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He Y, Zhang X, Li J, Chen Y, Zhang L, Wei Y. Factors influencing HPV vaccine hesitancy among university students in China: A cross-sectional survey utilizing the 3Cs model. Hum Vaccin Immunother 2024; 20:2400750. [PMID: 39288789 PMCID: PMC11409514 DOI: 10.1080/21645515.2024.2400750] [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: 05/22/2024] [Revised: 08/29/2024] [Accepted: 09/02/2024] [Indexed: 09/19/2024] Open
Abstract
The HPV vaccine, which has been demonstrated to be an effective method of reducing the risk of developing cervical cancer, is still being underutilized among college students in China. To assess the current status of HPV vaccine hesitancy among college students in Guangdong Province after the COVID-19 outbreak, and to systematically analyze the influencing factors of HPV vaccine hesitancy and construct a prediction model based on the WHO 3Cs model. A cross-sectional web-based survey was conducted in June 2023 among female college students in four cities in Guangdong Province. The data were analyzed using binary logistic regression with a focus on the 3Cs model: Complacency, Convenience, and Confidence. LASSO regression was employed to analyze the variables deemed to be of significance and to construct predictive models. Out of 1399 participants, 86.5% expressed no hesitancy toward HPV vaccination. However, 11.9% exhibited hesitancy, and 1.6% refused vaccination altogether. Factors such as trust in vaccine efficacy, perception of HPV infection risk, price considerations, and constraints like distance or time were significant contributors to hesitancy. Knowledge of the HPV vaccine, socio-demographic characteristics, and the educational level of participants' mothers also played a role in vaccine hesitancy. It is recommended that targeted interventions be implemented within educational institutions with the aim of raising awareness of cervical cancer and HPV vaccines, simplifying the scheduling of vaccination appointments, and increasing affordability through the implementation of strategic purchasing measures or subsidy schemes.
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Affiliation(s)
- Yuancheng He
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Xiuqing Zhang
- Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Jie Li
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yuehua Chen
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Lin Zhang
- Department of Parasite and Endemic Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yuehong Wei
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Department of Parasite and Endemic Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
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Koh C, Watanabe K, Saho M, Nakajima Y, Furuyama M, Yamada K, Nakai Y. Factors Related to Satisfaction with Decision-making Regarding Human Papillomavirus Vaccination Behavior among Female University Students in Japan. JMA J 2024; 7:30-39. [PMID: 38314423 PMCID: PMC10834260 DOI: 10.31662/jmaj.2022-0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 08/23/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Cervical cancer is the fourth most common cancer among women worldwide. Most cervical cancers are caused by persistent infection with human papillomavirus (HPV) acquired through sexual contact. Decision-making is the process of choosing among several options, and a better decision is one that the people engaged in the decision-making process express satisfaction with. Despite that HPV infection is associated with sexual behavior, no studies in Japan on HPV vaccination decision-making that include perspectives on sexuality exist. This study aimed to determine the factors that influence satisfaction with decision-making concerning HPV vaccination among female university students in Japan. Methods The cross-sectional study was carried out by an anonymous self-administered questionnaire mail survey of 1988 female university students in Japan between April and July 2021. Of them, 301 agreed to participate in the survey. After the exclusion of those with missing data, the analysis included 252 (12.7%) students. We summarized descriptive statistics in terms of characteristics, satisfaction with decision-making regarding HPV vaccination, HPV vaccination behavior, knowledge, attitude about HPV vaccination, influencing factors, and perceptions and behaviors related to sexuality. Furthermore, we conducted multivariate analyses to investigate factors that influence satisfaction with decision-making regarding HPV vaccination. Results Of the 252 participants, 102 (40.5%) were satisfied with their decisions regarding HPV vaccination. After adjustment for confounding factors, the multivariable-adjusted odds ratios (95% confidence intervals) for factors associated with satisfaction in decision-making regarding HPV vaccination were as follows: being vaccinated (vs. non-vaccinated) 5.46 (2.51-11.89), having high knowledge scores (vs. per 1 point) 1.09 (1.01-1.17), and having awareness about the risk of contracting sexually transmitted infections (STIs) via sexual intercourse (vs. per 1 point) 0.83 (0.72-0.96). Conclusions Being vaccinated, having higher knowledge scores, and having lower awareness regarding the risk of STIs were associated with satisfied decision-making concerning HPV vaccination. Providing younger people with correct information about cervical cancer, HPV vaccines, and STI prevention contributes to increased satisfaction with their HPV vaccination decisions.
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Affiliation(s)
- Chie Koh
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Kaori Watanabe
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Minako Saho
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Yukari Nakajima
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Miho Furuyama
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Kanako Yamada
- Graduate School of Nursing, Osaka Metropolitan University, Osaka, Japan
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Huang Y, Chen C, Wang L, Wu H, Chen T, Zhang L. HPV Vaccine Hesitancy and Influencing Factors among University Students in China: A Cross-Sectional Survey Based on the 3Cs Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14025. [PMID: 36360905 PMCID: PMC9657119 DOI: 10.3390/ijerph192114025] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The burden of disease caused by cervical cancer ranked second among female tumors in China. The HPV vaccine has been proven to be a cost-effective measure to prevent cervical cancer, but the vaccination rate remained low to date among university students. This study aimed to understand the status quo of HPV vaccine hesitancy among university students across China during the COVID-19 pandemics and systematically analyze determinants of HPV vaccine hesitancy based on the WHO 3Cs model. Cross-sectional data were collected using an online survey of female university students in four cities across China in June 2022. Multinomial logistic regression was adopted to determine factors influencing vaccine hesitancy based on the 3Cs model with three dimensions, namely complacency, convenience, and confidence. Among 1438 female university students surveyed in this study, 89.7% did not hesitate to vaccinate against HPV, only 8.9% hesitated to some extent, and 1.4% refused to vaccinate. The actual vaccination rate for the HPV vaccine was 34.2%. Based on the 3Cs model, this study found that the trust on the efficacy of vaccines, risk perception of being infected by HPV, price, and distance/time were influencing factors of vaccine hesitancy. Knowledge of the HPV vaccine and sociodemographic characteristics, such as education levels, were also statistically relevant. Therefore, it is recommended that relevant scientific knowledge on cervical cancer and the HPV vaccine should be spread on campus, the vaccination appointment procedure should be simplified, and the affordability of vaccination should be increased through strategic purchasing or providing subsidies, so as to reduce HPV vaccine hesitancy.
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Affiliation(s)
- Yan Huang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou 510275, China
| | - Cheng Chen
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
- National Institute of Hospital Administration, National Health Commission, Beijing 100044, China
| | - Lei Wang
- School of Public Administration and Emergency Management, Institute of Public Policy, Jinan University, Guangzhou 510632, China
| | - Huamei Wu
- Shanghai Urban Construction Vocational College, Shanghai 200438, China
| | - Ting Chen
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Luying Zhang
- School of Public Health, Fudan University, Shanghai 200032, China
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Si M, Su X, Jiang Y, Wang W, Zhang X, Gu X, Ma L, Li J, Zhang S, Ren Z, Liu Y, Qiao Y. An Internet-Based Education Program for Human Papillomavirus Vaccination Among Female College Students in Mainland China: Application of the Information-Motivation-Behavioral Skills Model in a Cluster Randomized Trial. J Med Internet Res 2022; 24:e37848. [PMID: 36178723 PMCID: PMC9568820 DOI: 10.2196/37848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/28/2022] [Accepted: 09/06/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Patients diagnosed with cervical cancer in the last 2 decades were mainly young females. Human papillomavirus (HPV) vaccination is the most radical way to prevent HPV infection and cervical cancer. However, most female college students in mainland China have not yet been vaccinated, and their relevant knowledge is limited. Theory-based education delivered via the internet is a potentially accessible and useful way to promote HPV vaccination among this population. OBJECTIVE This 3-month follow-up study intended to identify the feasibility and efficacy of an information-motivation-behavioral skills (IMB) model-based online intervention for promoting awareness and willingness regarding HPV vaccination among female college students. METHODS A 7-day online HPV education program for female college students in mainland China was developed using a cluster randomized trial design. Recruitment and questionnaire surveys were performed online without face-to-face contact. SPSS 23.0 was used for statistical analysis. The chi-square test and t test were used to compare differences in qualitative and continuous variables between intervention and control groups. The generalized estimating equation was used to test the effectiveness of the intervention with a consideration of the time factor. RESULTS Among 3867 participants, 102 had been vaccinated against HPV before the study (vaccination rate of 2.6%). A total of 3484 participants were followed up after the baseline survey, with no statistical difference in the loss rate between the intervention and control groups during the intervention and follow-up periods. At different follow-up time points, HPV-related knowledge, and the motivation, behavioral skills, and willingness regarding HPV vaccination were higher in the intervention group than in the control group. HPV-related knowledge was statistically different between the 2 groups, while the motivation, behavioral skills, and willingness regarding HPV vaccination only showed statistical differences right after the intervention, reaching a peak right after the intervention and then gradually reducing over time. Furthermore, there was no statistical difference in the HPV vaccination rate between the 2 groups. CONCLUSIONS IMB model-based online education could be a promising way to increase the HPV vaccination rate and reduce the burden of HPV infection and cervical cancer among high-risk female college students in China. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900025476; http://www.chictr.org.cn/showprojen.aspx? proj=42672. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-DOI:10.1186/s12889-019-7903-x.
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Affiliation(s)
- Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenjun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaofen Gu
- Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China
| | - Li Ma
- School of Public Health, Dalian Medical University, Dalian, China
| | - Jing Li
- West China School of Public Health, West China Forth Hospital, Sichuan University, Chengdu, China
| | - Shaokai Zhang
- Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Zefang Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Dai Z, Si M, Su X, Wang W, Zhang X, Gu X, Ma L, Li J, Zhang S, Ren Z, Qiao Y. Willingness to human papillomavirus (HPV) vaccination and influencing factors among male and female university students in China. J Med Virol 2022; 94:2776-2786. [PMID: 34825712 PMCID: PMC9299831 DOI: 10.1002/jmv.27478] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023]
Abstract
This study compared the willingness to receive human papillomavirus (HPV) vaccination and the influencing factors between male and female university students who had never been vaccinated against HPV in China. University students were recruited from seven universities in China. A self-administered questionnaire was used to collect information about demographic characteristics, willingness to HPV vaccination, and possible influencing factors including demographics, knowledge, and attitude toward HPV vaccination. The χ2 test was used to test the difference between males and females' knowledge and attitudes to HPV vaccination. Multivariate logistic regression was employed to detect the factors associated with willingness to HPV vaccination. A total of 7335 university students participated in the survey (3570 males and 3765 females). Over 70% of the participants had previously received sex education and knowledge. The average age of sexual debut was 17.5 years old. More male students reported acceptance of premarital sex than female students did (χ2 = 708.458, p < 0.001). Female students had better knowledge and attitudes to HPV in general, while male students perceived a higher chance of being infected by HPV compared with female students (χ2 = 6.047, p = 0.014). The level of knowledge (male: adjusted odds ratio [AOR] = 1.935, 95% confidence interval [CI]:1.516-2.470; female: AOR = 1.227, 95% CI: 1.055-1.428) and receiving sex education (male: AOR = 1.414, 95% CI: 1.109-1.804; female: AOR = 1.289, 95% CI: 1.064-1.562) were indicators of the HPV vaccination willingness for both genders. For male students, those who had ever inoculated optional self-paid vaccines were more likely to receive the HPV vaccine than those who had not (AOR = 1.567, 95% CI: 1.242-1.977). Female students were more willing to be vaccinated against HPV, if they had higher living expenses (AOR = 1.395 and 3.717, 95% CI: 1.071-1.426 and 1.776-7.752), relatives or friends had certain cancer (AOR = 1.290, 95% CI: 1.095-1.518), ever had sexual experiences (AOR = 2.628, 95% CI: 1.788-3.863), and had ever consulted on HPV vaccination issues (AOR = 1.612, 95% CI: 1.367-1.901). In China, more active education should be provided to improve university students' knowledge and attitudes on HPV and HPV vaccination. Including HPV vaccine uptake for both males and females at recommended ages in National Immunization Program would be the most cost-effective way to prevent HPV infection.
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Affiliation(s)
- Zhenwei Dai
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public HealthChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Mingyu Si
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public HealthChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Xiaoyou Su
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public HealthChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Wenjun Wang
- School of NursingJining Medical UniversityJiningShandongChina
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and ControlPeking University Cancer Hospital & InstituteBeijingChina
| | - Xiaofen Gu
- Affiliated Tumor Hospital, Xinjiang Medical UniversityUrumqiChina
| | - Li Ma
- School of Public HealthDalian Medical UniversityDalianChina
| | - Jing Li
- West China School of Public Health, West China Forth Hospital, Sichuan UniversityChengduChina
| | - Shaokai Zhang
- Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhouChina
| | - Zefang Ren
- School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Youlin Qiao
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public HealthChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- Department of EpidemiologyNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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Wang D, Wu J, Du J, Ong H, Tang B, Dozier M, Weller D, Campbell C. Acceptability of and barriers to human papillomavirus vaccination in China: A systematic review of the Chinese and English scientific literature. Eur J Cancer Care (Engl) 2022; 31:e13566. [PMID: 35229931 PMCID: PMC9287030 DOI: 10.1111/ecc.13566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Widespread adoption of the human papillomavirus (HPV) vaccine will require population acceptance and tailoring of immunisation services to community needs and preferences. We examined peer-reviewed publications on the acceptability of and barriers to the HPV vaccine across China. METHODS We searched English (MEDLINE, Embase, and Web of Science) and Chinese (CNKI, VIP, Wanfang data) databases between 1 January 2006 and 31 December 2017. We adopted a narrative approach for data synthesis. RESULTS We identified 73 studies. The overall median acceptability of HPV vaccine was 71.8% (Q1-Q3: 58.6%-81%). Low levels of acceptability (<40%) of HPV vaccine were found in eastern regions of China. The largest differences of acceptability were observed between rural western regions (all >90%) and urban eastern regions (all <35%). Despite these regional variations, common barriers to HPV vaccine acceptance were concerns about vaccine safety, uncertainty over vaccine effectiveness, low perceived risk of cervical cancer and the price of the vaccine. The level of willingness to pay for the HPV vaccine (over 153 US dollars) was very low (<7%). CONCLUSION The acceptability of and attitudes towards HPV vaccine vary by regions and populations across China. HPV vaccination programmes will need to tailor service delivery as well as information materials to take account of regional concerns.
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Affiliation(s)
- Du Wang
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK.,The George Institute for Global Health, Peking University Health Science Center, Beijing, China
| | - Jing Wu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Haley Ong
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK
| | - Biwei Tang
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Marshall Dozier
- College Lead for Library Academic Support, Medicine & Veterinary Medicine Library & University, University of Edinburgh, Edinburgh, UK
| | - David Weller
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK
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Gender Differences in Knowledge and Attitude towards HPV and HPV Vaccine among College Students in Wenzhou, China. Vaccines (Basel) 2021; 10:vaccines10010010. [PMID: 35062671 PMCID: PMC8779512 DOI: 10.3390/vaccines10010010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aimed to determine human papillomavirus (HPV)-related awareness and willingness to receive HPV vaccination among college students, in Wenzhou, and its associated factors. Methods: A cross-sectional epidemiological study was conducted among college students in Wenzhou to investigate their knowledge, attitude, and factors affecting their willingness to receive HPV vaccination. Results: A total of 1035 questionnaires were collected, of which 1002 were valid (males: 374, females: 628). In total, 904 (90.2%) college students had heard of HPV, with a lower rate among males than females (85.3% vs. 93.2%, p < 0.05) and 693 (69.2%) had heard of the HPV vaccine, with a significantly lower rate among males than females (53.7% vs. 78.3%, p < 0.05). Overall awareness of HPV and HPV vaccine among males and females was moderate, with lower awareness among males. A total of 55.9% of males and 80.4% of females indicated that they would be willing to receive the HPV vaccine, a significant difference (p < 0.001). The price, safety of HPV vaccine, and lack of knowledge about HPV and HPV vaccine were the major barriers to HPV vaccination for college students. Compared to females, inadequate knowledge of HPV was the main barrier factor for HPV vaccination among male college students. Conclusions: The overall knowledge level of males is lower than that of females. For male college students, providing more knowledge about HPV infection is helpful to promote their willingness to vaccinate. It is necessary to promote HPV-related knowledge for male and female college students, respectively.
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Chew KT, Kampan N, Shafiee MN. Perception and knowledge of human papillomavirus (HPV) vaccine for cervical cancer prevention among fully vaccinated female university students in the era of HPV vaccination: a cross-sectional study. BMJ Open 2021; 11:e047479. [PMID: 34876417 PMCID: PMC8655553 DOI: 10.1136/bmjopen-2020-047479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To assess the perception and knowledge of cervical cancer prevention among fully vaccinated female university students in the era of human papillomavirus (HPV) vaccination. DESIGN Cross-sectional using a validated questionnaire. SETTING Face-to-face interview at a public university in Malaysia. PARTICIPANTS 384 fully vaccinated female students were included in the study. RESULTS The total knowledge score in the questionnaire was 18 and was ranked according to score level into three groups: poor (score ≤5), moderate (score 6-10) and good (score ≥11). Mean score for knowledge of cervical cancer prevention was 8.24 (SD ±3.85), with 170 respondents (44.3%) scoring moderate knowledge level. The mean score for knowledge of HPV infection and its association with cervical cancer was 4.56±2.47, while the mean score for knowledge of HPV vaccination for cervical cancer prevention was 3.68 (SD ±1.98). A total of 186 (48.4%) respondents perceived that regular Pap smear was unnecessary after HPV vaccination. Respondents' perceived seriousness and susceptibility of HPV infection correlated well with knowledge of cervical cancer prevention. Two main reasons for their acceptance of HPV vaccine were self-health awareness and free vaccination. CONCLUSION The knowledge of HPV vaccination for cervical cancer prevention was average among vaccinated university students. Many of them had poor knowledge about Pap smear and did not consider regular Pap smear as an important cervical cancer screening tool following HPV vaccination. There is still a need for continued health education to improve the perception and knowledge about HPV infection and cervical cancer prevention among young adults in the community.
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Affiliation(s)
- Kah Teik Chew
- Obstetrics & Gynaecology, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Nirmala Kampan
- Obstetrics & Gynaecology, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Mohamad Nasir Shafiee
- Obstetrics & Gynaecology, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
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Wang L, Liang Y, Zhang X, Yang J. Vaccine attitudes among young adults in Asia: a systematic review. Hum Vaccin Immunother 2021; 17:1142-1155. [PMID: 33054512 DOI: 10.1080/21645515.2020.1810486] [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] [Indexed: 01/20/2023] Open
Abstract
Introduction: Young adults may be facing growing threats from vaccine-preventable diseases (VPDs). However, vaccination of young adults may not have drawn adequate attention. In Asia, adensely populated region with ahigh proportion of low-income countries, VPDs impose more of an economic and social burden than in western countries. However, knowledge about attitudes toward vaccines among young Asians is limited. This study aims to fill that gap by describing attitudes toward vaccines and how well they are accepted among young Asian adults through asystematic review of relevant Chinese and English publications.Methods: A three-stage searching strategy was adopted to identify eligible studies published during 2009-2019 according to the selection criteria, resulting in 68 articles being included.Results: The review finds that vaccination coverage among young Asians is generally lower than among their western peers, and there is a lack of relevant study in many Asian countries. Factors influencing young Asians' attitudes toward vaccines are categorized into contextual level, individual and social level, and vaccine-specific level.Conclusion: These suggest that there is a need to strengthen young adults' vaccination programs and to promote vaccine-related information and government.
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Affiliation(s)
- Li Wang
- School of Health Services Management, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yuanyuan Liang
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Xuan Zhang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinxia Yang
- School of Health Services Management, Anhui Medical University, Hefei, China
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Yin G, Zhang Y, Chen C, Ren H, Guo B, Zhang M. Have you ever heard of Human Papillomavirus (HPV) vaccine? The awareness of HPV vaccine for college students in China based on meta-analysis. Hum Vaccin Immunother 2021; 17:2736-2747. [PMID: 33787459 DOI: 10.1080/21645515.2021.1899731] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: To evaluate the awareness of College Students (CSs) of HPV vaccine in China and provide evidence-based recommendations for HPV vaccine's publicity and promotion.Methods: Web of Science, PubMed, Science of Direct, EBSCO, China National Knowledge Infrastructure and Wanfang Data were searched. A random effects meta-analysis was conducted to determine pooled estimates of Awareness Rate (AR) for HPV vaccine.Results: Of the 36 studies included, the estimated AR of HPV vaccine was 40.27% (95% CI: 30.86%, 50.06%) among Chinese CSs. The AR of HPV vaccine was stratified by factors as gender, major, area, city, survey time, and sampling method of the study. The pooled AR of HPV vaccine among CSs was as follows: 44.17% (95% CI: 31.65%, 57.09%) and 31.93% (95% CI: 13.25%, 54.30%) for females and males; 44.47% (95% CI: 29.90%, 59.55%) and 12.02% (95% CI: 7.69%, 17.15%) for medical-related and nonmedical majors; 44.47% (95% CI: 28.71-60.82%) and 41.16% (95% CI: 26.48-56.64%) for Eastern and Midwestern region; 48.86% (95% CI: 30.63-67.25%) and 33.19% (95% CI: 22.27-45.12%) for first-tier and second- and third-tier city; 29.67 (95% CI: 11.44-52.16%) and 38.81 (95% CI: 27.14-51.21%) for AR before and after HPV vaccine entered in China; 51.51% (95% CI: 32.21%, 70.53%) and 26.21% (95% CI: 17.41%, 36.10%) for nonrandom and random sampling.Conclusion: This review indicates that awareness of HPV vaccine among CSs remains relatively low in China compared with European countries. Our findings may provide useful information to better understand the HPV vaccine awareness status among Chinese CSs.
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Affiliation(s)
- Gang Yin
- Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yulin Zhang
- Department of Business Administration, School of Economics and Management, Wuchang Institute of Technology, Wuhan, China
| | - Chaoyi Chen
- Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huayu Ren
- Department of Ideological and Political Education, School of Marxism, Harbin Medical University, Harbin, China
| | - Botang Guo
- Department of Medical Psychology, School of Health Management, Harbin Medical University, Harbin, China
| | - Meng Zhang
- Department of Ideological and Political Education, School of Marxism, Harbin Medical University, Harbin, China
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Ou L, Chen ACC, Reifsnider E. Review of Chinese young adults' human papillomavirus knowledge, attitudes, and vaccine acceptability. Public Health Nurs 2021; 38:701-714. [PMID: 33715199 DOI: 10.1111/phn.12893] [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: 11/22/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The human papillomavirus (HPV) vaccine is effective in reducing HPV-related disease. The 2-, 4-, and 9-valent HPV vaccines have been approved by the Chinese FDA since 2016; however, factors associated with HPV vaccine acceptability and use in Chinese young adults remain unclear. DESIGN AND SAMPLE We conducted a systematic review to analyze factors affecting HPV vaccine acceptability and use in Chinese young adults. A comprehensive search of databases (e.g., PubMed, CINAHL, and PsycINFO) was conducted, and articles between 2011 and 2020 were included. RESULTS Seventeen studies were included in the final review, and eleven were conducted in mainland China and six in Hong Kong. All studies reported low level of HPV-related knowledge. Better knowledge, more concerns about HPV-associated diseases, and being female were found associated with higher vaccine acceptability. The vaccine cost and safety were the major concerns for vaccination. CONCLUSIONS Findings suggested a low level of HPV-related knowledge and suboptimal vaccination rate in Chinese young adults. Theory-based interventions addressing knowledge and other influencing factors and involving both males and females are urgently needed to increase vaccine acceptability and use in Chinese young adults.
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Affiliation(s)
- Lihong Ou
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Angela Chia-Chen Chen
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Elizabeth Reifsnider
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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Wang W, Lyu J, Li M, Zhang Y, Xu Z, Chen Y, Zhou J, Wang S. Quality evaluation of HPV vaccine-related online messages in China: a cross-sectional study. Hum Vaccin Immunother 2020; 17:1089-1096. [PMID: 33054581 DOI: 10.1080/21645515.2020.1814095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Since 2019, three types of HPV vaccine have been approved for use in mainland China. High quality messages are crucial for vaccine acceptance, but little is known about the online information quality concerning HPV vaccine in China. "HPV vaccine" and "cervical cancer vaccine" in the form of Chinese were used as keywords through search engines from personal computer (PC), portable mobile device (PMD), and WeChat Public Accounts in 2019. Readability, information content, as well as DISCERN scores were evaluated for each message included. Characteristics associated with quality indicators of the messages were also analyzed. A total of 294 messages from PC engines (104, 35%), PMD engines (128, 43%) and WeChat (62, 21%) were assessed. Most (269, 91%) messages required at least undergraduate readability level. The most frequently reported theme was HPV vaccine and its function (273, 93%), while the least was information regarding quality, safety and side effects (129, 44%). The frequency of messages with at least one error was 132 (45%). The median of sum DISCERN scores was 42 (IQR = 14), and only one (< 1%) message showed good DISCERN quality. Messages retrieved from PC engines and those with pictures were of better overall quality. The overall quality of HPV vaccine-related online messages in Chinese websites was not optimal. Government and health professionals should promote information quality construction to improve the status of HPV vaccination messages online.
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Affiliation(s)
- Wanzhou Wang
- School of Public Health, Peking University, Beijing, China
| | - Jinliang Lyu
- School of Public Health, Peking University, Beijing, China
| | - Mintao Li
- School of Public Health, Peking University, Beijing, China
| | - Yunjing Zhang
- School of Public Health, Peking University, Beijing, China
| | - Zhihu Xu
- School of Public Health, Peking University, Beijing, China
| | - Yuanyuan Chen
- School of Public Health, Peking University, Beijing, China
| | - Jiangjie Zhou
- School of Public Health, Peking University, Beijing, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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Wang S, Han B, Wan Y, Liu J, Zhao T, Liu H, Cui F. Do Male University Students Know Enough About Human Papillomavirus (HPV) to Make Informed Decisions About Vaccination? Med Sci Monit 2020; 26:e924840. [PMID: 32603317 PMCID: PMC7346751 DOI: 10.12659/msm.924840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background The aim of this study was to evaluate the awareness of human papillomavirus (HPV), knowledge of HPV-associated diseases, as well as willingness to undergo HPV vaccination among male university students in China, especially factors influencing vaccination willingness. Material/Methods We conducted a cross-sectional study among university students in Beijing, Tianjin, and Hebei, China by using a convenience sampling method. We assessed a) the awareness of HPV, b) knowledge of HPV-associated diseases, c) willingness to undergo HPV vaccination, and d) sexual behaviors among male university students. Results A total of 1274 male university students aged 16 to 26 years old were recruited to complete a self-administered questionnaire. In total, 39.6% of students had awareness of HPV. Among students who were aware of HPV, the percentage of participating students who knew that HPV causes cervical cancer, genital warts, penile cancer, anal cancer, and oropharyngeal cancer were 94.0%, 66.1%, 32.7%, 20.4%, and 18.7%, respectively. In total, 79.0% knew that men can acquire HPV; 38.7% were willing to receive HPV vaccination. Age, region, and major were related to the awareness of HPV. In addition, students who had previous sexual experiences had more knowledge about HPV and were more likely to express willingness to vaccinate. Conclusions Male university students do not know enough about HPV infection, and males’ attitudes regarding vaccination are not sufficient. Education should be provided to promote awareness of HPV-associated diseases and vaccination.
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Affiliation(s)
- Shuai Wang
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China (mainland).,Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Bingfeng Han
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China (mainland)
| | - Yongmei Wan
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China (mainland)
| | - Jiang Liu
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China (mainland)
| | - Tianshuo Zhao
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China (mainland)
| | - Hanyu Liu
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China (mainland)
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing, China (mainland)
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Qin S, Fu JX, Chen MZ, Meng YT, Xu C, Luo Y. Acceptability of vaccination against human papillomavirus among women aged 20 to 45 in rural Hunan Province, China: A cross-sectional study. Vaccine 2020; 38:4732-4739. [PMID: 32471777 DOI: 10.1016/j.vaccine.2020.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/21/2020] [Accepted: 05/06/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study aimed to examine the intentions of and barriers to vaccination against human papillomavirus (HPV) among women aged 20 to 45 in rural areas, and to determine the popular sources to getting information about HPV vaccine and vaccination. METHODS This cross-sectional study was conducted in 2018 with a sample of women aged 20 to 45 from rural areas of Hunan Province in China. Anonymous self-administered questionnaires were used to collect sociodemographic information and characteristics related to reproductive health of participants, and intentions of and barriers to HPV vaccination. All statistical analysis methods were performed with SPSS 18.0. RESULTS A total of 2101 women participated in the study, with 58.55% intended to vaccinate against HPV. Increased intention of HPV vaccination was associated with higher age (adjusted odds ratio [AOR] = 1.35 and 1.50, respectively) and education level (AOR = 1.13 and 1.47, respectively). Women who have heard of HPV vaccine (AOR = 2.67, 95% confidence interval [CI]: 1.20-5.98) and have been aware of that cervical cancer could be prevented (AOR = 2.01, 95%CI: 1.44-2.82) were more willing to vaccinate. Having never heard of HPV vaccine and worry about efficacy and safety of vaccines were the most commonly cited reasons to refuse vaccination. The preferred source to get the knowledge was medical personnel (58.45%), followed by WeChat or Microblog, TV programs, and Internet. CONCLUSION We found the intention of HPV vaccination among women aged 20 to 45 in rural China is low. Findings highlighted the importance of knowledge and trust in HPV vaccine, and suggested strengthening educational interventions on HPV vaccine and vaccination through multiple sources, including HPV vaccine coverage in health insurance to increase access.
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Affiliation(s)
- Si Qin
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Jing-Xia Fu
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Ming-Zhu Chen
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Yan-Ting Meng
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Chen Xu
- Xiangya Nursing School of Central South University, Changsha, PR China.
| | - Yang Luo
- Xiangya Nursing School of Central South University, Changsha, PR China.
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Exploring Chinese College Students' HPV Awareness, Knowledge, Attitudes, and Intent of HPV Vaccination: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 36:1211-1218. [PMID: 32314310 DOI: 10.1007/s13187-020-01750-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Human papillomavirus (HPV) infection is the world's most prevalent sexually transmitted infection and causes cancers. In China, about 47,739 deaths occur annually from HPV-related cervical cancer, and this number continues to increase. HPV vaccines have shown promising results in preventing HPV-associated cancers; however, the vaccination rate in Chinese college students remains extremely low. This qualitative research explored Chinese college students' HPV-related awareness, knowledge, attitudes and beliefs, and their vaccination intention as well as the strategies promoting vaccination in China. We conducted four focus groups with 18 male and 20 female students; prompts were developed based on the health belief model (HBM). Discussions were audiotaped, transcribed, and translated from Chinese to English by three bilingual researchers. Content analysis of the data revealed eight themes addressing HBM. Participants demonstrated high awareness (71% had heard of HPV) with limited knowledge. They perceived very low risks of being infected but expressed high vaccination intention if the cost was covered by the government. Participants identified reasons that facilitate and prevent vaccination and proposed culturally and developmentally congruent strategies to promote vaccination in China. It is essential to address facilitators and barriers at individual, societal, political, and cultural levels to promote HPV vaccination in Chinese college students.
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Wei M, Zhou W, Bi Y, Wang H, Liu Y, Zhang ZJ. Rising Mortality Rate of Cervical Cancer in Younger Women in Urban China. J Gen Intern Med 2019; 34:281-284. [PMID: 30484099 PMCID: PMC6374275 DOI: 10.1007/s11606-018-4732-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 09/11/2018] [Accepted: 10/25/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND In recent decades, much effort has been made in China to reduce the burden of cervical cancer. OBJECTIVE Our study's purpose was to examine trends of cervical cancer mortality in each 5-year age group for urban and rural Chinese women, respectively. DESIGNS Retrospective analysis of cervical cancer mortality from 1987 to 2015 from the World Health Organization Cancer Mortality Database and China Health Statistical Yearbooks. PARTICIPANTS Chinese women. MAIN MEASURES Trends were examined using annual percent change (APC) and average annual percent change (AAPC) via Joinpoint regression models for each 5-year age group in urban and rural areas, respectively. RESULTS In urban China, mortality rate of cervical cancer increased significantly among urban women aged 25-54 years (AAPC 2.12~5.49%), in contrast to a decline trend among urban women older than 60 years (AAPC - 3.61~- 5.35%). In rural China, cervical cancer rates declined in all age groups, but the magnitude was smaller in women aged 30-54 years (AAPC - 0.59~- 2.20%) compared to women older than 55 years (AAPC - 3.06~- 4.33%). CONCLUSION Mortality rate of cervical cancer is rising at an alarming rate in younger women in urban China. Timely intervention is required for these vulnerable populations.
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Affiliation(s)
- Min Wei
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Wei Zhou
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yongyi Bi
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Hong Wang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yu Liu
- Department of Statistics and Management, School of Management, Wuhan Institute of Technology, Wuhan, 430205, China
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, 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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18
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Gender and Sexual Orientation Differences in Human Papillomavirus (HPV) Vaccine Uptake among Chinese Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061099. [PMID: 29843439 PMCID: PMC6025058 DOI: 10.3390/ijerph15061099] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/16/2018] [Accepted: 05/25/2018] [Indexed: 11/16/2022]
Abstract
To date, empirical studies on HPV vaccine uptake are still limited in Chinese populations and mainly conducted in female cohorts. In order to inform health services planning and health promotion programmes for HPV vaccination, this cross-sectional study aimed to report the prevalence of self-reported HPV vaccination status and to examine gender and sexual orientation differences in the uptake of HPV vaccine in Chinese college students. The overall prevalence of HPV vaccine uptake was 27.6% (n = 242), with a significantly higher prevalence in females (39.7%) than in males (4.7%). 91.4% of subjects heard about HPV vaccination, with a significantly higher prevalence in females (93.8%) than in males (86.8%). The prevalence of HPV vaccine uptake was only 2.6% for bisexual/ homosexual males and 5.0% for heterosexual males. Only 45.8% of the overall subjects knew HPV vaccination is not for females only, with a significantly higher prevalence in females (49.7%) than in males (38.6%). The low prevalence of male HPV vaccine uptake and awareness called for the need to have more male-specific HPV campaigns to promote HPV vaccination awareness and uptake in males to reduce the overall prevalence of HPV infection.
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Xue L, Hu W, Zhang H, Xie Z, Zhang X, Zhao F, Qiao Y, Gao L, Ma W. Awareness of and willingness to be vaccinated by human papillomavirus vaccine among junior middle school students in Jinan, China. Hum Vaccin Immunother 2017; 14:404-411. [PMID: 29048994 DOI: 10.1080/21645515.2017.1393132] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Willingness to be vaccinated with human papillomavirus (HPV) vaccine among junior middle school students in China is not well understood. We conducted a cross-sectional study to assess awareness of HPV and the HPV vaccine and explore the factors associated with willingness to be vaccinated. METHODS First-year students from two junior middle schools in Jinan, China were selected by cluster sampling on December 28, 2015, December 26, 2016, and January 11, 2017, and a self-administered questionnaire was used to collect information. Multivariate logistic regression was conducted to explore the factors associated with willingness to be vaccinated with the HPV vaccine. RESULTS A total of 1021 junior middle school students participated in this survey. Only 15.5% of them had heard of HPV and 18.9% of them had heard of the HPV vaccine. Students who were willing to take the HPV vaccine in the future accounted for 66.9%. Factors associated with the HPV vaccination were: urban junior middle school students (AOR: 1.51, 95% CI: 1.09-2.09), female students (AOR: 1.90, 95% CI: 1.36-2.66), students surveyed in 2015 (AOR: 1.69, 95% CI: 1.26-2.28), regarding menstruation/spermatorrhoea as a normal physiological phenomenon (AOR: 1.64, 95% CI: 1.14-2.36), believing vaccination is an important way to prevent diseases (AOR: 1.36, 95% CI: 1.01-1.83), believing that the first vaccination should be in infancy (AOR: 1.41, 95% CI: 1.04-1.92), believing that cervical cancer is a concern for themselves (AOR: 1.95, 95% CI: 1.28-2.97), and having heard of HPV (AOR: 1.84, 95% CI: 1.13-2.98). CONCLUSIONS Awareness of HPV and the HPV vaccine among junior students was low, however willingness to be vaccinated was high. Education focusing on HPV-related knowledge in addition to sex education is needed to promote the coverage of the HPV vaccine.
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Affiliation(s)
- Li Xue
- a Department of Epidemiology , School of Public Health, Shandong University , Jinan , China
| | - Wenqi Hu
- a Department of Epidemiology , School of Public Health, Shandong University , Jinan , China
| | - Haiman Zhang
- b Division of Biology , The High School Affiliated To Shandong University , Jinan , China
| | - Zhongling Xie
- c Youth League, The Yanxin Middle School , Jinan , China
| | - Xi Zhang
- d Department of Epidemiology , Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Fanghui Zhao
- d Department of Epidemiology , Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Youlin Qiao
- d Department of Epidemiology , Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China
| | - Lijie Gao
- a Department of Epidemiology , School of Public Health, Shandong University , Jinan , China
| | - Wei Ma
- a Department of Epidemiology , School of Public Health, Shandong University , Jinan , China
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20
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Pharmacy student involvement with increasing human papillomavirus (HPV) vaccination among international college students. J Am Pharm Assoc (2003) 2017; 57:127-128. [DOI: 10.1016/j.japh.2016.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 11/22/2022]
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Zhang Y, Wang Y, Liu L, Fan Y, Liu Z, Wang Y, Nie S. Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies. BMC Public Health 2016; 16:216. [PMID: 26936076 PMCID: PMC4776385 DOI: 10.1186/s12889-016-2873-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 02/16/2016] [Indexed: 11/25/2022] Open
Abstract
Background The human papillomavirus (HPV) vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese population. Methods A meta-analysis was conducted across two English (PubMed, EMBASE) and three Chinese (China National Knowledge Infrastructure, Wan Fang Database and VIP Database for Chinese Technical Periodicals) electronic databases in order to identify HPV vaccination studies conducted in mainland China. We conducted and reported the analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Fifty-eight unique studies representing 19 provinces and municipalities in mainland China were assessed. The pooled awareness and knowledge rates about HPV vaccination were 15.95 % (95 % CI: 12.87–19.29, I2 = 98.9 %) and 17.55 % (95 % CI: 12.38–24.88, I2 = 99.8 %), respectively. The female population (17.39 %; 95 % CI: 13.06–22.20, I2 = 98.8 %) and mixed population (18.55 %; 95 % CI: 14.14–23.42, I2 = 98.8 %) exhibited higher HPV vaccine awareness than the male population (1.82 %; 95 % CI: 0.50–11.20, I2 = 98.5 %). Populations of mixed ethnicity had lower HPV vaccine awareness (9.61 %; 95 % CI: 5.95–14.03, I2 = 99.0 %) than the Han population (20.17 %; 95 % CI: 16.42–24.20, I2 = 98.3 %). Among different regions, the HPV vaccine awareness was higher in EDA (17.57 %; 95 % CI: 13.36–22.21, I2 = 98.0 %) and CLDA (17.78 %; 95 % CI: 12.18–24.19, I2 = 97.6 %) than in WUDA (1.80 %; 95 % CI: 0.02–6.33, I2 = 98.9 %). Furthermore, 67.25 % (95 % CI: 58.75–75.21, I2 = 99.8 %) of participants were willing to be vaccinated, while this number was lower for their daughters (60.32 %; 95 % CI: 51.25–69.04, I2 = 99.2 %). The general adult population (64.72 %; 95 % CI: 55.57–73.36, I2 = 99.2 %) was more willing to vaccinate their daughters than the parent population (33.78 %; 95 % CI: 26.26–41.74, I2 = 88.3 %). Safety (50.46 %; 95 % CI: 40.00–60.89, I2 = 96.6 %) was the main concern about vaccination among the adult population whereas the safety and efficacy (68.19 %; 95 % CI: 53.13–81.52, I2 = 98.6 %) were the main concerns for unwillingness to vaccinate their daughters. Conclusions Low HPV vaccine awareness and knowledge was observed among the Chinese population. HPV vaccine awareness differed across sexes, ethnicities, and regions. Given the limited quality and number of studies included, further research with improved study designis necessary. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2873-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yanru Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. .,Mental Health Center, Renmin Hospital of Wuhan University, Hubei Provincial Mental Health Center Wuchang District, Wuhan, Hubei, P. R. China.
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yunzhou Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Zhihua Liu
- Shenzhen Maternity and Child Health Hospitals, Shenzhen, Guangdong, P. R. China.
| | - Yueyun Wang
- Shenzhen Maternity and Child Health Hospitals, Shenzhen, Guangdong, P. R. China.
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Zou H, Meng X, Jia T, Zhu C, Chen X, Li X, Xu J, Ma W, Zhang X. Awareness and acceptance of human papillomavirus (HPV) vaccination among males attending a major sexual health clinic in Wuxi, China: A cross-sectional study. Hum Vaccin Immunother 2015; 12:1551-9. [PMID: 26467510 DOI: 10.1080/21645515.2015.1099771] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To study the awareness and acceptance of human papillomavirus (HPV) vaccination among sexually active men having sex with men (MSM) and men not having sex with men (MNSM) attending the largest sexual health clinic in Wuxi, China. METHODS A questionnaire about participants' socio-demographic characteristics and view on HPV vaccination was collected. RESULTS A total of 186 MSM and 182 MNSM were recruited. Among MSM, 12.4% were under 20 years old, 64.5% never married and 56.5% from Jiangsu Province (where Wuxi City is located); 64.0% had resided in Wuxi for over 2 years, 64.5% had high school education or more, and 83.9% had an income of 5000 RMB or less per month compared to figures of 5.5%, 50.6%, 73.6%, 54.9%, 86.8% and 64.8% among MNSM, respectively (All P values < 0.05). Among these 2 groups of men, 18.4% and 23.1% had heard of HPV; 10.2% and 15.4% had heard of HPV vaccine; and 26.2% and 20.2% would take HPV vaccine before sexual debut, respectively. MNSM were significantly more willing to take HPV vaccine than MSM (70.9 vs 34.9%, p < 0.001). Factors associated with HPV vaccine acceptance among MSM included engaging mostly in receptive anal sex (Odds ratio (OR)=3.9, 95% Confidence interval (CI): 1.8-13.5), never using a condom in anal sex in the past 6 months (3.5, 1.5-20.2), ever diagnosed with a sexually transmitted infection (STI) (3.4, 1.3-8.4) and ever receiving HIV related services (1.6, 1.1-4.4). Among MNSM these Factors included commercial sex with women (1.7, 1.2-8.6), never using a condom in commercial sex (1.6, 1.4-7.6) and STI diagnosis (2.0, 1.6-7.3). CONCLUSIONS Sexually active MSM and MNSM in Wuxi lacked knowledge of HPV and HPV vaccination. The majority of these at-risk men would not benefit from HPV vaccination as their age at first sex proceeded perceived age of vaccine uptake. Aggressive education aimed at increasing knowledge of HPV and HPV vaccination among these men is warranted.
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Affiliation(s)
- Huachun Zou
- a Kirby Institute, University of New South Wales , Sydney , Australia
| | - Xiaojun Meng
- b Wuxi Municipal Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
| | - Tianjian Jia
- b Wuxi Municipal Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
| | - Chen Zhu
- c Nanchang District Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
| | - Xin Chen
- c Nanchang District Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
| | - Xiaolin Li
- d Shanghai Entry-Exit Inspection and Quarantine Bureau , Shanghai , China
| | - Junjie Xu
- e The First Affiliated Hospital, China Medical University , Shenyang , China
| | - Wei Ma
- f Department of Epidemiology and Health Statistics , School of Public Health, Shandong University , Jinan , Shandong Province , China
| | - Xuan Zhang
- b Wuxi Municipal Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
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