1
|
Ullah MI, Mikhailova MV, Alkhathami AG, Carbajal NC, Zuta MEC, Rasulova I, Najm MAA, Abosoda M, Alsalamy A, Deorari M. Molecular pathways in the development of HPV-induced oropharyngeal cancer. Cell Commun Signal 2023; 21:351. [PMID: 38098017 PMCID: PMC10722793 DOI: 10.1186/s12964-023-01365-0] [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: 09/27/2023] [Accepted: 10/25/2023] [Indexed: 12/17/2023] Open
Abstract
Oropharyngeal cancer, a subset of head and neck cancer, is increasingly recognized as a unique clinical entity primarily influenced by high-risk human papillomavirus (HPV) infections, particularly HPV-16. This review delves into the viral life cycle of HPV-16 and its interactions with host cells, with a specific focus on the crucial roles played by the viral oncoproteins E6 and E7. These oncoproteins drive cellular proliferation by targeting critical tumor suppressor proteins like p53 and Rb, resulting in uncontrolled cell growth and genomic instability. Furthermore, the significance of epigenetic modifications induced by HPV-16 and their implications is important for cancer progression. This comprehensive review provides valuable insights into the intricate molecular landscape of HPV-induced oropharyngeal cancer, shedding light on the development of targeted therapies and preventive strategies for this emerging global health concern. Video Abstract.
Collapse
Affiliation(s)
- Muhammad Ikram Ullah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka-72388, Aljouf, Saudi Arabia
| | - Maria V Mikhailova
- Department of Prosthetic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Ali G Alkhathami
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Nestor Cuba Carbajal
- Doctor en Gestión Pública y Gobernabilidad, Docente en La Universidad Norbert Wiener, Lima, Perú.
| | | | - Irodakhon Rasulova
- School of Humanities, Natural & Social Sciences, New Uzbekistan University, 54 Mustaqillik Ave, 100007, Tashkent, Uzbekistan
- Department of Public Health, Tashkent Pediatric Medical Institute, Bogishamol Street 223, Tashkent, Uzbekistan
| | - Mazin A A Najm
- Pharmaceutical Chemistry Department, College of Pharmacy, Al-Ayen University, Thi-Qar, Nasiriyah, Iraq
| | - Munther Abosoda
- College of Pharmacy, the Islamic University, Najaf, Iraq
- College of Pharmacy, the Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
- College of Pharmacy, the Islamic University of Babylon, Hillah, Iraq
| | - Ali Alsalamy
- College of Pharmacy, Imam Ja'afar Al-Sadiq University, Al-Muthanna, 66002, Iraq
| | - Mahamedha Deorari
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun, India
| |
Collapse
|
2
|
Xiao H, Chang M, Torres A, Flores G, Lau M. Preventing Teen Pregnancy: A Qualitative Study of the Perspectives of Parenting and Expecting Latino Adolescents. J Pediatr Adolesc Gynecol 2023; 36:532-540. [PMID: 37468034 DOI: 10.1016/j.jpag.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/26/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
STUDY OBJECTIVE Latino youths in the United States experience disproportionately high rates of teen pregnancy. The aim of this study was to obtain expecting and parenting Latino adolescents' perspectives regarding factors contributing to teen pregnancy and pregnancy prevention. METHODS Expecting/parenting Latino adolescents were recruited from high schools with high proportions of Latino youths and teen pregnancy. Participants completed a questionnaire on sociodemographic and background characteristics. Focus groups were stratified by age and gender and audio recorded. Grounded theory was used to identify themes from the transcribed audio recordings. RESULTS Thirty-two expecting/parenting Latino adolescents (20 females, 12 males) 14-19 years old participated in four focus groups. Quantitative results revealed that two-thirds of participants at birth had adolescent mothers. Over three-quarters of participants reported that their pregnancies had occurred too soon. Qualitative themes for factors contributing to teen pregnancy included lack of contraceptive knowledge/access, belief of invincibility, influence within relationships, male decisions on contraceptive use, desire to belong among peers, lack of parental support for contraceptive use, lack of parental attention, rebellion, normalization of adolescent parenthood in Latino culture, and media. Themes for pregnancy prevention included time alone with physicians, parenting teens as mentors, reproductive health education, and community pregnancy-prevention programs. CONCLUSION Multiple factors contribute to teen pregnancy in Latino youth, including influences from Latino culture, family, peers, partners, and social determinants of health. Pregnancy prevention should incorporate interventions to address these aspects, including disseminating culturally sensitive education materials, providing parenting teens as peer mentors, encouraging time alone with health care providers, and addressing various social determinants of health.
Collapse
Affiliation(s)
- H Xiao
- University of Texas Southwestern Medical School, Dallas, Texas
| | - M Chang
- Los Angeles County & University of Southern California Medical Center, Los Angeles, California
| | - A Torres
- Universidad Autonoma de Guadalajara School of Medicine, Guadalajara, Mexico
| | - G Flores
- Department of Pediatrics, University of Miami Miller School of Medicine, and Holtz Children's Hospital, Jackson Health System, Miami, Florida
| | - M Lau
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Children's Health System of Texas, Dallas, Texas.
| |
Collapse
|
3
|
Taumberger N, Joura EA, Arbyn M, Kyrgiou M, Sehouli J, Gultekin M. Myths and fake messages about human papillomavirus (HPV) vaccination: answers from the ESGO Prevention Committee. Int J Gynecol Cancer 2022; 32:ijgc-2022-003685. [PMID: 35820716 PMCID: PMC9554067 DOI: 10.1136/ijgc-2022-003685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Nadja Taumberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Elmar A Joura
- Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre Sciensano, Brussels, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maria Kyrgiou
- Department of Metabolism, Digestion and Reproduction - Surgery and Cancer, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Jalid Sehouli
- Department of Gynaecology and Obstetrics with Centre of Oncological Surgery, Charité Universitatsmedizin Berlin, Charité, Berlin, Germany
| | - Murat Gultekin
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
4
|
Psychological Variables Associated with HPV Vaccination Intent in Romanian Academic Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178938. [PMID: 34501527 PMCID: PMC8430846 DOI: 10.3390/ijerph18178938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/20/2021] [Accepted: 08/20/2021] [Indexed: 01/05/2023]
Abstract
The aim of this study was to evaluate (1) the female medical students’ knowledge about HPV infection; (2) the associations between the HPV vaccination intent and coping strategies, health locus of control (HLOC), and sense of coherence; and (3) the specific differences between preclinical and clinical students in terms of the vaccination intent. Participants included 1243 female medicine students (mean age = 21.526, SD = 2.007), who completed The Multidimensional Health Locus of Control (MHLC)—Form A, the Brief COPE Scale, the Sense of Coherence Scale (SOC-13), and two questionnaires measuring the knowledge about the HPV infection and the HPV vaccination intent. Results show a good knowledge about HPV, which progressively increased during the study cycles. Still, the main contributors to vaccination intent are represented by coping strategies and health locus of control. Refusal of vaccination is associated to behavioral disengagement and the use of religion, precontemplation and contemplation to denial, and preparation to planning, positive reframing, and the powerful others component of HLOC. Sense of coherence did not predict vaccination intent. In clinical years, active coping outweighs HLOC in making the decision to get vaccinated. These results could be helpful in designing personalized strategies for addressing vaccine hesitancy in academic communities.
Collapse
|
5
|
Sauvageau C, Gilca V, Ouakki M, Kiely M, Coutlée F, Mathieu-Chartier S, Defay F, Lambert G. Sexual behavior, clinical outcomes and attendance of cervical cancer screening by HPV vaccinated and unvaccinated sexually active women. Hum Vaccin Immunother 2021; 17:4393-4396. [PMID: 34410872 DOI: 10.1080/21645515.2021.1961470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Concerns were raised about HPV vaccination possibly leading to riskier sexual behavior. We assessed sexual behaviors, risk of sexually transmitted infection, and attendance to cervical cancer screening by HPV vaccinated and unvaccinated young women. In this analysis, 1475 questionnaires completed by women aged 17-29 years were included. The majority of respondents (67.9%) were vaccinated against HPV. The proportion of those vaccinated decreased with age: from 93.2% in those aged 17-19 to 72.9% in those aged 20-22, and 21.8% in 23-29-year olds. A higher proportion of unvaccinated respondents had at least one sexual intercourse under the age of 15 when compared to those vaccinated (30% vs. 23%, p < .0001). The number of sexual partners during the last 12 months was similar between vaccinated and unvaccinated participants. Vaccinated participants reported more condom use (45% versus 38%; p = .0002), and less sexually transmitted infections (10% versus 28%; p < .0001), and less anogenital condylomas (2.2% vs. 11.6%; p < .0001). A screening test has been reported by 51% and 77% of vaccinated and unvaccinated participants, respectively (p < .0001). The association between vaccination status and cervical cancer screening disappeared when adjusting for participants' age. The study results consolidate the existing body of data regarding the absence of an impact of HPV vaccination on sexual behavior or use of contraceptives.
Collapse
Affiliation(s)
- Chantal Sauvageau
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada, Université Laval, Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du CHU de Quebec, Quebec, Canada
| | - Vladimir Gilca
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada, Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du CHU de Quebec, Quebec, Canada
| | - Manale Ouakki
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada
| | - Marilou Kiely
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada
| | - François Coutlée
- Service de Biologie Moléculaire du Département de Médecine de Laboratoire et Service d'infectiologie du Département de Médecine, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
| | | | - Fannie Defay
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada
| | - Gilles Lambert
- Direction Régionale de Santé Publique, Centre Intégré Universitaire de Santé et de Services Sociauxdu Centre-Sud-de-l'Île-de-Montréal, Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montreal and Quebec, Quebec, Canada
| |
Collapse
|
6
|
González-Cano M, Garrido-Peña F, Gil-Garcia E, Lima-Serrano M, Cano-Caballero MD. Sexual behaviour, human papillomavirus and its vaccine: a qualitative study of adolescents and parents in Andalusia. BMC Public Health 2021; 21:1476. [PMID: 34320959 PMCID: PMC8320038 DOI: 10.1186/s12889-021-11510-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background Human papillomavirus (HPV) is one of the most common sexually transmitted infections and can be prevented by vaccination. The purpose of this study is to gain a better understanding, by analysing interview responses of adolescents and parents, of how adolescent sexual behaviour is approached in families, how widespread knowledge about HPV is in Andalusia, the autonomous region with the lowest vaccination rate in Spain, as well as to learn more about the interviewees’ position regarding vaccination. Methods A qualitative study by means of 15 focus groups of adolescents (N = 137, aged 14–17 years) and five focus groups of parents with children of those ages (N = 37) was conducted in the provinces of Granada, Seville and Jaén (Andalusia, Spain). The audio data were transcribed verbatim, coded and analysed thematically using NVIVO-10 software. Results There were three major results: (1) There is a lack of communication between adolescents and parents regarding sexual behaviour; (2) In both groups, scarce knowledge about HPV and vaccination was found; (3) Parents mistrust vaccination due to a lack of qualified and verified information about its benefits. Conclusions Healthy adolescent sexual behaviour is aided by communication within the family. Families need more information based on the evidence about HPV and vaccination. Health professionals are a key element in this process. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11510-4.
Collapse
Affiliation(s)
| | - Francisco Garrido-Peña
- Department of Criminal Law, Philosophy of Law, Moral Philosophy and Philosophy, University of Jaen, Jaen, Spain
| | | | | | - María Dolores Cano-Caballero
- Department of Nursing, University of Granada, Granada, Spain.,Biosanitary Research Institute of Granada, Granada, Spain.,University Hospital Virgen de las Nieves, Granada, Spain
| |
Collapse
|
7
|
School-based HPV vaccination positively impacts parents' attitudes toward adolescent vaccination. Vaccine 2021; 39:4190-4198. [PMID: 34127299 DOI: 10.1016/j.vaccine.2021.05.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION This qualitative study aimed to explore parental attitudes, knowledge and decision-making about HPV vaccination for adolescents in the context of a gender-neutral school-based Australian National Immunisation Program (NIP). METHODS Semi-structured interviews with parents of adolescents eligible for HPV vaccination were undertaken as part of an evaluation of a cluster-randomised controlled trial of a complex intervention in 40 schools (2013-2015). In this qualitative study, we purposively recruited a nested sample of parents from 11 schools across two Australian jurisdictions. Interviews explored parent knowledge and understanding of the HPV vaccine program; HPV vaccination decision-making; their adolescent's knowledge about HPV vaccination; and their adolescent's understanding about HPV vaccination, sexual awareness and behaviour. Transcripts were analysed using inductive and deductive thematic analysis. RESULTS Parents' of 22 adolescents had positive attitudes towards the program; the school-based delivery platform was the key driver shaping acceptance of and decision-making about HPV vaccination. They had difficulty recalling, or did not read, HPV vaccination information sent home. Some adolescents were involved in discussions about vaccination, with parents' responsible for ultimate vaccine decision-making. All parents supported in-school education for adolescents about HPV and HPV vaccination. Parents' knowledge about HPV vaccination was limited to cervical cancer and was largely absent regarding vaccination in males. CONCLUSIONS Parents' positive attitudes towards the NIP and inclusion of the HPV vaccine is central to their vaccine decision-making and acceptance. More intensive communication strategies including school education opportunities are required to improve parents' knowledge of HPV-related disease and to promote vaccine decision-making with adolescents.
Collapse
|
8
|
Butterfield R, Dhanani S. The Development of Human Papillomavirus (HPV) Vaccines and Current Barriers to Implementation. Immunol Invest 2021; 50:821-832. [PMID: 33724139 DOI: 10.1080/08820139.2021.1897612] [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: 01/05/2023]
Abstract
The identification of the human papillomavirus (HPV) as the causative agent of multiple cancers allowed for the development of vaccines and immunization strategies to prevent cancers caused by HPV infection. The public health ramifications of reduction of HPV disease burden are momentous in scope. Vaccine hesitancy has impacted widespread vaccination, but strategies have been identified to combat vaccine safety and efficacy misinformation and promote immunization.
Collapse
Affiliation(s)
| | - Salimah Dhanani
- Department of Pediatrics, Albany Medical Center, Albany, New York, USA
| |
Collapse
|
9
|
Borrull-Guardeño J, Sebastiá-Laguarda C, Donat-Colomer F, Sánchez-Martínez V. Women's knowledge and attitudes towards cervical cancer prevention: A qualitative study in the Spanish context. J Clin Nurs 2021; 30:1383-1393. [PMID: 33528874 DOI: 10.1111/jocn.15687] [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: 07/28/2020] [Revised: 12/19/2020] [Accepted: 01/22/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore the knowledge, attitudes and practices related to cervical cancer and its prevention in Spain. BACKGROUND Worldwide, women's knowledge about cervical cancer is low, and their attitudes towards its prevention are good, but they do not correlate with the screening uptake. Although the rates of Spanish women performing cervical cancer screening are mostly acceptable, their knowledge and attitudes about it have not been explored. DESIGN Qualitative descriptive study. METHODS Three focus groups were conducted, with 21 women aged 25 to 65 years. Participants were recruited through convenience sampling. For intragroup homogeneity, women participated in age groups. The COREQ reporting guidelines were used. RESULTS Women expressed their knowledge about cervical cancer was low. None of the participants identified the human papillomavirus as a cause of cervical cancer, nor did they mention the vaccine as a preventive measure. They all knew about the screening existence, but not about its frequency nor target population. About the attitudes and practice, 18 women had an appropriate screening, and they were favourable to this health check, claiming an increase in its frequency. Nineteen women claimed they had not received enough information from the healthcare system and a lack of social awareness in comparison with breast cancer. They demanded from the professionals more health education, a reminder of their appointments and a report of the Pap test results. CONCLUSIONS There was a self-perceived low level of knowledge about cervical cancer risk factors and its prevention in the participants. However, they expressed favourable attitudes towards screening, and they demanded more information about cervical cancer and its prevention measures, and they regretted its low social awareness. RELEVANCE TO CLINICAL PRACTICE Midwives, general nurses and other nurse specialists may have a leading position in health education for cervical cancer prevention in different population levels.
Collapse
Affiliation(s)
- Jessica Borrull-Guardeño
- Arnau de Vilanova- Llíria Health Department, Ministry of Universal Healthcare and Public Health, Valencia, Spain.,Department of Nursing, University of Valencia, Valencia, Spain
| | | | | | | |
Collapse
|
10
|
Lahijani AY, King AR, Gullatte MM, Hennink M, Bednarczyk RA. HPV Vaccine Promotion: The church as an agent of change. Soc Sci Med 2020; 268:113375. [PMID: 32979772 DOI: 10.1016/j.socscimed.2020.113375] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/12/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023]
Abstract
Vaccination to prevent human papillomavirus (HPV) infections and associated cancers has been recommended for use in the US since 2006; however, vaccine uptake remains suboptimal. Many sociodemographic factors have been evaluated with regard to HPV vaccine uptake but there has been less focus on the role of religion and religiosity. Our qualitative case study aimed to identify community perceptions of HPV and HPV vaccination via seven focus group discussions (FGDs) with leaders and members of an African Methodist Episcopal (AME) church in metro-Atlanta, Georgia from April 2018 to July 2018. A Social and Behavior Change Communication (SBCC) conceptual framework was used to identify potential avenues to strengthen communication and health promotion strategies in the church community. Results showed diverse perceptions about HPV vaccine amongst the church community, ranging from viewing the HPV vaccine as essential to unnecessary for adolescents. Two key barriers to the HPV vaccine that may be addressed through the SBCC strategies were identified: 1) general mistrust in the healthcare system and 2) the expectation of abstinence among adolescents. For future HPV prevention opportunities, congregants highlighted they would be more receptive to receiving HPV vaccine promotion messages from pre-established trustworthy sources. Church leaders hold the trust of their congregation, therefore implementation of a church-based intervention utilizing the SBCC strategies has considerable potential to transform perceptions of the HPV vaccine and increase vaccination uptake. These findings may be implemented in future HPV vaccine promotion strategies within faith-based communities to promote safe and open dialogue for health communication messages to be disseminated in a familiar and trusted setting.
Collapse
Affiliation(s)
- Ariana Y Lahijani
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Adrian R King
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Mary M Gullatte
- Winship Cancer Institute, Emory University, 1365 Clifton Rd, Atlanta, GA, 30322, USA; Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, 30322, USA; Emory Healthcare, 235 Peachtree Street, NE, Atlanta, GA, 30303, USA
| | - Monique Hennink
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA; Winship Cancer Institute, Emory University, 1365 Clifton Rd, Atlanta, GA, 30322, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA; Emory Vaccine Center, Emory University, 954 Gatewood Road, Atlanta, GA, 30329, USA.
| |
Collapse
|
11
|
Abstract
BACKGROUND Social determinants of health explain most health inequities. Intermediate determinants dictate differences in the exposure and vulnerability of people based on social stratification. Vulnerable women (lower education level, older age, uninsured, etc.) have lower adherence to recommended Pap smear screening guidelines. However, a gap remains concerning the effect of social determinants on human papillomavirus (HPV) infection. OBJECTIVES The aim of this study was to analyze the association between the level of knowledge about HPV infection and HPV vaccines with education level and residential setting among a sample of Spanish women. METHODS A cross-sectional study at six primary care centers (Cantabria, Spain) was performed. All women >21 years consecutively attended by midwives for routine follow-up were invited to participate during the study period (2015-2016) until a convenience sample was recruited. Participants completed an anonymous questionnaire addressing sociodemographic variables (age, education level, and residential setting) and the level of knowledge regarding HPV infection, including general knowledge about infection and knowledge about the HPV vaccine. Associations between education level (primary, secondary, and university) and residential setting (urban, semiurban, and rural) with the level of knowledge of HPV infection and HPV vaccine were calculated using adjusted logistic regressions. Dose-response associations were estimated based on p-trend. RESULTS Compared to university women, a lower education level was associated with limited or no knowledge of either HPV infection or the HPV vaccine. Women living in rural areas poorly identified "promiscuity" as a risk factor of HPV infection and "the use of condoms" as a protective factor. Moreover, living in rural areas was associated with limited or no knowledge of HPV infection and HPV vaccine. There were significant dose-response trends; those who were more educated and living in more urban areas had more knowledge about either HPV infection or the vaccine. DISCUSSION In our sample, the level of knowledge of HPV infection and HPV vaccine was high. However, vulnerable women, defined by a lower education level and living in rural areas, presented a greater lack of knowledge regarding HPV infection and the HPV vaccine.
Collapse
|
12
|
Shaikh MY, Hussaini MF, Narmeen M, Effendi R, Paryani NS, Ahmed A, Khan M, Obaid H. Knowledge, Attitude, and Barriers Towards Human Papillomavirus (HPV) Vaccination Among Youths of Karachi, Pakistan. Cureus 2019; 11:e6134. [PMID: 31886070 PMCID: PMC6903894 DOI: 10.7759/cureus.6134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Human papillomavirus (HPV) is the most common infection of the reproductive tract. The introduction of HPV vaccines by WHO aims to reduce the incidence of cervical cancer. Pakistan lacks an effective nationwide HPV vaccination program, thereby making HPV a major threat. In this study, we aimed to assess the knowledge of HPV vaccination in Pakistan and to determine the barriers against it. Methods A cross-sectional study was conducted in Karachi, Pakistan, between April and May 2019. A convenience sampling technique was implemented using a self-administered questionnaire, which was filled by individuals aged 18-26. The questionnaire assessed the knowledge regarding HPV and also evaluated the attitude and acceptability amongst these individuals towards the vaccine. Data were analyzed using Statistical Package for Social Sciences (SPSS), version 20.0. Results The majority of the participants belonged to the monthly household income range of 200,000 rupees and above, which was labeled as the high-income category (n=158, 39.5%). Out of the 18 people who were vaccinated, eight belonged to the aforementioned category. Of these 18, nearly two-thirds (n=11, 61.1%) had gotten vaccinated upon the recommendation of their doctor. A statistically significant difference was found only between those currently enrolled in universities and previously vaccinated for HPV (p=.047). Nearly half of the responders perceived the vaccine to be time-consuming (n=167, 41.8%) and overpriced (n=187, 46.8%). Conclusion The vaccination rate is low in Karachi, Pakistan. Concentrated efforts involving the healthcare system should be made to raise awareness regarding HPV and its vaccine thereby reducing barriers to HPV prevention.
Collapse
Affiliation(s)
- Mahnoor Y Shaikh
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Maheen F Hussaini
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Mehek Narmeen
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Rida Effendi
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Neha S Paryani
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Ameer Ahmed
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Muhammad Khan
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Hasan Obaid
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi , PAK
| |
Collapse
|
13
|
Wong LP, Han L, Li H, Zhao J, Zhao Q, Zimet GD. Current issues facing the introduction of human papillomavirus vaccine in China and future prospects. Hum Vaccin Immunother 2019; 15:1533-1540. [PMID: 31017500 DOI: 10.1080/21645515.2019.1611157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The introduction of human papillomavirus (HPV) vaccination in China aims to prevent HPV infection in all women. The issues that China might face include high cost of vaccines made in other countries, shortage in HPV vaccine supply, negative events attributed to vaccination (whether justified or not) that jeopardizes the general public's confidence in the HPV vaccine, cultural and literacy barriers, and sensitivity to receiving a vaccine for a sexually transmitted disease. Ensuring the effective delivery of the HPV vaccine in China, a country with vast economic, geographical, and cultural complexities, will require a commitment of significant resources. In light of the high price of imported vaccines, the availability of locally manufactured HPV vaccines would greatly facilitate the national HPV vaccination program. New evidence supporting the efficacy of a two-dose regime in younger adolescents would also be advantageous in terms of affordability and logistical simplicity of vaccine administration. Furthermore, it would potentially enhance the compliance and uptake, especially for hard to reach women in remote regions.
Collapse
Affiliation(s)
- Li Ping Wong
- a Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia.,b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Liyuan Han
- b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Hui Li
- c Non-infectious Disease Prevention and Control Institute, Ningbo Municipal Center for Disease Control and Prevention , Ningbo , PR China
| | - Jinshun Zhao
- b Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo , Zhejiang , PR China
| | - Qinjian Zhao
- d State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University , Xiamen , Fujian PR China
| | - Gregory D Zimet
- e Department of Pediatrics, School of Medicine, Indiana University , Indianapolis , IN , USA
| |
Collapse
|
14
|
Vatopoulou A, Papanikolaou A, Diavatis S, Goulis DG. Human papilloma virus vaccination and attitudes towards contraception: a cross-sectional study. EUR J CONTRACEP REPR 2019; 24:182-187. [PMID: 30966837 DOI: 10.1080/13625187.2019.1595573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: Human papilloma virus (HPV) vaccination may result in misconceptions that encourage young women to adopt risky contraceptive practices. The purpose of this article was to investigate whether HPV vaccination status was associated with choice of contraceptive method and adoption of risky sexual behaviour. Methods: Vaccinated and non-vaccinated visitors to a university department paediatric and adolescent gynaecology clinic were asked to anonymously fill in a survey comprising questions on sociodemographic characteristics, sexual history, opinions on contraception and attitudes towards contraception. Results: A total of 191 women were studied, 75 (39.3%) of whom had received the HPV vaccination and 116 (60.7%) of whom had not. The main contraceptive methods used in both groups were male condom (46%), emergency contraception (14%) and coitus interruptus (12%). The vaccinated group was less religious and had better educated mothers compared with the non-vaccinated group (relative risk [RR] 0.64; 95% confidence interval [CI] 0.45, 0.93; p = .016 vs RR 1.91; 95% CI 1.01, 3.63; p = .027, respectively). They also had an earlier sexual debut (RR 1.94; 95% CI 1.06, 3.55; p = .015), agreed that vaccination increased the safety of sex (RR 1.45; 95% CI 1.02, 2.05; p = .039) and considered the HPV vaccine a prerequisite to initiation of a sexual relationship (RR 1.87; 95% CI 1.34, 2.63; p < .001). Conclusion: HPV vaccination did not affect sexual behaviour, attitudes to condom use or choice of contraceptive method.
Collapse
Affiliation(s)
- Anastasia Vatopoulou
- a Paediatric and Adolescent Gynaecology Clinic, First Department of Obstetrics and Gynaecology , Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Alexios Papanikolaou
- b First Department of Obstetrics and Gynaecology , Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | | | - Dimitrios G Goulis
- b First Department of Obstetrics and Gynaecology , Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece
| |
Collapse
|
15
|
Karafillakis E, Simas C, Jarrett C, Verger P, Peretti-Watel P, Dib F, De Angelis S, Takacs J, Ali KA, Pastore Celentano L, Larson H. HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe. Hum Vaccin Immunother 2019; 15:1615-1627. [PMID: 30633623 PMCID: PMC6783136 DOI: 10.1080/21645515.2018.1564436] [Citation(s) in RCA: 155] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/03/2018] [Accepted: 12/18/2018] [Indexed: 11/15/2022] Open
Abstract
Europe is increasingly described as the region in the world with the least confidence in vaccination, and particularly in the safety of vaccines. The aim of this systematic literature review was to gather and summarise all peer-reviewed and grey literature published about determinants of Human Papillomavirus (HPV) vaccine hesitancy in Europe. Ten thematic categories were identified across the 103 articles which were included in the review. Participants from European studies most commonly reported issues with the quantity and quality of information available about HPV vaccination; followed by concerns about potential side effects of the vaccine; and mistrust of health authorities, healthcare workers, and new vaccines. Comparative analyses indicated that confidence determinants differed by country and population groups. This evidence supports the need to develop context-specific interventions to improve confidence in HPV vaccination and design community engagement strategies aiming to build public trust.
Collapse
Affiliation(s)
- Emilie Karafillakis
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Clarissa Simas
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Caitlin Jarrett
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Universität Basel, Basel, Switzerland
| | - Pierre Verger
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Aix Marseille Université, UMR_S 912, IRD, Marseille, France
- INSERM, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu, Paris, France
| | - Patrick Peretti-Watel
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Aix Marseille Université, UMR_S 912, IRD, Marseille, France
- INSERM, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu, Paris, France
| | - Fadia Dib
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, France
- INSERM CIC 1417, F-CRIN, I-REIVAC, Paris, France
- Assistance Publique Hopitaux de Paris (AP-HP), Hôpital Cochin, CIC Cochin, Pasteur, Paris, France
| | - Stefania De Angelis
- Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Judit Takacs
- Centre for Social Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Karam Adel Ali
- Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Lucia Pastore Celentano
- Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Heidi Larson
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| |
Collapse
|
16
|
Bednarczyk RA. Addressing HPV vaccine myths: practical information for healthcare providers. Hum Vaccin Immunother 2019; 15:1628-1638. [PMID: 30676241 DOI: 10.1080/21645515.2019.1565267] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Human papillomavirus (HPV) vaccine uptake consistently lags behind that of other adolescent vaccines. In 2017, uptake of a single HPV vaccine dose and HPV vaccine series completion was 66% and 49%, respectively, compared to uptake of tetanus, diphtheria, and acellular pertussis vaccine (89%) and quadrivalent meningococcal conjugate vaccine (85%). Reasons for not vaccinating adolescents again HPV are varied, and in many cases, are rooted in commonly spread myths and misperceptions about the vaccine. In this review, we address five key myths - HPV vaccination is not effective at preventing cancer; Pap smears are sufficient to prevent cervical cancer; HPV vaccination is not safe; HPV vaccination is not needed since most infections are naturally cleared by the immune system; 11-12 years of age is too young to vaccinate. For each myth, we summarize the scientific evidence refuting the myth and provide speaking prompts for healthcare professionals to communicate about HPV vaccination.
Collapse
Affiliation(s)
- Robert A Bednarczyk
- a Hubert Department of Global Health, Rollins School of Public Health, Emory University , Atlanta GA , USA.,b Department of Epidemiology, Rollins School of Public Health, Emory University , Atlanta GA , USA.,c Cancer Prevention and Control Program, Winship Cancer Institute, Emory University , Atlanta GA , USA.,d Emory Vaccine Center, Emory University , Atlanta GA , USA
| |
Collapse
|
17
|
Fernandes R, Potter BK, Little J. Attitudes of undergraduate university women towards HPV vaccination: a cross-sectional study in Ottawa, Canada. BMC Womens Health 2018; 18:134. [PMID: 30071837 PMCID: PMC6090914 DOI: 10.1186/s12905-018-0622-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Persistent infection with certain subtypes of human papillomavirus (HPV) is a necessary cause of cervical cancer. Although two prophylactic vaccines have been licensed in Canada against cancerous subtypes of HPV, vaccine uptake has been lower than anticipated. The primary objective of this study was to determine the acceptability of catch-up HPV vaccination to undergraduate university women under the age of 25, by assessing their perceptions of HPV vaccination. METHODS A total of 401 University of Ottawa female undergraduate students participated in a cross-sectional bilingual web-based survey on HPV vaccination. RESULTS The prevalence of immunization with at least 1 HPV vaccine dose was 49% in the study population. Although the overall attitude of study participants towards the vaccine was positive, vaccinated respondents had a more favourable attitude towards the vaccine than non-vaccinated respondents. Approximately half of the non-vaccinated respondents were interested in receiving the vaccine at some point in the future. The primary barriers to HPV vaccination identified by non-vaccinated respondents were lack of knowledge about the vaccines, potential vaccine side effects and cost of vaccination. Multivariable analysis comparing non-vaccinated respondents who intended to be vaccinated and those who did not suggests that the former group had a more favourable attitude towards the vaccine and would be influenced by doctor recommendation. CONCLUSIONS Offering HPV vaccination for women aged 18 to 25 provides an opportunity to address suboptimal vaccination coverage in the population and may reduce health inequities demonstrated by variations in cervical cancer incidence within jurisdictions.
Collapse
Affiliation(s)
- Rachel Fernandes
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 207G, Ottawa, On K1G 5Z3 Canada
| | - Beth K. Potter
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Canada Research Chair in Human Epidemiology, Ottawa, Canada
| |
Collapse
|
18
|
Grigore M, Teleman SI, Pristavu A, Matei M. Awareness and Knowledge About HPV and HPV Vaccine Among Romanian Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:154-159. [PMID: 27830570 DOI: 10.1007/s13187-016-1130-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cervical cancer is one of the most prevalent gynecological malignancies worldwide. Romania has the highest incidence of this type of cancer in Europe. A successful prevention strategy has to consider the primary prevention measures (including health education on human papilloma virus (HPV) infection but also vaccination). The aim of this study was to assess the knowledge and attitudes of Romanian women about HPV and HPV vaccine. We conducted a cross-sectional study survey of 454 women using an anonymously completed questionnaire covering the awareness and knowledge of HPV infection and attitudes to vaccination. We also analyzed the discussions and conclusion from a focus group of healthcare professionals regarding (1) HPV and HPV awareness and attitude, and (2) suggestions for improving HPV vaccine knowledge and acceptance. 69.2% of women were aware about HPV but their knowledge was minimal and incomplete. While 62.3% had heard about HPV vaccine, only 50.7% had a positive attitude toward it. The main barriers to vaccination were the fear of side effects, the perception that is risky, and the financial concerns. Deficiencies in knowledge were noted for vaccine, genital warts, or risks factors for HPV infection like the early onset of sexual life. The information regarding HPV and vaccine is not always accurate and complete, and only 50.7% of women have a positive attitude toward the vaccine. More educational programs and clearer communication are needed to raise awareness and knowledge regarding HPV and HPV vaccine.
Collapse
Affiliation(s)
- Mihaela Grigore
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", Str. Universitatii 16, 700115, Iasi, Romania.
| | - Sergiu Iuliu Teleman
- Department of Pathology, University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania
| | - Anda Pristavu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", Str. Universitatii 16, 700115, Iasi, Romania
| | - Mioara Matei
- Department of Epidemiology, University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania
| |
Collapse
|
19
|
Fernández-Feito A, Antón-Fernández R, Paz-Zulueta M. [Sexual risk behaviours and PAP testing in university women vaccinated against human papillomavirus]. Aten Primaria 2017; 50:291-298. [PMID: 28867156 PMCID: PMC6836978 DOI: 10.1016/j.aprim.2017.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/05/2017] [Accepted: 05/14/2017] [Indexed: 11/24/2022] Open
Abstract
Objetivo Estimar la asociación entre la vacunación frente al virus papiloma humano (VPH) y las conductas sexuales de riesgo, así como la participación en el Programa de Detección Precoz de Cáncer de Cuello Uterino (PDPCCU). Diseño Estudio descriptivo transversal. Emplazamiento Facultad de Medicina y Ciencias de la Salud, Facultad de Derecho y Facultad de Economía y Empresa (Universidad de Oviedo). Participantes Estudiantes universitarias. Mediciones principales Se recogió información sobre métodos anticonceptivos, conducta sexual, conocimientos sobre VPH y participación en el PDPCCU. Se estimaron proporciones y odds ratio (OR) con sus correspondientes intervalos de confianza al 95% (IC 95%). Resultados El 67,7% de la muestra estaban vacunadas frente al VPH. Un total de 216 mujeres (65,3%) eran sexualmente activas. El 67,6% utilizaba un método de barrera en la relación actual, siendo menos frecuente entre las mujeres no vacunadas (54,9% frente al 75,4% en estudiantes vacunadas) (p = 0,002). El riesgo de mantener al menos una conducta sexual de riesgo era mayor entre las mujeres no vacunadas: OR 2,29 (IC 95%: 1,29-4,07). La probabilidad de realizar una citología dentro del PDPCCU fue mayor entre las mujeres no vacunadas: OR 2,18 (IC 95%: 1,07-4,47). Conclusiones La prevalencia de conductas sexuales de riesgo en mujeres no vacunadas es elevada y se relaciona con la no utilización de métodos de barrera. La vacunación frente al VPH puede influir en la conducta sexual y en la participación en PDPCCU. Se debería reforzar la información que reciben los jóvenes sobre anticoncepción, enfermedades de transmisión sexual y prevención del cáncer.
Collapse
Affiliation(s)
- Ana Fernández-Feito
- Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España.
| | | | - María Paz-Zulueta
- Departamento de Enfermería, Escuela Universitaria de Enfermería, Universidad de Cantabria, Santander, España
| |
Collapse
|
20
|
Osazuwa-Peters N, Adjei Boakye E, Mohammed KA, Tobo BB, Geneus CJ, Schootman M. Not just a woman's business! Understanding men and women's knowledge of HPV, the HPV vaccine, and HPV-associated cancers. Prev Med 2017; 99:299-304. [PMID: 28341458 DOI: 10.1016/j.ypmed.2017.03.014] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/15/2017] [Accepted: 03/20/2017] [Indexed: 11/30/2022]
Abstract
Few studies have included men when assessing differences in knowledge about HPV, and HPV-associated cancers. We examined gender differences in knowledge about HPV, HPV vaccine, and HPV-associated cancers. Multivariable logistic regression models were used to analyze data of 3,677 survey respondents aged 18 years and older from the 2014 Health Information National Trends Survey. Covariates included age, race/ethnicity, marital status, education, income level, regular provider, general health, internet use, and family structure aged 9 to 27 years. Analyses were conducted in 2015. Sixty-four percent of respondents had heard of HPV and the HPV vaccine. Seventy-eight percent of respondents knew HPV causes cervical cancer, but only 29% knew it causes penile cancer, 26% knew it causes anal cancer, and 30% knew it causes oral cancer. In multivariable analyses, males were less likely to have heard of HPV (aOR: 0.33; 95% CI: 0.25-0.45), and less likely to have heard of the HPV vaccine (aOR: 0.24; 95% CI: 0.18-0.32) compared to females. No differences existed between males and females regarding knowledge about HPV-associated cancers. In conclusion, knowledge of HPV, the vaccine, and HPV-associated cancers in both males and females in the United States remains very low, especially among men.
Collapse
Affiliation(s)
- Nosayaba Osazuwa-Peters
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA; Saint Louis University Cancer Center, St. Louis, MO 63110, USA; Saint Louis University, School of Medicine, Department of Otolaryngology - Head and Neck Surgery, St. Louis, MO, USA
| | - Eric Adjei Boakye
- Saint Louis University Center for Outcomes Research (SLUCOR), Saint Louis University, St. Louis, MO, USA.
| | - Kahee A Mohammed
- Saint Louis University Center for Outcomes Research (SLUCOR), Saint Louis University, St. Louis, MO, USA
| | - Betelihem B Tobo
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Christian J Geneus
- Department of Biostatistics and Bioinformatics, Tulane School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Mario Schootman
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| |
Collapse
|
21
|
Zhuang QY, Wong RX, Chen WMD, Guo XX. Knowledge, attitudes and practices regarding human papillomavirus vaccination among young women attending a tertiary institution in Singapore. Singapore Med J 2017; 57:329-33. [PMID: 27353611 DOI: 10.11622/smedj.2016108] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION This study aimed to describe the knowledge, attitudes and practices of young women regarding human papillomavirus (HPV) vaccination. METHODS We conducted a descriptive, cross-sectional, questionnaire-based study among female students at a tertiary institute in Singapore. RESULTS A total of 255 questionnaires were completed and formed the basis of the analysis. 244 (95.7%) of the total participants were of the age group 15-22 years. 252 (98.8%) participants were unmarried and 240 (94.1%) had never had sexual intercourse. Only 25 (9.8%) women had received vaccination. Among the unvaccinated participants, 96 (41.7%) had no intention to receive HPV vaccination and 62 of them cited lack of information as a major barrier to HPV vaccination. Knowledge of cervical cancer and HPV vaccination was also assessed and graded via a point system, with a maximum score of 14. Knowledge was found to be low, with a median score of 7. There was a significant association between HPV vaccination uptake and the source from which they first heard about the vaccine (p = 0.007). Vaccinated respondents tended to first hear about it from their relatives and friends, as compared to unvaccinated respondents (60.0% vs. 27.0%). CONCLUSION There is poor uptake of HPV vaccination amongst Singapore's susceptible youth as well as poor knowledge of cervical cancer and HPV vaccination. Public health education regarding cervical cancer and HPV vaccination is still needed and has to be targeted at not only respondents, but also their family and friends.
Collapse
Affiliation(s)
- Qing Yuan Zhuang
- Division of Palliative Medicine, National Cancer Centre Singapore, Singapore
| | - Ru Xin Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | | | | |
Collapse
|
22
|
Prayudi PKA, Permatasari AAIY, Winata IGS, Suwiyoga K. Impact of human papilloma virus vaccination on adolescent knowledge, perception of sexual risk and need for safer sexual behaviors in Bali, Indonesia. J Obstet Gynaecol Res 2016; 42:1829-1838. [PMID: 27762471 DOI: 10.1111/jog.13123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/07/2016] [Accepted: 07/07/2016] [Indexed: 11/26/2022]
Abstract
AIM To determine the impact of human papilloma virus (HPV) vaccination on knowledge, perception of sexual risk and need for continued safe sexual behavior among Indonesian girls. METHODS A comparative cross-sectional study was carried on in Denpasar, the capital city of Bali, Indonesia, during September 2015-February 2016. A total of 828 adolescent girls (12-16 years) were recruited to assess their knowledge on HPV/HPV vaccine, perception of sexual risks and need for continued safe sexual behavior. RESULTS A total of 419 girls (50.7%) had received HPV vaccination prior to the study, 76.4% of whom (320/419) had sufficient knowledge about HPV. HPV vaccination was a strong and independent predictor of higher HPV/HPV vaccine knowledge (adjusted OR [AOR], 9.358; 95%CI: 6.816-12.849, P < 0.001). HPV vaccination (AOR, 0.107; 95%CI: 0.074-0.155, P < 0.001) and higher knowledge level (AOR, 0.667; 95%CI: 0.464-0.958, P = 0.028) were associated with lower perceived HPV risk. Despite the low risk perception, most of the vaccinated girls (408/419, 97.4%) continued to perceive higher need for safe sexual behaviors. On multivariate analysis, higher knowledge was the independent predictor for higher perceived need for safe sexual behaviors (AOR, 4.260; 95%CI: 2.016-9.001, P < 0.001). CONCLUSION The HPV vaccination was associated with higher knowledge and appropriately lower perception of HPV risk. Despite the vaccination, most of the adolescents continued to perceive a need for safer sexual behavior. All adolescent girls should receive HPV vaccination in order to reduce cervical cancer burden in the future.
Collapse
Affiliation(s)
- Pande Kadek Aditya Prayudi
- Department of Obstetrics and Gynecology, Sanglah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | | | - I Gde Sastra Winata
- Department of Obstetrics and Gynecology, Sanglah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Ketut Suwiyoga
- Department of Obstetrics and Gynecology, Sanglah General Hospital/Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| |
Collapse
|
23
|
Kasting ML, Shapiro GK, Rosberger Z, Kahn JA, Zimet GD. Tempest in a teapot: A systematic review of HPV vaccination and risk compensation research. Hum Vaccin Immunother 2016; 12:1435-50. [PMID: 26864126 PMCID: PMC4964724 DOI: 10.1080/21645515.2016.1141158] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/21/2015] [Accepted: 01/07/2016] [Indexed: 10/24/2022] Open
Abstract
There has been some concern among parents and in the media that vaccinating children against human papillomavirus could be seen as giving children permission to engage in risky sexual behaviors (also known as sexual disinhibition). Several studies have found this concern to be unfounded but there have been no attempts to synthesize the relevant studies in order to assess if there is evidence of sexual disinhibition. The aim of this study was to synthesize recent literature examining sexual behaviors and biological outcomes (e.g., sexually transmitted infections) post-HPV vaccination. We reviewed literature from January 1, 2008-June 30, 2015 using PubMed, CINAHL, and Embase with the following search terms: [(sex behavior OR sex behavior OR sexual) AND (human papillomavirus OR HPV) AND (vaccines OR vaccine OR vaccination)] followed by a cited reference search. We included studies that examined biological outcomes and reported behaviors post-vaccination in both males and females. Studies were reviewed by title and abstract and relevant studies were examined as full-text articles. We identified 2,503 articles and 20 were eventually included in the review. None of the studies of sexual behaviors and/or biological outcomes found evidence of riskier behaviors or higher rates of STIs after HPV vaccination. Instead, the studies found that vaccinated compared to unvaccinated individuals were less likely to report vaginal intercourse without a condom (OR = 0.5; 95%CI = 0.4-0.6) and non-use of contraception (OR = 0.27; 95%CI = 0.15-0.48) and unvaccinated participants had higher rates of Chlamydia (OR = 2.3; 95%CI = 1.06-5.00). These results should be reassuring to parents and health care providers.
Collapse
Affiliation(s)
- Monica L. Kasting
- Indiana University School of Public Health, Department of Epidemiology, Indianapolis, IN, USA
| | - Gilla K. Shapiro
- Department of Psychology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research & Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital, Montreal, QC, Canada
| | - Zeev Rosberger
- Department of Psychology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research & Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital, Montreal, QC, Canada
| | - Jessica A. Kahn
- Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Gregory D. Zimet
- Indiana University School of Medicine, Section of Adolescent Medicine, Indianapolis, IN, USA
| |
Collapse
|