the goal of better understanding CIS knowledge and awareness of HPV disease, vaccination and healthcare behaviors, and sexual activity. Among participants, the reported HPV vaccination rate was 61% (females: 85%; males: 32%). HPV vaccination was significantly correlated with a past visit to the on-campus student health center, having university-sponsored student health insurance, higher self-perceived HPV knowledge, and increased willingness to pay for vaccination. A large portion of participants portrayed low levels of sexual activity, which suggests that CIS can take advantage of catch-up HPV vaccination recommendations through 26 years of age. The results of this study can be used to inform policy initiatives, particularly at the campus level, that attempt to improve HPV vaccination rates amongst CIS.
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Affiliation(s)
- Aaron Esagoff
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA,MiOra, Public Health Nonprofit, Encino, CA, USA,CONTACT Aaron Esagoff Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205
| | - Samuel A. Cohen
- MiOra, Public Health Nonprofit, Encino, CA, USA,Stanford University School of Medicine, Stanford, CA, USA
| | - Guoxuan Chang
- Keck School of Medicine of USC, USC Student Health, Los Angeles, CA, USA
| | | | - Sarah Van Orman
- Keck School of Medicine of USC, USC Student Health, Los Angeles, CA, USA
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Bai Y, Ip P, Chan K, Ngan H, Yip P. HPV Vaccination Intentions of Female Students in Chinese Universities: A Systematic Literature Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10207. [PMID: 36011838 PMCID: PMC9407966 DOI: 10.3390/ijerph191610207] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To systematically evaluate the human papillomavirus (HPV) vaccination intentions among female university students in China and establish a basis for improving HPV vaccination coverage. METHODS We searched CNKI, EBSCO, JSTOR, MESH or Emtree, Weipu Information Chinese Journal Service Platform, Wanfang Data, China Biomedical Literature Database, PubMed, Embase, Web for the Web of Science, and the Cochrane Library to identify peer-reviewed published research on intentions by female college students in China to receive the HPV vaccination. RESULTS A preliminary search of 408 papers resulted in the inclusion of 12 studies, all cross-sectional, of moderate or high quality, with a sample size of 12,600. The HPV vaccination intention rate among Chinese female university students was 16.67% (95% CI: 12.38% to 21.24%). The vaccination intention rates of medical students, non-medical students, and Tibetan students were 30.37% (95% CI: 28.80-34.12%), 15.53% (95% CI: 11.2-20.22%), and 14.12% (95 % CI: 10.59-18.04%), respectively. The vaccination intention rates of the participants with parental education of junior high school and below, high school, and bachelor's degree and above were 15.36% (95 % CI: 11.59 to 17.54%), 17.18% (95 % CI: 12.33% to 19.61%), and 19.81% (95 % CI: 15.61% to 22.25%), respectively. The intention rates of vaccination among residents of first-tier, second-tier, and third-tier cities were 17.64% (95% CI: 12.76-21.63%), 15.39% (95% CI: 11.74-19.82%), and 13.87% (95% CI: 9.36-15.65%), respectively. The results of the meta-analysis were relatively stable with little publication bias. CONCLUSION The intention rate of HPV vaccination among female university students in China is low and varies among different populations. There is a need to increase HPV vaccination promotion efforts to improve the intention of female university students to receive the vaccine.
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Affiliation(s)
- Yiming Bai
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong (HKU), Hong Kong, China
| | - Karen Chan
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Hextan Ngan
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Paul Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
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Knowledge, attitudes, and practices among Indonesian urban communities regarding HPV infection, cervical cancer, and HPV vaccination. PLoS One 2022; 17:e0266139. [PMID: 35552546 PMCID: PMC9098048 DOI: 10.1371/journal.pone.0266139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Few studies explored Indonesian understanding of cervical cancer (CC) and the human papillomavirus (HPV) vaccination. We aimed to investigate the association between knowledge, attitudes, and practices (KAP) and socio-demographical influences related to HPV, CC, and vaccination among Indonesian urban citizens. Methods We conducted an online survey during March 2020-August 2021 using the Snowball sampling technique. The socio-demographic characteristic and KAP responses were collected via Google Forms from 400 respondents in Jakarta. The knowledge and attitudes were divided into HPV and CC (aspect 1) and HPV vaccination (aspect 2). Correlation between KAP scores was performed using Spearman’s test, and multiple logistic regression analyses were conducted to determine KAP predictors. Results Indonesian urban citizens in Jakarta were found to have poor knowledge in individual aspects of the inquiry but moderate knowledge overall, good attitude in inquiry both in each aspect and overall, and unsatisfying practices. Overall, in the general population, men, and women respectively: 50.8%, 32.4%, and 53.6% had good knowledge; 82.0%, 75.2%, and 84.4% expressed positive attitude; and 30.3%, 15.2%, and 35.6% applied favorable practice regarding questions inquired. Knowledge was weakly correlated towards attitude (ρ = 0.385) but moderately correlated with practice (ρ = 0.485); attitude was moderately correlated with practice (ρ = 0.577), all results: p<0.001. Significant odds ratio (OR) for predictors to good knowledge were female sex (OR = 2.99), higher education (OR = 2.91), and higher mother’s education (OR = 2.15). Factors related to positive attitudes were higher mother’s education (OR = 4.13), younger age (OR = 1.86), and better results in the knowledge inquiries (OR = 2.96). Factors that suggested better practices were female sex (OR = 2.33), being employed (OR = 1.68), excellent knowledge scores (OR = 4.56), and positive attitudes expressions (OR = 8.05). Having done one vaccination dose and intention to receive vaccines were significantly influenced by good KAP. Conclusions KAP had inter-association to successful CC and HPV prevention programs, and socio-demographical characteristics are critical to influencing better KAP.
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Zhai ZH, Ning JH, Wang LDL. Psychometric Evaluation of the Chinese Version of Decisional Conflict Scale in Chinese Young Women Making HPV Vaccination Decisions. Patient Prefer Adherence 2022; 16:761-769. [PMID: 35356105 PMCID: PMC8959717 DOI: 10.2147/ppa.s358292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/11/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The Decisional Conflict Scale (DCS) is a well-known scale for measuring personal decisional conflict, particularly when a person feels uninformed about the risks/benefits of choices, is unclear about personal values, and feels unsupported in making a choice. Higher scores of DCS indicate higher decisional conflict. In the present study, we aimed to assess the psychometric properties of the Chinese version of the DCS among Chinese young women making HPV vaccination decisions. METHODS A total of 107 HPV-unvaccinated Chinese women aged 18-26 completed the survey assessing decisional conflict, knowledge and decision of HPV vaccination. Factorial validity, construct validity, and reliability of the DCS were examined. RESULTS The mean score of the DCS-16 was 41.5 (SD=20.0). Principal component analysis extracted a 3-factor model of DCS containing 13 items (DCS-13), but both the original DCS-16 and extracted DCS-13 showed poor factorial validity. An alternative DCS-10 revealed a good fit to the data with Cronbach's alpha 0.86. Some subscales of the three versions of DCS showed inconsistent correlation. CONCLUSION The DCS-10 demonstrated good model fit to the data. By using the DCS-10 total score rather than sub-scores to measure Chinese young women's HPV vaccination decisional conflict a more valid assessment can be obtained.
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Affiliation(s)
- Zi Han Zhai
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
- Jiangsu Key Laboratory of Experimental & Translational Non-Coding RNA Research, Yangzhou, 225001, People’s Republic of China
| | - Jun Hao Ning
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
- Jiangsu Key Laboratory of Experimental & Translational Non-Coding RNA Research, Yangzhou, 225001, People’s Republic of China
| | - Linda Dong-Ling Wang
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
- Centre for Psycho-Oncology Research & Training, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
- Correspondence: Linda Dong-Ling Wang, Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China, Tel +86-051487978925, Email
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Cheung TH, Cheng SSY, Hsu DC, Wong QWL, Pavelyev A, Walia A, Saxena K, Prabhu VS. The impact and cost-effectiveness of 9-valent human papillomavirus vaccine in adolescent females in Hong Kong. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2021; 19:75. [PMID: 34801050 PMCID: PMC8606050 DOI: 10.1186/s12962-021-00328-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction In Hong Kong (HK), a single-cohort vaccination program for 10–12-year-old girls with the 9-valent human papillomavirus (HPV) vaccine (9vHPV; types 6/11/16/18/31/33/45/52/58) has been launched. This study assessed the public health impact and cost-effectiveness of implementing routine 9vHPV vaccination (12-year-olds) with or without catch-up 9vHPV vaccination (13–18-year-olds) in HK. Methods The health impact and costs of implementing routine 9vHPV vaccination with or without catch-up vaccination over a 100-year time horizon were evaluated using a validated HPV-type transmission dynamic model adapted to the HK population; analyses were performed from a healthcare payer perspective. Routine vaccination (12-year-old girls) and catch-up vaccination (13–18 years) assumed vaccine coverage rates of 70% (base case) and 30%, respectively. The model also assumed herd immunity, lifelong vaccine protection, a discount rate of 3%, and a cost per dose of HK dollars (HKD) 858 [United States dollars (USD) 110] and HKD 1390 (USD 179) for the 2-valent HPV (2vHPV) and 9vHPV vaccines, respectively. HPV disease-related incidence and the incremental cost-effectiveness ratio (ICER) per quality-adjusted-life-year (QALY) were estimated. Cost-effectiveness was determined at a ceiling threshold of HK dollars (HKD) 382,046 (USD 49,142) or 1.0 times the gross domestic product per capita of HK. Results Compared with routine 9vHPV alone, routine plus catch-up 9vHPV is projected to reduce cervical cancer incidence by 3.4%. Routine plus catch-up 9vHPV will also reduce genital warts incident cases for males/females by 2.6%/5.4%. The incremental cost-effectiveness ratios were HKD 29,911 (USD 3847)/quality-adjusted life-year (QALY) for routine plus catch-up 9vHPV versus routine 9vHPV alone and HKD 25,524 (USD 3283)/QALY for routine 9vHPV alone versus screening only. Sensitivity analyses indicated that routine plus catch-up 9vHPV compared with routine 9vHPV alone remained cost-effective at coverage rates of 30% and 90%. Conclusions This analysis predicts that the current HK vaccination strategy can be considered cost-effective and will provide maximum health benefit. These results support addition of the routine 9vHPV vaccine with or without catch-up 9vHPV vaccination to the regional vaccination program in HK. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-021-00328-x.
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Affiliation(s)
- Tak Hong Cheung
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Sally Shuk Yee Cheng
- Global Medical and Scientific Affairs, MSD Asia Ltd, 27/F Lee Gardens Two, 28 Yun Ping Road, Causeway Bay, Hong Kong, People's Republic of China
| | - Danny C Hsu
- Global Medical and Scientific Affairs, MSD Asia Ltd, 27/F Lee Gardens Two, 28 Yun Ping Road, Causeway Bay, Hong Kong, People's Republic of China
| | - Queenie Wing-Lei Wong
- Global Medical and Scientific Affairs, MSD Asia Ltd, 27/F Lee Gardens Two, 28 Yun Ping Road, Causeway Bay, Hong Kong, People's Republic of China
| | - Andrew Pavelyev
- MRL, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ, 07033, USA.,HCL America, Inc., Sunnyvale, CA, USA
| | - Anuj Walia
- MRL, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ, 07033, USA
| | - Kunal Saxena
- MRL, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ, 07033, USA
| | - Vimalanand S Prabhu
- MRL, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ, 07033, USA.
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Chau JPC, Lo SHS, Lee VWY, Lui GCY, Butt L, Chan KM, Kwok CY, Lau AYL. Multistakeholder knowledge levels and perspectives of human papillomavirus and its vaccination: An exploratory qualitative study. Eur J Cancer Care (Engl) 2021; 30:e13511. [PMID: 34622502 DOI: 10.1111/ecc.13511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/03/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This qualitative study was an integral part in the development of a multidisciplinary team-led school-based human papillomavirus vaccination health-promotion programme (MDL-SHPVP) aiming to increase HPV vaccine uptake in Hong Kong. Study findings will inform the design of the MDL-SHPVP by drawing on interview data regarding the expectations and needs of key stakeholders and potential programme users. METHODS Eight mother-daughter dyads, four secondary school teachers, two school principals, three social workers and one school nurse were interviewed. All interviews were audio-recorded and transcribed verbatim for thematic analysis. RESULTS Most participants had misconceptions about HPV and the vaccine. Alhough there was no immediate perceived need for the vaccination, most participants had favourable attitudes towards HPV inoculation and vaccines in general. Factors affecting vaccine uptake included perceptions about risk of infection, vaccine availability, and cost. Participants were largely open to suggested MDL-SHPVP components (videos, digital game, and group discussions). CONCLUSION Findings have highlighted knowledge gaps among potential users and key stakeholders and will be used to inform the design of the MDL-SHPVP to ensure that their needs and expectations are addressed. Study findings may also aid future HPV vaccine promotion efforts and boost HPV vaccine uptake among youth in the city.
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Affiliation(s)
- Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vivian Wing Yan Lee
- Centre for Learning Enhancement and Research, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Grace Chun Yan Lui
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Laveeza Butt
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kam Ming Chan
- Department of Paediatrics & Adolescent Medicine, United Christian Hospital, Hong Kong
| | - Chiu Yin Kwok
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Alexander Yuk Lun Lau
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Ma Y, Wang C, Liu F, Lian G, Li S, He Q, Li T. Human papillomavirus vaccination coverage and knowledge, perceptions and influencing factors among university students in Guangzhou, China. Hum Vaccin Immunother 2021; 17:3603-3612. [PMID: 34156312 DOI: 10.1080/21645515.2021.1927411] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction: HPV vaccines were administered in mainland China from July 2017 at a gradual rate. We aimed to assess the vaccination rate and vaccination influencing factors among college students in mainland China.Methods: From October to December 2018, we conducted face-to-face questionnaires including 5 sections and 22 questions to collect demographic information, HPV infection and transmission knowledge, HPV vaccine knowledge and attitudes among college students in Guangzhou, China. HPV vaccine vaccination status and cervical screening behaviors were self-reported. Knowledge and attitudes differences between the vaccinate and non-vaccinate groups were analyzed using univariable logistic regression. Vaccination-related influencing factors were estimated using multivariable logistic regression.Results: 5307 of 5414 valid questionnaires were collected. The self-reported cervical screening rate and HPV vaccine coverage were 11.82% (9.03%-14.61%) and 3.09% (2.62%-3.56%). In total, 55.57% of the participants were hesitant about vaccination. Urban residence (OR = 2.1, 95%CI: 1.4-3.3), high monthly consumption (OR = 2.6, 95%CI: 1.9-3.6), awareness of vaccination adaptive population (OR = 3.1, 95%CI: 1.9-5.0), awareness of infection-related risk factors (OR = 2.5, 95%CI: 1.1-5.7), and awareness of HPV vaccine effectiveness (OR = 3.2, 95%CI: 2.0-5.2) were significant in multivariable logistic regression.Conclusion: HPV vaccine coverage is quite low among college students in China Guangzhou. Economic affordability, awareness of HPV infection, and belief in the effectiveness of HPV vaccine are influencing factors for vaccination. In the future, establishing a national financial subsidy and strengthening health education is needed to increase the vaccination rate in China.
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Affiliation(s)
- Yu Ma
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China.,Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangdong, China.,Disease Control and Prevention Department, Guangzhou Health Committee, Guangzhou, Guangdong Province, P.R. China
| | - Cuixiu Wang
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Fanghua Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China.,Disease Control and Prevention Department, Guangzhou Health Committee, Guangzhou, Guangdong Province, P.R. China
| | - Guixiong Lian
- Center for Disease Control and Prevention of Panyu District of Guangzhou City, Guangzhou, Guangdong Province, China
| | - Shuxue Li
- Guangzhou Medical University, Guangzhou, Guangdong Province, P.R. China
| | - Qing He
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China
| | - Tiegang Li
- Disease Control and Prevention Department, Guangzhou Health Committee, Guangzhou, Guangdong Province, P.R. China
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Associations of Family Meals with Adolescent Perception of Family Relationship and Compliance with Parental Guidance in Hong Kong: Results of a Representative Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105402. [PMID: 34069361 PMCID: PMC8158745 DOI: 10.3390/ijerph18105402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/17/2022]
Abstract
Family meals are beneficial for adolescent development, but evidence from Chinese populations has been limited. This study aimed to examine the associations between family meal frequency and adolescent perception of family relationship and compliance with parental guidance in Hong Kong. During the period from October to December 2016, a stratified random sample of 3359 students were recruited from 25 secondary schools in Hong Kong. Students completed questionnaires about family characteristics, relationship quality, and meal frequency by paper-and-pencil in class. Multiple regression analyses were conducted to examine the associations between family meal frequency and perceived family relationship and compliance with parental guidance overall and by subgroups. After adjusting for sociodemographic and school confounders, family breakfast and dinner frequency were significantly associated with adolescent compliance (breakfast: B = 0.07, p < 0.001; dinner: B 0.07, p < 0.001) and perception of family relationship (breakfast: B = 0.10, p < 0.001; dinner: B = 0.25, p < 0.001). Risk factors for infrequent family meals included older age, not born in Hong Kong, less educated fathers, and unmarried parents. Our findings support the associations of regular family meals with adolescent perception of high family bond and compliance with parental guidance. Interventions are needed to enhance quality family meal interactions in disadvantaged families.
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Wu Q, Kuk JH, Ryu YJ. A Study of Human Papillomavirus Genotypes Specificity and the Vaccines Introducing System for Korean-Chinese Women in the Yanbian Autonomous Region. Asian Pac J Cancer Prev 2020; 21:3331-3338. [PMID: 33247692 PMCID: PMC8033106 DOI: 10.31557/apjcp.2020.21.11.3331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 11/27/2022] Open
Abstract
Objectives: Human papillomavirus (HPV) is a major cause of cervical cancer in women. The characteristics of HPV infection vary; therefore, it is necessary to identify the most common HPV genotypes among a group of subjects when introducing a vaccine program. Currently, in the Yanbian Autonomous Region, no HPV vaccinations are not provided, and no data has been reported regarding HPV rates or genotype prevalence. We aimed to find the most suitable HPV vaccine for this region and reasons why no vaccine has been introduced. Methods: HPV genotyping of 200 Korean-Chinese women living in the Yanbian Autonomous Region who visited the hospital for annual health examination was done. We also checked main factors necessary for HPV vaccine administrative system; (1) vaccine manufacturers in China, (2) vaccine importers, (3) vaccine suppliers, (4) applicable vaccine laws, (5) the HPV vaccine permit system in Jilin Province, and (6) vaccination hospital facilities-were assessed by direct inquiry and search. Results: The results showed that HPV genotypes 52, 58, 16, 53, and 33 were the most common among Korean-Chinese women. These results differed from those previously reported for Korean or Chinese women. All elements necessary for introduction of HPV vaccine were prepared, but there is no HPV vaccination plan based on epidemiological investigation. Conclusions: Gardasil® 9 should be the most suitable vaccine for Korean-Chinese women with HPV infection and cervical cancer in this region considering the prevalence of certain genotypes. Governments and medical institutions should take an active stance on HPV vaccination to lower the incidence of cervical cancer here. Our study may serve as an important reference for introducing a Chinese government program designed to prevent cervical cancer.
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Affiliation(s)
- Qunying Wu
- Department of Pathology, College of Medicine, Kangwon National University, Chun-Cheon, Republic of Korea.,Department of Pathology, Yanbian Maternal and Child Health Care Hospital, Yanji, China
| | - Jin-Ho Kuk
- Department of Pathology, College of Medicine, Kangwon National University, Chun-Cheon, Republic of Korea
| | - Young-Joon Ryu
- Department of Pathology, College of Medicine, Kangwon National University, Chun-Cheon, Republic of Korea
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Chau JPC, Lo SHS, Choi KC, Lee VWY, Lui GCY, Chan KM, Lau AYL. Effects of a multidisciplinary team-led school-based human papillomavirus vaccination health-promotion programme on improving vaccine acceptance and uptake among female adolescents: A cluster randomized controlled trial. Medicine (Baltimore) 2020; 99:e22072. [PMID: 32925744 PMCID: PMC7489727 DOI: 10.1097/md.0000000000022072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Evidence has consistently shown the high efficacy of human papillomavirus (HPV) vaccines in preventing cervical cancers. However, the HPV vaccine uptake rate in Hong Kong is very low. We will develop and evaluate an innovative, theory-based multidisciplinary team-led school-based HPV vaccination health-promotion program (MDL-SHPVP), engaging female adolescents, parents/guardians, and secondary school personnel in multicomponent educational strategies and interactive discussions. METHODS AND ANALYSIS A cluster randomized controlled trial is proposed. We will recruit 2520 female adolescents and their parents/guardians from 18 secondary day schools. The MDL-SHPVP is underpinned by the Health Belief Model and Precaution Adoption Process Model. Multicomponent interventions will be offered, including education sessions with small group dialogues with a registered nurse and trained healthcare and lay volunteers, and educational computer games. A team of volunteers will be established to raise HPV, cervical cancer, and HPV vaccine awareness. Outcomes include adolescents' uptake of the HPV vaccine, adolescents' intention to receive HPV vaccination, vaccine acceptance among parents/guardians, and parents'/guardians' and adolescents' HPV knowledge, attitudes, and beliefs. Data will be collected at baseline, 1 month, and 1 year after intervention. The generalized estimating equations analysis will be used for comparing the outcomes between the 2 groups. ETHICS AND DISSEMINATION Ethical approval was obtained from the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (Ref. no.: 2019.055). We will disseminate the study findings via peer-reviewed publications and presentations at relevant events and international and local conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT04438291.
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Affiliation(s)
- Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
| | - Vivian Wing Yan Lee
- Centre for Learning Enhancement And Research, The Chinese University of Hong Kong
| | - Grace Chung Yan Lui
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong
| | - Kam Ming Chan
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hospital Authority, Hong Kong
| | - Alexander Yuk Lun Lau
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong
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12
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Siu JYM, Fung TKF, Leung LHM. Barriers to Receiving HPV Vaccination Among Men in a Chinese Community: A Qualitative Study in Hong Kong. Am J Mens Health 2020; 13:1557988319831912. [PMID: 30776950 PMCID: PMC6775547 DOI: 10.1177/1557988319831912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Human papillomavirus (HPV) can cause various diseases; low-risk strains can cause
genital warts, whereas high-risk strains can cause cervical cancer and cancer of
the vulva in women and cancers of the penis, anus, and oropharynx in men.
Although HPV affects men, literature has reported that the prevalence of HPV
vaccination is far lower among men than among women. Few studies have examined
perceptions and acceptability of the HPV vaccine among men, particularly in
Chinese communities. In this study, the acceptability of the HPV vaccine to men
was investigated using Hong Kong men as a case group. A qualitative research
approach was adopted. Thirty-nine men were purposively sampled for the in-depth
individual semistructured interviews from June to October 2017 to investigate
their perceptions of the HPV vaccine and the barriers for them to receive the
vaccination. Limited knowledge and awareness of HPV-related issues, low
perceived risk of HPV infection, perceived association between HPV vaccine and
promiscuity, and lack of accessible official information on HPV-related topics
were identified as the key barriers. These barriers intermingled with the
sociocultural environment, cultural values of sexuality, and patriarchal gender
values. HPV vaccine is shown to be socially constructed as a vaccine for women
exclusively and for promiscuity. The participants were discouraged from
receiving HPV vaccination because of its signaling of socially deviant
promiscuity. Cultural taboo on sex served as a social oppression of open
discussion about HPV vaccine and affected the participants’ perceived need of
vaccination. Perceived insignificance of reproductive organs also influenced the
participants’ perceived need of vaccination.
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Affiliation(s)
- Judy Yuen-Man Siu
- 1 Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Timothy K F Fung
- 2 Department of Communication Studies, School of Communication, Hong Kong Baptist University, Hong Kong
| | - Leo Ho-Man Leung
- 1 Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
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13
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Chua GT, Ho FK, Tung KT, Wong RS, Cheong KN, Yip PS, Fan SY, Wong WH, Qiao Y, Chui CS, Li SX, Ip P. Sexual behaviors and intention for cervical screening among HPV-vaccinated young Chinese females. Vaccine 2019; 38:1025-1031. [PMID: 31786002 DOI: 10.1016/j.vaccine.2019.11.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 10/19/2019] [Accepted: 11/18/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Human papillomavirus (HPV) vaccination and cervical screening prevent cervical cancer effectively. However, there are concerns whether vaccination leads to high-risk sexual behaviors and less intention for cervical screening. We aimed to evaluate the influence of HPV vaccination on high-risk sexual behaviors, and intention for cervical screening among young Chinese females. We also reported the latest HPV vaccination uptake in Hong Kong. METHODS A population-based survey was conducted between September 2016 and January 2017. Subjects were school-age girls from twenty-five secondary schools (in-school) and community females between 18 and 27 years (out-school). Demographics, vaccine-related attitudes, intention for cervical screening and participants' sexual behaviors were examined. RESULTS We surveyed 2260 females from in-school (n = 1664) and out-school (n = 596) settings. 11.5% in-school and 23.5% out-school participants received at least one dose of HPV vaccine. Vaccination was not associated with age (in-school Odds Ratio [OR] 0.99, p = 0.87; out-school OR 1, p = 0.94), ethnicity (in-school OR 0.82, p = 0.72; out-school OR 0, p = 0.98), maternal education (in-school OR for secondary school 1.19, p = 0.43; for post-secondary school 1.28, p = 0.48), underage sex (in-school OR 1.22, p = 0.80; out-school OR 0.63, p = 0.67), earlier sexual exposure (in-school β 0.01, p = 0.99; out-school β 0.13, p = 0.68), multiple sex partners (in-school OR 3.27, p = 0.22; out-school OR 1.16, p = 0.43), and unprotected sex (in-school OR 1.14, p = 0.78; out-school OR 0.60, p = 0.10). Out-school females with higher personal education level was associated with higher vaccine uptake (post-secondary OR 3.4, p < 0.001; bachelor's degree or above OR 3.71, p < 0.001). More vaccinated females intended for cervical screening (in-school 23.6% vs. 21.1%; out-school 53.6% vs. 43.6%). Costs and knowledge were important factors for non-vaccination and non-intention for cervical screening. CONCLUSIONS HPV vaccination was not associated with earlier and high risk sexual behavior among Chinese young females. Vaccinated Chinese young females had a higher intention for cervical screening.
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Affiliation(s)
- Gilbert T Chua
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Frederick K Ho
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Keith T Tung
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Rosa S Wong
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kai Ning Cheong
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Paul S Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong
| | - Susan Y Fan
- The Family Planning Association of Hong Kong, Hong Kong
| | - Wilfred H Wong
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Youlin Qiao
- Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Celine S Chui
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Shirley X Li
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Patrick Ip
- Department of Paedaitrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
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14
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Siu JYM, Fung TKF, Leung LHM. Social and cultural construction processes involved in HPV vaccine hesitancy among Chinese women: a qualitative study. Int J Equity Health 2019; 18:147. [PMID: 31533722 PMCID: PMC6751778 DOI: 10.1186/s12939-019-1052-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/11/2019] [Indexed: 11/15/2022] Open
Abstract
Background HPV vaccine is a prophylactic vaccine to prevent HPV infections. Recommended by the World Health Organization, this vaccine is clinically proven to be one of the most effective preventive measures against the prevalence of cervical cancer and other HPV-associated cancers and chronic genital conditions. However, its uptake rate among women in Hong Kong is insignificant—only approximately 2.9% adolescent girls and 9.7% female university students received HPV vaccination in 2014. With the notion of Critical Medical Anthropology, we aimed to identify if different influential factors, ranging from individual, societal, and cultural, are involved in the decision-making process of whether to receive HPV vaccination. Methods We adopted a qualitative approach and conducted in-depth individual semistructured interviews with 40 women in Hong Kong between May and August 2017. Results We noted that the following factors intertwined to influence the decision-making process: perceptions of HPV and HPV vaccine; perceived worthiness of HPV vaccines, which was in turn influenced by vaccine cost, marriage plans, and experiences of sexual activities; history of experiencing gynecological conditions, stigma associated with HPV vaccination, acquisition of information on HPV vaccines, distrust on HPV vaccines, and absence of preventive care in the healthcare practice. Conclusions HPV vaccination is promoted in a manner that is “feminized” and “moralized” under the patriarchal value system, further imposing the burden of disease on women, and leading to health inequality of women in pursuing the vaccination as a preventive health behaviour as a result. We believe that this ultimately results in an incomplete understanding of HPV, consequently influencing the decision-making process. The “mixed-economy” medical system adopting capitalist logic also molds a weak doctor–patient relationship, leading to distrust in private practice medical system, which affects the accessibility of information regarding HPV vaccination for participants to make the decision.
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Affiliation(s)
- Judy Yuen-Man Siu
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Timothy K F Fung
- Department of Communication Studies, School of Communication, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Leo Ho-Man Leung
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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15
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Liu Y, Di N, Tao X. Knowledge, practice and attitude towards HPV vaccination among college students in Beijing, China. Hum Vaccin Immunother 2019; 16:116-123. [PMID: 31373874 DOI: 10.1080/21645515.2019.1638727] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This cross-sectional study aimed to assess the knowledge, practice and attitude towards HPV vaccination among college students in Beijing, China. Furthermore, the factors influencing vaccination were analyzed. The data were collected via self-administered anonymous questionnaires completed by 884 college students who were recruited from a random sample at Peking University in China between September and December 2018. In total, 72.6% of the participants had previously heard of but had insufficient knowledge about HPV and the vaccine. The level of knowledge was significantly associated with the participants' age, major, and family members' or friends' vaccination status. In total, 68.8% of the students viewed college education as the primary source from which they hoped to receive information about the vaccine. Only 9.5% of the females had received the vaccine. Relationships with doctors, sexual experience and a high level of knowledge were positive predictors of vaccine uptake. Limited knowledge about the HPV vaccine was the primary and most common reason for refusing vaccination and not recommending the vaccine to others. Knowledge of the HPV vaccine among college students at Peking University was low to moderate, and the vaccine uptake was low. Policies and measures, such as college health education, are needed to increase college students knowledge of HPV and the vaccine, which may help improve the vaccination rate.
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Affiliation(s)
- Yingnan Liu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Peking University, Beijing, China
| | - Na Di
- Department of General Medicine, Peking University First Hospital, Peking University, Beijing, China
| | - Xia Tao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Peking University, Beijing, China.,Department of General Medicine, Peking University First Hospital, Peking University, Beijing, China
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Chen L, Song Y, Ruan G, Zhang Q, Lin F, Zhang J, Wu T, An J, Dong B, Sun P. Knowledge and Attitudes Regarding HPV and Vaccination Among Chinese Women Aged 20 to 35 Years in Fujian Province: A Cross-Sectional Study. Cancer Control 2018; 25:1073274818775356. [PMID: 29761723 PMCID: PMC6028175 DOI: 10.1177/1073274818775356] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The use of the human papillomavirus (HPV) vaccine was recently approved in Mainland China. This study determined the knowledge and attitudes of young women aged 20 to 35 years in Fujian Province, China, with regard to HPV and vaccination and explored the potential factors influencing their attitudes toward HPV vaccination. This was a cross-sectional study that collected data regarding the knowledge on and attitudes toward HPV and vaccination using questionnaires. Furthermore, the prevalence of HPV was determined from the sampled participants. A total of 1001 young women were included in the survey. This study demonstrated that the HPV prevalence rate was 15.7% (157/1001). Among all patients, 44.9% (n = 449) had heard of HPV; however, detailed knowledge about HPV was lacking. The majority (83.7%) expressed a willingness to be vaccinated. Specifically, knowledge of the dangers of HPV infection was significantly associated with the willingness to be vaccinated. In this study, women cited some concerns and expressed high expectations for the HPV vaccine, but the costs of vaccination reduced their willingness to be vaccinated. This study found that most patients did not have a detailed knowledge of HPV. Thus, there is a need for continued HPV promotion and education efforts, especially on the dangers of HPV infection, among young women aged 20 to 35 years in Fujian Province, China. Furthermore, it is important to subsidize the costs of vaccination for promoting vaccination campaigns in China.
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Affiliation(s)
- Lihua Chen
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Yiyi Song
- 2 Department of Gynecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Guanyu Ruan
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Qiaoyu Zhang
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Fen Lin
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Jun Zhang
- 3 Research Center for Medical Molecular Virology of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Ting Wu
- 3 Research Center for Medical Molecular Virology of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Jian An
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Binhua Dong
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Pengming Sun
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,2 Department of Gynecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
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17
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Ma X, Wang Q, Ong JJ, Fairley CK, Su S, Peng P, Jing J, Wang L, Soe NN, Cheng F, Zhang L. Prevalence of human papillomavirus by geographical regions, sexual orientation and HIV status in China: a systematic review and meta-analysis. Sex Transm Infect 2018; 94:434-442. [PMID: 29794242 DOI: 10.1136/sextrans-2017-053412] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 03/26/2018] [Accepted: 04/21/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Human papillomavirus (HPV) infection causes multiple cancers in both women and men. In China, both HPV vaccination and cervical cancer screening coverages are low. We aim to investigate the temporal and geographical trends of HPV DNA prevalence in heterosexual men, women, men who have sex with men (MSM) and people living with HIV (PLHIV) in China. METHODS We conducted a systematic review, collecting publications in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Data from January 2000 to May 2017. A total of 247 studies were selected for this meta-analysis to estimate pooled HPV prevalence, incidence of cervical cancer and risk of infection for subgroups. Meta-regression was applied to identify contributing factors to prevalence heterogeneities. RESULTS The national HPV prevalence was 15.6% (95% CI (14.4% to 16.9%)) in women with normal cervical cytology, and Central China had the highest prevalence (20.5% (15.2% to 25.8%)). HPV prevalence in heterosexual men (14.5% (11.3% to 17.7%)) was comparable with that of women (OR=1.09 (0.98 to 1.17)), but HPV prevalence in MSM (59.9% (52.2% to 67.6%)) was significantly higher than that in heterosexual men (OR=8.81 (8.01 to 9.69)). HIV-positive women (45.0% (38.4% to 51.6%)) and HIV-positive MSM (87.5% (82.3% to 90.9%)) had 4.67 (3.61 to 6.03) and 6.46 (5.20 to 8.02) times higher risk of HPV infection than their HIV negative counterparts. CONCLUSION HPV infection is prevalent in China, particularly in Central China, in comparison with the global level and neighbouring countries. Targeted HPV vaccination for women, MSM and PLHIV and scale-up of cervical screening for women are priorities in curbing the HPV epidemic in China.
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Affiliation(s)
- Xiaomeng Ma
- Division of Health Sciences Informatics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Research Centre for Public Health, School of Medicine, Tsinghua University, Beijing, China
| | - Qian Wang
- Maternal and Child Healthcare Center, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jason J Ong
- Central Clinical School, Monash University Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Christopher K Fairley
- Central Clinical School, Monash University Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Shu Su
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Peng Peng
- Research Centre for Public Health, School of Medicine, Tsinghua University, Beijing, China
| | - Jun Jing
- Research Centre for Public Health, School of Medicine, Tsinghua University, Beijing, China
| | - Linhong Wang
- Maternal and Child Healthcare Center, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nyi Nyi Soe
- Research Centre for Public Health, School of Medicine, Tsinghua University, Beijing, China
| | - Feng Cheng
- Research Centre for Public Health, School of Medicine, Tsinghua University, Beijing, China
| | - Lei Zhang
- Research Centre for Public Health, School of Medicine, Tsinghua University, Beijing, China
- Central Clinical School, Monash University Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia
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18
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Wong CKH, Man KKC, Ip P, Kwan M, McGhee SM. Mothers' Preferences and Willingness to Pay for Human Papillomavirus Vaccination for Their Daughters: A Discrete Choice Experiment in Hong Kong. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:622-629. [PMID: 29753361 DOI: 10.1016/j.jval.2017.10.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 10/05/2017] [Accepted: 10/13/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To determine the preference of mothers in Hong Kong and their willingness to pay (WTP) for human papillomavirus (HPV) vaccination for their daughters. METHOD A discrete choice experiment survey with a two-alternative study design was developed. Data were collected from pediatric specialist outpatient clinics from 482 mothers with daughters aged between 8 and 17 years. Preferences of the four attributes of HPV vaccines (protection against cervical cancer, protection duration, side effects, and out-of-pocket costs) were evaluated. The marginal and overall WTP were estimated using multinomial logistic regression. A subgroup analysis was conducted to explore the impact of socioeconomic factors on mothers' WTP. RESULTS Side effects, protection against cervical cancer, protection duration, and out-of-pocket cost determined the decision to receive or not receive the vaccine. All attributes had a statistically significant effect on the preference of and the WTP for the vaccine. Maximum WTP for ideal vaccines (i.e., 100% protection, lifetime protection duration, and 0% side effects) was HK$8976 (US $1129). The estimated WTP for vaccines currently available was HK$1620 (US $208), lower than the current market price. Among those who had a monthly household income of more than HK$100,000 (US $12,821), the WTP for vaccines currently offered was higher than the market price. CONCLUSIONS This study provides new data on how features of the HPV vaccine are viewed and valued by mothers by determining their perception of ideal or improved and current vaccine technologies. These findings could contribute to future policies on the improvement of HPV vaccine and be useful for the immunization service in Hong Kong.
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Affiliation(s)
- Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong.
| | - Kenneth K C Man
- Department of Paediatrics and Adolescent Medicine, Pok Fu Lam, The University of Hong Kong, Hong Kong
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Pok Fu Lam, The University of Hong Kong, Hong Kong
| | - Mike Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong
| | - Sarah M McGhee
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
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19
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Yuen WWY, Lee A, Chan PKS, Tran L, Sayko E. Uptake of human papillomavirus (HPV) vaccination in Hong Kong: Facilitators and barriers among adolescent girls and their parents. PLoS One 2018; 13:e0194159. [PMID: 29543839 PMCID: PMC5854366 DOI: 10.1371/journal.pone.0194159] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/26/2018] [Indexed: 12/31/2022] Open
Abstract
The present study is aimed at assessing the feasibility of delivering the HPV (human papillomavirus) vaccine to girls through a school-based program in Hong Kong, as well as to examine the facilitators and barriers associated with their participation. We approached 1,229 eligible girls aged 9 to 14 at eight schools in Hong Kong to join the program and then delivered the bivalent HPV vaccine at 0 and 6 months over the course of one school year. The students and their parents completed separate questionnaires to indicate their decision on whether or not to participate, and to assess their knowledge of cervical cancer and the HPV vaccine. The overall vaccine uptake was 81.4% (1,000/1,229) for the first dose and 80.8% (993/1,229) for the second dose. Parents and students were given separate questionnaires and asked whether or not they would like to participate in the vaccination program. 87.1% (1,010/1,160) of parents and 84.9% (974/1,147) of students indicated that they would join the program. The reasons associated with parents’ decision not to vaccinate their daughters primarily included concerns around side effects and safety. Multivariate regression analysis showed that parents who thought that the vaccine would protect their daughter from getting cervical cancer (OR = 3.16, 95% CI = 1.39–7.15, p < .01), and those who reported having a doctor’s recommendation (OR = 4.54, 95% CI = 1.05–19.57, p < .05) were more likely to join the program. In contrast, parents who had never heard of the vaccine (OR = .15, 95% CI = .03–.71, p < .02), those who were willing to pay more than HK$2,000 for the vaccine (OR = .39, 95% CI = .19–.81, p < .05), or had a preference to access it through a private clinic (OR = .44, 95% CI = .26–.75, p < .01) were significantly less likely to allow their daughter to join the program. Delivery of the HPV vaccine with high uptake rate in a school setting is feasible in Hong Kong. Engaging key stakeholders including school administrators, teachers and community physicians, and providing relevant information on safety and vaccine effectiveness to parents were important to the success of the program.
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Affiliation(s)
| | - Albert Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - Paul K S Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - Lynn Tran
- Karen Leung Foundation Limited, Hong Kong SAR, China
| | - Erica Sayko
- Karen Leung Foundation Limited, Hong Kong SAR, China
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20
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Liu A, Ho FK, Chan LK, Ng JY, Li SL, Chan GC, Leung TF, Ip P. Chinese medical students' knowledge, attitude and practice towards human papillomavirus vaccination and their intention to recommend the vaccine. J Paediatr Child Health 2018; 54:302-310. [PMID: 28876498 DOI: 10.1111/jpc.13693] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 06/22/2017] [Accepted: 07/30/2017] [Indexed: 11/29/2022]
Abstract
AIM The human papillomavirus (HPV) vaccine is effective in preventing cervical cancer, but its global uptake rate in vulnerable populations is unsatisfactory. Physician's recommendation is an important determinant for vaccine uptake, but we have limited understanding on the contributing factors of physician's recommendation. This study investigated whether the knowledge, attitudes and vaccination status of medical students would affect their intention to recommend HPV vaccination. METHODS This is a population-representative survey of medical schools in Hong Kong. RESULTS Participants included 1022 Chinese medical students (46.9% of all in Hong Kong; 46.3% female). Better HPV-related knowledge and a more positive attitude towards HPV vaccination were important factors predicting vaccine uptake and intention to recommend. HPV vaccination status and intention to receive the vaccine were positively associated with intention to recommend among females. CONCLUSION Better HPV-related medical education may be a feasible way to promote the HPV vaccine in regions without universal coverage. Medical students who have not received the HPV vaccine should also be encouraged to receive the vaccine.
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Affiliation(s)
- Anthony Liu
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Frederick K Ho
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Lily Kl Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Joanne Yw Ng
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Sophia L Li
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Godfrey Cf Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Ting Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
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Santhanes D, Wong CP, Yap YY, San SP, Chaiyakunapruk N, Khan TM. Factors involved in human papillomavirus (HPV) vaccine hesitancy among women in the South-East Asian Region (SEAR) and Western Pacific Region (WPR): A scoping review. Hum Vaccin Immunother 2018; 14:124-133. [PMID: 28933635 PMCID: PMC5791566 DOI: 10.1080/21645515.2017.1381811] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/19/2017] [Accepted: 09/15/2017] [Indexed: 01/23/2023] Open
Abstract
A scoping review was performed to identify factors that may lead to human papillomavirus (HPV) vaccine hesitancy among women in low- and middle-income countries in South East Asian Region (SEAR) and Western Pacific Region (WPR). A systematic search of English and non-English articles using Pubmed, EMBASE, PsycINFO, Cochrane, MEDLINE, and CINAHL plus was conducted. Only 63 studies conducted in SEAR and WPR were included from inception until December 2016. Results of these studies have shown that poor awareness and knowledge of practices on cervical cancer prevention was evident in both SEAR and WPR. Concerns on safety and efficacy of the vaccine, and costs in getting vaccinated were significant barriers. Most women stated that they needed more information, and strongly welcomed a physician's recommendation in both geographical regions. Women also felt they have a low risk of acquiring HPV infection and cervical cancer. Most women in SEAR and WPR were unable to decide on whether to accept HPV vaccination.
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Affiliation(s)
- Diviya Santhanes
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Che Pui Wong
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Yan Ye Yap
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Saw Pui San
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
- School of Pharmacy, University of Wisconsin, Madison, WI, USA
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Tahir Mehmood Khan
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- College of Pharmacy, Department of Pharmacy, Abasyn University, Peshawar, Pakistan
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22
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Loke AY, Kwan ML, Wong YT, Wong AKY. The Uptake of Human Papillomavirus Vaccination and Its Associated Factors Among Adolescents: A Systematic Review. J Prim Care Community Health 2017; 8:349-362. [PMID: 29161946 PMCID: PMC5932744 DOI: 10.1177/2150131917742299] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. Methods: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination. Results: Twenty-eight studies were identified and included. The HPV vaccination uptake rate (at least 1 dose) varied significantly among countries, ranging from 2.4% to 94.4%. Scotland achieved the highest uptake of all the studies included in this review, while Hong Kong had the lowest, at 2.4% to 9.1%. This review also showed that adolescents had limited awareness and knowledge of HPV infections and vaccines, even 10 years after the vaccine had become available. Conclusions: It is recommended that barriers to the uptake of the vaccine should be addressed, and that school-based sexual health education of HPV infection and vaccine promotion should be reinforced.
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Affiliation(s)
- Alice Yuen Loke
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Miu Ling Kwan
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR.,2 Tuen Mun Hospital, Hospital Authority, Hong Kong SAR
| | - Yuen-Ting Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Alice Kar Yan Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
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23
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Wang LDL, Lam WWT, Fielding R. Determinants of human papillomavirus vaccination uptake among adolescent girls: A theory-based longitudinal study among Hong Kong Chinese parents. Prev Med 2017; 102:24-30. [PMID: 28652087 DOI: 10.1016/j.ypmed.2017.06.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 05/24/2017] [Accepted: 06/18/2017] [Indexed: 01/13/2023]
Abstract
Human papillomavirus (HPV) vaccination uptake among Chinese adolescent girls remains extremely low. This two-year longitudinal study examined theoretical predictors of adolescent girls' HPV vaccination uptake using an extended Theory of Planned Behaviour (TPB). Between February and November 2014, a random sample of 1996 (response rate 60%) Hong Kong Chinese parents of 12- to 17-year-old HPV unvaccinated girls completed baseline telephone interviews assessing attitudes and intention towards HPV vaccination. Six and 12months later 1255 and 979 parents reported their daughters' HPV vaccination status, respectively. Structural equation modelling tested data fit to an TPB-derived hypothesized model of baseline factors predicting parental decisionmaking for adolescent girls' subsequent HPV vaccination uptake. Overall, at 1-year follow-up, only 9.8% (97/988) of participants' daughters received at least one dose of HPV vaccines. Descriptive norms (β=0.28), perceived greater benefits of HPV vaccination (β=0.17), anticipated affective consequences (β=0.32), and attitude to general optional vaccines (β=0.09) were associated with parental vaccination intention. Barriers to HPV vaccination (β=-0.31), descriptive norms (β=0.17), perceived self-efficacy (β=0.73), and vaccination intention (β=0.11) were associated with vaccination planning. Vaccination intention (β=0.31) and planning (β=0.18) modestly predicted vaccination uptake. The lack of government-organized HPV vaccination programme may result in persistent low HPV vaccination uptake and many young women may remain vulnerable to future cervical cancer risk in Hong Kong.
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Affiliation(s)
- Linda Dong-Ling Wang
- College of Medicine, Yangzhou University, Jiangsu Province, China; Division of Behavioural Sciences, School of Public Health, University of Hong Kong, Hong Kong.
| | - Wendy Wing Tak Lam
- Division of Behavioural Sciences, School of Public Health, University of Hong Kong, Hong Kong.
| | - Richard Fielding
- Division of Behavioural Sciences, School of Public Health, University of Hong Kong, Hong Kong.
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24
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Yam PWA, Lam PL, Chan TK, Chau KW, Hsu ML, Lim YM, Lo CH, Siu L, Tang HF, Tong AMJM, Yeung WL. 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. Asian Pac J Cancer Prev 2017; 18:1689-1695. [PMID: 28670890 PMCID: PMC6373786 DOI: 10.22034/apjcp.2017.18.6.1689] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
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.
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Affiliation(s)
- Pui Woo Angela Yam
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
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Zhang H, Wong WCW, Ip P, Fan S, Yip PSF. Health Status and Risk Behaviors of Sexual Minorities Among Chinese Adolescents: A School-Based Survey. JOURNAL OF HOMOSEXUALITY 2016; 64:382-396. [PMID: 27183532 DOI: 10.1080/00918369.2016.1190221] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study aimed to examine the association between sexual orientation and health disparities among a stratified random sample of 3776 secondary students in Hong Kong. The prevalence of homosexuality and bisexuality were 1.5% and 2.6% in boys and 1.8% and 3.7% in girls, respectively. A total of 10.7% of boys and 8.8% of girls were unsure of their sexual orientation. Homosexual and bisexual boys reported poorer physical and mental health than their heterosexual peers. Homosexual and bisexual boys were more likely to engage in smoking, frequent drinking, and vaginal sex and be subjected to sexually transmitted disease and sexual victimization. However, lesbian and bisexual girls were less likely to engage in risky health behaviors except for smoking and being subjected to sexual victimization. There is a gender-specific problem that may warrant prevention and intervention programs to address the unique health issues facing homosexual and bisexual adolescents in Hong Kong.
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Affiliation(s)
- Huiping Zhang
- a Department of Social Work, The School of Sociology and Population Studies , Renmin University of China , Beijing , China
| | - William C W Wong
- b Department of Family Medicine, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Hong Kong , China
| | - Patrick Ip
- c Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Hong Kong , China
| | - Susan Fan
- d Family Planning Association of Hong Kong , Hong Kong , China
| | - Paul S F Yip
- e Department of Social Work and Social Administration , The University of Hong Kong , Hong Kong , China
- f Center for Suicide Research and Prevention , The University of Hong Kong , Hong Kong , China
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26
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Chiang VCL, Wong HT, Yeung PCA, Choi YK, Fok MSY, Mak OI, Wong HY, Wong KH, Wong SY, Wong YS, Wong EYY. Attitude, Acceptability and Knowledge of HPV Vaccination among Local University Students in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050486. [PMID: 27187424 PMCID: PMC4881111 DOI: 10.3390/ijerph13050486] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/27/2016] [Accepted: 05/05/2016] [Indexed: 11/16/2022]
Abstract
The Human Papillomavirus (HPV) vaccine has the great potential to prevent HPV-related infections for millions of women and men worldwide. However, the success of the vaccine is highly dependent on the vaccination rate. Factors influencing the attitudes of undergraduate students towards HPV vaccination should be studied. This is a cross-sectional survey that was conducted to estimate the HPV vaccination rate among undergraduate students in Hong Kong, and to identify the predictors of their attitude towards HPV vaccination. The results showed that the HPV vaccination rate was 13.3%. Factors related to knowledge of vaccination were the main predictors of the students’ attitude towards vaccination (there were seven predictors, with B = 1.36 to 2.30; p < 0.05), followed by gender (B = −1.40; p < 0.05), acceptable maximum price (B = 0.35; p < 0.05), and willingness to receive the HPV vaccine if it can protect against cervical/anal cancer and genital warts (B = −1.90; p < 0.001). The regression model that was developed based on the predictors had a moderate effect size (adj-R2 = 0.33). To conclude, the HPV vaccination rate among undergraduate students in Hong Kong was low. They should be provided with more active education and activities to promote HPV vaccination to improve their knowledge on the subject.
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Affiliation(s)
| | - Ho Ting Wong
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China.
| | - Pui Chun Au Yeung
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China.
| | - Yuk Ki Choi
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China.
| | | | - Oi In Mak
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China.
| | - Hing Yu Wong
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China.
| | - Kim Ho Wong
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China.
| | - Shui Yan Wong
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China.
| | - Yee Shan Wong
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China.
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Lee A, Wong MCS, Chan TT, Chan PKS. A home-school-doctor model to break the barriers for uptake of human papillomavirus vaccine. BMC Public Health 2015; 15:935. [PMID: 26392084 PMCID: PMC4578840 DOI: 10.1186/s12889-015-2269-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 09/14/2015] [Indexed: 11/17/2022] Open
Abstract
Background A high coverage of human papillomavirus (HPV) vaccination is required to achieve a clinically significant reduction in disease burden. Countries implementing free-of-charge national vaccination program for adolescent girls are still challenged by the sub-optimal uptake rate. Voluntary on-site school-based mass vaccination programs have demonstrated high coverage. Here, we tested whether this could be an option for countries without a government-supported vaccination program as in Hong Kong. Method A Home-School-Doctor model was evolved based on extensive literature review of various health promotion models together with studies on HPV vaccination among adolescent girls. The outcome measure was uptake of vaccination. Factors associated with the outcome were measured by validated surveys in which 4,631 students from 24 school territory wide participated. Chi-square test was used to analyze association between the categorical variables and the outcome. Multivariate analysis was performed to identify independent variables associated with the outcome with vaccine group as case and non-vaccine group as control. Results In multivariate analysis, parental perception of usefulness of the Home-School-Doctor model had a very high odds ratio for uptake of HPV vaccination (OR 26.6, 95 % CI 16.4, 41.9). Paying a reasonable price was another independent factor associated with increased uptake (OR 1.71, 95 % CI 1.39, 2.1 for those with parents willing to pay US$125-250 for vaccination). For parents and adolescents who were not sure where to get vaccination, this model was significantly associated with improved uptake rate (OR 1.66, 95 % CI 1.23, 2.23). Concerns with side effects of vaccine (OR 0.70, 95 % CI 0.55, 0.88), allowing daughters to make their own decisions (OR 0.49, 95 % CI 0.38, 0.64) and not caring much about daughters’ social life (95 % CI 0.45, 0.92) were factors associated with a lower uptake. Discussion The findings of this study have added knowledge on how a school-based vaccination program would improve vaccine uptake rate even when the users need to pay. Our findings are consistent with other study that the most acceptable way to achieve high uptake of HPV vaccine is to offer voluntary school-based vaccination. Conclusion A model of care incorporating the efforts and expertise of academics and health professionals working closely with school can be applied to improve the uptake of vaccine among adolescent girls. Subsidized voluntary school-based vaccination scheme can be an option.
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Affiliation(s)
- Albert Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 4th Floor, School of Public Heath, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. .,Centre for Health Education and Health Promotion, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, New Territories, Hong Kong.
| | - Martin C S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 4th Floor, School of Public Heath, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
| | - Tracy T Chan
- Centre for Health Education and Health Promotion, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, New Territories, Hong Kong.
| | - Paul K S Chan
- Department of Microbiology, The Chinese University of Hong Kong, 1st Floor, Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
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Wang LDL, Lam WWT, Fielding R. Cervical cancer prevention practices through screening and vaccination: A cross-sectional study among Hong Kong Chinese women. Gynecol Oncol 2015; 138:311-6. [DOI: 10.1016/j.ygyno.2015.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 11/30/2022]
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Wang LDL, Lam WWT, Wu J, Fielding R. Psychosocial determinants of Chinese parental HPV vaccination intention for adolescent girls: preventing cervical cancer. Psychooncology 2015; 24:1233-1240. [PMID: 26042656 DOI: 10.1002/pon.3859] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/20/2015] [Accepted: 04/27/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Intention is an important precursor of decisions to undergo vaccination. Using an extensively modified theory of planned behaviour, we explored psychosocial determinants of vaccination intention against human papillomavirus (HPV) among Hong Kong Chinese parents. METHODS A random sample of 368 (response rate 54.6%) Chinese parents who had at least one daughter aged 12-17 years, had heard of HPV vaccine before but had not vaccinated daughters against HPV and had completed telephone interviews between February and April 2014. Hierarchical multiple regression analysis examined the additive effect of theoretical constructs. Stepwise multiple regression analysis determined which variables contributed the most to the prediction of vaccination intention. RESULTS Principal determinants of parental HPV vaccination intention were anticipated worry if not vaccinated (β = 0.23, p = 0.001), anticipated anxiety reduction after HPV vaccination (β = 0.19, p = 0.005), proneness to peer influence (β = 0.17, p = 0.002), private health insurance for children (β = 0.14, p = 0.009), perceiving daughter's susceptibility to cervical cancer (β = 0.17, p = 0.003), number of daughters (β = -0.13, p = 0.011), descriptive norms of HPV vaccination (β = 0.13, p = 0.021), perceiving cervical cancer as behaviour-preventable disease (β = -0.11, p = 0.031) and anticipated regret if not vaccinated (β = 0.14, p = 0.046). Cervical cancer-related worry/anxiety explained 32.8% of the variance in parental HPV vaccination intention. CONCLUSIONS Results suggest that cervical cancer-related worry/anxiety is the most important predictor of parental HPV vaccination intention in Hong Kong Chinese and possibly other populations. Social influences also play an important role affecting parental vaccination intention, particularly peer influence and descriptive norm beliefs. Implications of these results are discussed in terms of future HPV vaccination promotion and cervical cancer prevention programme. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Linda Dong-Ling Wang
- Centre for Psycho-Oncology Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wendy Wing Tak Lam
- Centre for Psycho-Oncology Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Joseph Wu
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Richard Fielding
- Centre for Psycho-Oncology Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
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Wang LDL, Lam WWT, Wu J, Fielding R. Hong Kong Chinese Women's Lay Beliefs about Cervical Cancer Causation and Prevention. Asian Pac J Cancer Prev 2014; 15:7679-86. [DOI: 10.7314/apjcp.2014.15.18.7679] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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