Factors associated with intention of human papillomavirus vaccination among Chinese college students: implications for health promotion

Exploring factors influencing awareness and knowledge of human papillomavirus in Chinese college students: A cross-sectional study

Cervical cancer remains a significant health burden in China, characterized by high incidence and mortality rates, which are exacerbated by low Human Papillomavirus (HPV) vaccination coverage, leading to substantial loss of productivity, emotional suffering, and family strain. Understanding factors that influence HPV awareness and knowledge is crucial for developing effective educational strategies. This cross-sectional study, conducted from September to October 2022, involved 2,679 college students from various educational institutions in Jiangsu Province, China. Data were collected via an online questionnaire covering demographics, HPV knowledge, and vaccination behaviors. Statistical analyses, including Chi-square tests and multifactorial logistic regression, were used to identify factors influencing HPV knowledge. The study revealed that while over 90% of students correctly identified HPV's transmission and risks, significant knowledge gaps and misconceptions persist, particularly regarding HPV's association with HIV/AIDS and its treatment. Factors significantly associated with better HPV knowledge included age (22-24 years), female gender, being a medical major, being in a relationship, familiarity with HPV, and participation in sexual education programs. Despite a high willingness to receive the HPV vaccine (91.64%), actual vaccination rates remained low. These findings suggest that while Chinese college students were generally aware of HPV, targeted educational interventions are essential to address knowledge gaps and promote HPV vaccination effectively.

Understanding the Reasons for Receiving HPV Vaccination among Eligible Adults in Italy

BACKGROUND

This cross-sectional survey aimed to explore the reasons for receiving the HPV vaccination among eligible adults in Italy.

METHODS

The survey was conducted from July 2023 to April 2024 in Naples, Southern Italy.

RESULTS

A total of 282 questionnaires were collected. The majority of the respondents (73.2%) was aware that HPV vaccination was recommended and this was more likely among women, healthcare workers (HCWs) or students in health sciences, and those who had acquired information from physicians. The most frequently cited reasons for vaccinating were self-protection from the infection (77.6%) and from cervical/oral/penile/anal cancer (68.9%), knowing that the vaccination was free of charge (46.2%), awareness of the severity of the HPV disease (43%), to protect their partner (42.6%), and perception of being at risk (24.2%). Being HCWs or students in health sciences, believing that HPV infection could cause a serious disease, and having a higher number of oral intercourse experiences in the last year were significant predictors of the perception of being at risk. Female and Italian respondents were more likely to receive the HPV vaccination because it was effective in preventing cancer.

CONCLUSIONS

Targeted educational programs and health interventions should be developed to ensure enhancing knowledge and fostering positive attitudes toward the HPV vaccination.

Human papillomavirus vaccination and contributing factors of vaccination intention among adolescents and young adults in China from a socio-ecological perspective: A cross-sectional study

OBJECTIVES

Adolescents and young adults are the main target population for human papillomavirus (HPV). The study aimed to investigate school students' HPV vaccination intentions and explore the contributing factors from a socio-ecological perspective.

DESIGN

A questionnaire survey was conducted in three secondary schools and three colleges in China.

SAMPLE

A total of 1756 students aged 14-22 years participated in this study. Among the 1756 participants, 182 students have received the HPV vaccine. For the remaining 1574 students, we analyzed their HPV vaccination intentions and the influencing factors.

MEASUREMENTS

Survey items for sociodemographics, knowledge and awareness of HPV, sexual intercourse and sexual knowledge, subjective socioeconomic status, self-efficacy, eHealth literacy, perceived social support from family, and the availability of HPV vaccine information were measured.

RESULTS

Only 182 (10.4%) had received the HPV vaccine among the 1756 participants. Among the remaining 1574 students, the majority of the students (1403, 89.1%) were willing to receive the HPV vaccine. Binary logistic regression analysis showed that students who were female, had lower self-efficacy, scored higher on sexual knowledge, believed vaccination preventing related diseases, worried about side effects after vaccination, thought oneself at risk of contracting HPV, had higher family support, knew the availability of the HPV vaccine in Mainland China from healthcare institutions, and with family residence in rural areas were more willing to receive the HPV vaccine.

CONCLUSIONS

Students had high HPV vaccination intentions while had low vaccination rate. Intrapersonal, interpersonal and institutional or community factors predicted HPV vaccination intention. Public health nurses in communities and schools could target the modifiable factors to promote students' HPV vaccine uptake.

A survey of potential acceptance of 9-valent HPV vaccine among Chinese male college students

Human papillomavirus (HPV) has a great impact on world health. Vaccination is among the most important methods of preventing HPV infection. This study investigated Chinese male college students' knowledge of, attitude toward, and acceptance of the 9vHPV vaccine and the independent predictors. An online cross-sectional study was conducted among male college students at Chinese colleges and universities from March 12 to March 23, 2022. Based on a literature review of similar studies, a self-questionnaire was designed to investigate the students' knowledge of, attitude toward, and acceptance of the 9vHPV vaccine. Multivariate logistic regression analysis was performed to identify factors influencing their willingness to be vaccinated. In addition, the structural equation model was constructed. A total of 1,547 male college students completed the survey. Of all the students, 54.95% were unwilling to receive a 9vHPV vaccination, while only 45.05% expressed willingness. Multivariate logistic regression analysis revealed that the male college students willing to receive the vaccine included medical students, those in a romantic relationship, those whose relatives and friends had cervical cancer, those whose relatives and friends had received the 9vHPV vaccine, those supportive of promoting the vaccine for men, and those who would recommend the vaccine to their relatives and friends. Male college students exhibited high hesitancy toward the 9vHPV vaccine. Acceptance of the 9vHPV vaccine by male college students can be improved by deepening their accurate understanding of the vaccine and enhancing their positive attitude toward it.

Uptake of human papillomavirus vaccination and its associated factors among adolescents in Gambella town, Southwest, Ethiopia: a community-based cross-sectional study

OBJECTIVE

To assess the uptake of human papillomavirus (HPV) vaccination and its associated factors among adolescents in Gambella town, Southwest Ethiopia.

DESIGN

A community-based cross-sectional study.

SETTING

Gambella town, Southwest Ethiopia.

PARTICIPANTS

A total of 882 adolescents were included between May and July 2022.

OUTCOME

Uptake of HPV vaccination.

METHODS

A cluster sampling technique was used to select study participants. An interviewer-administered and pretested questionnaire was used to collect the data. The collected data were entered into Epi-data V.4.6 and exported to STATA V.16 for cleaning, coding and analysis. A binary logistic regression model was used to test the association between independent and dependent variables. Variables with a p<0.05 in the multivariable logistic regression were considered statistically significant factors for the uptake of HPV vaccination.

RESULTS

A total of 825 adolescents participated in this study. Among participants, 48% (95% CI 44.6% to 51.4%) have been vaccinated for HPV. Ever heard of the HPV vaccine (AOR 2.5, 95% CI 1.23 to 5.08), good knowledge of HPV infection (AOR 3.62, 95% CI 2.17 to 6.02), good knowledge of the HPV vaccine (AOR 5.54, 95% CI 3.28 to 9.36) and attitude towards the HPV vaccine (AOR 2.74, 95% CI 1.88 to 3.98) were significantly associated HPV vaccination.

CONCLUSION

In the current study, the uptake of HPV vaccination was found to be low. The finding highlights the importance of promoting community health education about HPV infection and vaccines and providing behaviour change education, which plays a substantial role in promoting the uptake of HPV vaccination.

The Effect of University Students' Levels of Knowledge about HPV Infection and the HPV Vaccine on Their Health Beliefs: Health Sciences Students

The aim of this study was to determine health sciences students' levels of knowledge about HPV infection and the vaccine and their health beliefs, to compare them in terms of individual characteristics, and to examine the relationship between their knowledge of the HPV infection/vaccine and their health beliefs. The data of the study were collected from Health Sciences Faculty students through a face-to-face setting (n: 824). The data tools used in the study were the identification form, the health belief model scale for human papillomavirus infection and vaccination, and the human papillomavirus knowledge scale. The results showed that (1) although the students' levels of knowledge about HPV infection and the vaccine were low, (2) they did perceive HPV infection to be a severe problem. According to the multilinear regression analysis performed, the main predictor of the perceived severity (β = 0.29; 95% Cl: 0.04, 0.07), obstacle (β = 0.21; 95% Cl: 0.01, 0.04), and sensitivity (β = 0.22; 95% Cl: 0.02, 0.06) subscales of the HBMS-HPVV was general HPV knowledge. It was also determined that as the students' knowledge about HPV increased, their health belief levels regarding HPV infection and the vaccine increased as well (n: 824). In conclusion, for nurses and other healthcare professionals to be effective in informing individuals, they should have knowledge of HPV infection and the vaccine. In this context, the necessary education and advice about the importance of HPV infection and the vaccine should be provided to students receiving education in the field of healthcare.

Knowledge and Awareness of Algerian Students about Cervical Cancer, HPV and HPV Vaccines: A Cross-Sectional Study

Cervical cancer is one of the most recurrent and dangerous female cancers in Algeria and worldwide. It is mainly caused by human papillomaviruses (HPV), which can induce other cancers as well. Although it can be fatal, cervical cancer is one of the most preventable and manageable cancers. While HPV vaccination is the key weapon to win the battle against this pathology, it is still not approved in Algeria. Therefore, we set up a cross-sectional survey to assess the knowledge and awareness of students from Algerian universities concerning cervical cancer and HPV and to understand their attitudes towards HPV vaccination. The results reveal that, out of 715 students, the majority of students were aware of cervical cancer (84.6%). However, only 46.2% of students had heard about HPV. Furthermore, willingness to get the HPV vaccine was estimated at 26.7% among students with prior knowledge of HPV, and 21.5% of these students claimed to be willing to pay to get the HPV vaccine if available. Nevertheless, HPV vaccine hesitancy was estimated at 37.5% among the students aware of HPV. The main causes of HPV vaccine reluctance were: complacency (30.6%), refusal of vaccination in general (20.2%) and belief in the rarity of HPV-induced infections in Algeria (19.4%). Moreover, the embrace of vaccine conspiracy beliefs among students were significantly related with their HPV vaccine rejection. Overall, these findings encourage the establishment of a social education policy concerning the fight against HPV-induced cancers, particularly that of the cervix, and the implementation of a national HPV vaccination program targeting young people.

Impact of web-based health education on HPV vaccination uptake among college girl students in Western and Northern China: a follow-up study

Objective

To investigate the effect of a web-based educational intervention on changing female college students’ willingness and uptake of human papillomavirus (HPV) vaccines, and factors associated with HPV vaccination acceptance in Western and Northern China.

Methods

A web-based cluster randomized controlled trial was conducted in Western and Northern China from February to May 2020. A total of 967 female freshmen were recruited from two universities through convenience sampling, stratified sampling (liberal arts or sciences), and cluster sampling. Eligible students were randomized into intervention and control group with a 1:1 allocation ratio. The intervention group received seven days of web-based health education regarding HPV and HPV vaccines, whereas the control group received non-HPV-related materials. All students were asked to complete a post-intervention questionnaire to measure their awareness, uptake, and willingness to receive HPV vaccination at 7-day and one-month intervals. The chi-square test and Student’s t-test were employed to examine the differences between the intervention and control groups for categorical and continuous data. Logistic regressions were used to analyze factors associated with vaccination intentions.

Results

Nine hundred forty-six female freshmen aged 18.99 ± 0.63 years were enrolled in the study, with 532 in the intervention group and 414 in the control group. Prior to the intervention, 63.8%, 66.3%, and 60.8% of students had heard of HPV, HPV-related diseases, and HPV vaccines, respectively. Only 2.2% of students reported being vaccinated, but 33.0% were willing to be vaccinated against HPV. After seven days of education, students in the intervention group exhibited higher awareness (p < 0.001) and knowledge scores (5.13 ± 1.23 vs. 3.10 ± 1.99, p < 0.001) than those in the control group. Similarly, in the intervention groups, willingness to be vaccinated against HPV was significantly higher than in the control groups (p < 0.001). The high cost (57.7%) and concerns about adverse events (56.0%) were the main reasons female college students did not accept HPV vaccines. School location in urban areas, parents’ higher education backgrounds, history of HPV vaccination counseling, history of sexual behavior, and having heard of HPV vaccines were associated with a higher willingness to be vaccinated.

Conclusion

Female college students’ HPV vaccination uptake is insufficient, and they have minimal detailed knowledge about HPV and its vaccines. Web-based health education on HPV vaccines is an easy, feasible, and effective way to improve the awareness and acceptance of HPV vaccination among female college students, but it has limited effect on HPV vaccination uptake.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01625-0.