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Chen J, Zhang R, Xu W, Bai L, Hu D, Nie Y, Xiang R, Kang D, Shi QL. Knowledge and Practices Regarding Human Papillomavirus and Cervical Cancer Screening Among Women in Low-Income Areas of China: A Cross-Sectional Study. Cureus 2024; 16:e55930. [PMID: 38601389 PMCID: PMC11004842 DOI: 10.7759/cureus.55930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Persistent human papillomavirus (HPV) infection is the primary cause of cervical cancer. However, this can be prevented through vaccination and screening. This study aimed to clarify the relationship between behavior, knowledge, and attitude toward cervical cancer and regular screening and HPV infection among women in Lueyang County. METHODS Women who underwent cervical cancer screening at the outpatient department of a maternal and child health center between September and December 2021 were invited to participate. In total, 2,303 women completed the questionnaire. Women who underwent regular or irregular screening were 1:1 matched for age. Differences in knowledge of HPV and attitudes toward HPV vaccination among different populations were assessed. Logistic regression analysis was performed to identify the factors influencing HPV infection. RESULTS In total, 417 pairs of women who underwent regular and irregular screening were successfully matched. Multivariate logistic regression results indicated that age is a risk factor for HPV infection (OR=1.056 95%CI: [1.031 1.082]), while regular screening acts as a protective factor against HPV infection (OR=0.174 95%CI: [0.117 0.259]). Additionally, regular screening was associated with a higher level of knowledge about HPV among women compared to those who did not undergo regular screening (p<0.001). CONCLUSIONS Women in Lueyang County have low levels of knowledge regarding HPV and cervical cancer. Regular screening is a protective factor against HPV infection. The regular screening group demonstrates a higher level of HPV knowledge compared with the irregular screening group. These findings highlight the importance of regular screening and the need to strengthen public health education.
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Affiliation(s)
- Jiaojiao Chen
- School of Public Health, Chongqing Medical University, Chongqing, CHN
| | - Ruoyi Zhang
- College of Public Health, Chongqing Medical University, Chongqing, CHN
| | - Wei Xu
- College of Public Health, Chongqing Medical University, Chongqing, CHN
| | - Li Bai
- Obstetrics and Gynecology, Centre of Maternal and Child Health, Shaanxi, CHN
| | - Dehua Hu
- Obstetrics and Gynecology, Centre of Maternal and Child Health, Shaanxi, CHN
| | - Yuxian Nie
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, CHN
| | - Rumei Xiang
- College of Public Health, Chongqing Medical University, Chongqing, CHN
| | - Dan Kang
- College of Public Health, Chongqing Medical University, Chongqing, CHN
| | - Qiu-Ling Shi
- College of Public Health, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, CHN
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He ZY, Wei JH, Jiang JM, Hu R, Qi GZ. Analysis of influencing factors of HPV vaccination willingness of female sex workers in urban entertainment venues based on the IMB model in Guangxi, China. BMC Womens Health 2024; 24:141. [PMID: 38402149 PMCID: PMC10893625 DOI: 10.1186/s12905-024-02962-y] [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: 09/07/2023] [Accepted: 02/09/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVE Understanding HPV vaccination willingness and its influencing factors among female sex workers (FSWs) in entertainment venues in an urban area of Guangxi, China. METHODS From 15 August to 15 October 2022, FSWs in entertainment venues with commercial sex trade in an urban area of Guangxi were selected as the study subjects for the questionnaire survey using the method of intentional sampling. The questionnaire based on the information-motivation-behavior (IMB) skills model was used to collect the basic characteristics, HPV and HPV vaccine-related information and cognition, motivation to vaccinate, behavioral skills and willingness to vaccinate from the research targets. A multifactor logistic regression model was used to analyze the factors influencing the research targets' willingness to receive HPV vaccination. RESULTS Of the 921 research targets, 712 (77.31%) were willing to receive HPV vaccination. The higher the level of knowledge regarding HPV and HPV vaccine-related information, the higher the motivation for HPV vaccination. In addition, the higher the behavioral skills score, the higher the willingness of FSWs in entertainment venues to receive HPV vaccination (P<0.001). FSWs in entertainment venues with lower venue grades [OR(95% CI)=0.693 (0.539, 0.891), P=0.004] were more reluctant to receive HPV vaccination. Those who favored the effectiveness of the vaccine in preventing the disease [OR(95% CI)=2.144 (1.449, 3.174), P<0.001] and those who had heard of HPV vaccine [OR(95% CI)=2.105 (1.451, 3.054), P<0.001], were able to perceive the benefits of HPV vaccination [OR(95% CI)=1.134 (1.045, 1.230), P=0.002]. These individuals acquired greater behavioral skills i.e., self-decision making for HPV vaccination [OR(95% CI)=1.130 (1.008, 1.267), P=0.036] and self-efficacy [OR(95% CI)=1.135 (1.081, 1.191), P<0.001] and they were more willing to receive HPV vaccine. CONCLUSIONS There was a relatively high HPV vaccination willingness among FSWs in entertainment venues in an urban area of Guangxi, China. Attention should be focused on introducing the benefits of primary prevention measures such as the HPV vaccine for individuals and behavioral skills for HPV vaccination in order to increase their willingness to be vaccinated thus increasing their HPV vaccination rate.
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Affiliation(s)
- Zhi-Yan He
- College of Public Health and Management, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China
| | - Jun-Hong Wei
- College of Public Health and Management, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China
| | - Jian-Ming Jiang
- College of Public Health and Management, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China
| | - Rui Hu
- College of Basic Medical Sciences, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China
| | - Guang-Zi Qi
- College of Public Health and Management, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
- Modern Industrial College of Biomedicine and Great Health, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
- Key Laboratory of Research on Environment and Population Health in aluminium mining areas (Youjiang Medical University for Nationalities), Education Department of Guangxi Zhuang Autonomous Region, Baise, 533000, Guangxi, China.
- Key Laboratory of Research on Environmental pollution and health risk assessment, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
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Shamaun S, Jaleel R, Gull Y, Shahid A, Iqbal M, Qazi TN. Knowledge and Attitude of Cervical Cancer Screening and Vaccination in Patients Attending Gynecology Outpatient Clinic at a Tertiary Care Hospital in Pakistan. South Asian J Cancer 2023; 12:17-22. [PMID: 36851927 PMCID: PMC9966166 DOI: 10.1055/s-0042-1751093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Shamaila ShamaunBackground Cervical cancer is the third most prevalent female cancer in Pakistan; nearly 70% present at a very advanced stage of malignancy due to lack of awareness, proper screening, and vaccination. Therefore, we aimed to assess the knowledge and attitude toward screening, vaccination, and risk factors of cervical cancer in sexually active women of Pakistan. Methods This cross-sectional study was conducted at the gynecology outpatient clinic of a public sector hospital in Karachi, Pakistan, from December 2021 to March 2022. We included sexually active women with exception of diagnosed cases of cervical cancer, pregnancy, vaginal bleeding, and psychological disorder. Collected data were regarding demographic characteristics, awareness regarding cervical cancer, screening, human papillomavirus (HPV) vaccine, and risk factors, history of cervical screening, and wiliness to opt-in for cervical screening. Results We included 226 women with a mean age of 41.25 ± 10.54 years. The mean parity level was observed to be 3.8 ± 1.95. A majority of women were housewives by profession (88.9%) and uneducated (61.9%). Only 41.2% (93) of women were aware of cervical cancer, 33.6% (76) were aware of cervical screening, and only 15.9% (36) had a history of cervical screening. Only four women (1.8%) were aware of the HPV vaccine and 31% (70) showed intention to opt-in for cervical screening. A vast majority of women (96.9%) were not aware of the risk factors of cervical cancer. Conclusion(s) We have observed poor awareness regarding cervical cancer, HPV vaccination, and cervical screening among women in our population. Lack of awareness was not restricted to a certain segment but it prevails all across the demographic in our population.
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Affiliation(s)
- Shamaila Shamaun
- Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Riffat Jaleel
- Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan.,Dr Ruth KM Pfau Civil Hospital, Karachi, Pakistan
| | - Yasmeen Gull
- Meer Jam Ghulam Qadir Hospital Hub District, Lasbella Balochistan, Pakistan
| | - Afshan Shahid
- Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Mehreen Iqbal
- Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Tabinda Naseer Qazi
- Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
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Hu J, Whyke TW, Lopez-Mugica J. Investigating Media Coverage and Public Perceptions of the HPV Vaccine in China - A Content Analysis of Weibo Posts. SEXUALITY & CULTURE 2022; 27:363-388. [PMID: 36093363 PMCID: PMC9443650 DOI: 10.1007/s12119-022-10017-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The HPV vaccination has been widely advocated around the world since the vaccine is beneficial in avoiding diseases, including some sexually transmitted diseases, brought on by HPV infections. For most Chinese, the HPV vaccine is still a relatively new concept, having only been made available to the general public in 2016. Despite the vaccine's increased prominence, there is still a lack of investigation about how the public is influencing the conversation about HPV vaccines and the public's perception of this vaccine. With the theoretical construct of the Health Belief Model, this study conducts both quantitative and qualitative content analysis to investigate the existing media narratives around HPV vaccines in China and the changes in public opinion by looking at users' contributions on Weibo, one of China's most popular social networking sites. It was found that different groups of Weibo users had contributed to diverse narratives surrounding HPV vaccination. Though the public awareness of HPV vaccination had been improved along with increasingly active communication practices and enhanced public health services, public knowledge about HPV remains inadequate. Therefore, to facilitate the popularisation of HPV related knowledge, more effort should be invested in tailoring and disseminating messages that communicate responsive and comprehensive HPV related information.
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Affiliation(s)
- Junyi Hu
- The School of International Communications, The University of Nottingham Ningbo China, Ningbo, Zhejiang China
| | - Thomas William Whyke
- The School of International Communications, The University of Nottingham Ningbo China, Ningbo, Zhejiang China
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Braga LP, Szwarcwald CL, Damacena GN, de Souza-Júnior PRB, Dourado I, de Brito AM, Grangeiro A, Crosland Guimarães MD. Health vulnerabilities in female sex workers in Brazil, 2016. Medicine (Baltimore) 2022; 101:e30185. [PMID: 36107499 PMCID: PMC9439778 DOI: 10.1097/md.0000000000030185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Female sex workers (FSW) suffer stigma and discrimination that negatively impact their physical and mental health and affect access to health care services. This paper aims to describe selected health indicators among FSW in 12 Brazilian cities in 2016. Brazilian cross-sectional Biological Behavioral Surveillance Survey was conducted in 2016 among 4328 FSW recruited by respondent-driven sampling. The sample weighing was inversely proportional to participant's network sizes and the seeds were excluded from the analysis. Health indicators were estimated with 95% confidence interval and included indicators of health status, symptoms of depression, antenatal care, pap smear coverage, signs and symptoms of sexually transmitted infection, contraception and regular condom use, number of births and children alive per women, human immunodeficiency virus and syphilis testing, usual source of care, and perception of discrimination. Most participants self-rated their health as very good/good (65.8%) and 27.7% were positively screened for major depressive disorder episode on Patient Health Questionnaire-2. Antenatal coverage was 85.8% and 62.3% of FSW had access to pap smear exam in the past 3 years. A total of 67.0% of FSW were using some contraceptive method at the time of the study. Male condom was the most common method (37.1%), followed by oral pill (28.9%). A total of 22.5% FSW had never been tested for HIV and the main reasons were "not feeling at risk" (40.4%) and "being afraid or ashamed" (34.0%). The vast majority of FSW used Brazilian National Health System as their usual source of health care (90.2%). Approximately one-fifth of the participants felt discriminated against or were treated worse for being FSW (21.4%) and only 24.3% disclose their sex work status in health services. The vulnerability of FSW is expressed in all health indicators. Indicators of health status, antenatal care, pap smear coverage, and contraception were worse than in the Brazilian population, and point out to the importance of increase FSW's access to health care services. Also, stigma and discrimination emerged as an important barrier to FSW's health care in all dimensions and need to be struggled.
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Affiliation(s)
- Letícia Penna Braga
- Postgraduate Program in Epidemiology in Public Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- *Correspondence: Letícia Penna Braga, Postgraduate Program in Epidemiology in Public Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil (e-mail: )
| | - Célia Landmann Szwarcwald
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Giseli Nogueira Damacena
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Paulo Roberto Borges de Souza-Júnior
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Inês Dourado
- Collective Health Institute, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Ana Maria de Brito
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation IAM/Fiocruz, Recife, Pernambuco, Brazil
| | | | - Mark Drew Crosland Guimarães
- Department of Preventive and Social Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Arechkik A, Lahlou L, Obtel M, Kharbach A, Razine R. Cervical cancer in Morocco: A systematic review. Rev Epidemiol Sante Publique 2022; 70:230-242. [DOI: 10.1016/j.respe.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/13/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
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Knowledge, attitudes, and practices among Indonesian urban communities regarding HPV infection, cervical cancer, and HPV vaccination. PLoS One 2022; 17:e0266139. [PMID: 35552546 PMCID: PMC9098048 DOI: 10.1371/journal.pone.0266139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Few studies explored Indonesian understanding of cervical cancer (CC) and the human papillomavirus (HPV) vaccination. We aimed to investigate the association between knowledge, attitudes, and practices (KAP) and socio-demographical influences related to HPV, CC, and vaccination among Indonesian urban citizens. Methods We conducted an online survey during March 2020-August 2021 using the Snowball sampling technique. The socio-demographic characteristic and KAP responses were collected via Google Forms from 400 respondents in Jakarta. The knowledge and attitudes were divided into HPV and CC (aspect 1) and HPV vaccination (aspect 2). Correlation between KAP scores was performed using Spearman’s test, and multiple logistic regression analyses were conducted to determine KAP predictors. Results Indonesian urban citizens in Jakarta were found to have poor knowledge in individual aspects of the inquiry but moderate knowledge overall, good attitude in inquiry both in each aspect and overall, and unsatisfying practices. Overall, in the general population, men, and women respectively: 50.8%, 32.4%, and 53.6% had good knowledge; 82.0%, 75.2%, and 84.4% expressed positive attitude; and 30.3%, 15.2%, and 35.6% applied favorable practice regarding questions inquired. Knowledge was weakly correlated towards attitude (ρ = 0.385) but moderately correlated with practice (ρ = 0.485); attitude was moderately correlated with practice (ρ = 0.577), all results: p<0.001. Significant odds ratio (OR) for predictors to good knowledge were female sex (OR = 2.99), higher education (OR = 2.91), and higher mother’s education (OR = 2.15). Factors related to positive attitudes were higher mother’s education (OR = 4.13), younger age (OR = 1.86), and better results in the knowledge inquiries (OR = 2.96). Factors that suggested better practices were female sex (OR = 2.33), being employed (OR = 1.68), excellent knowledge scores (OR = 4.56), and positive attitudes expressions (OR = 8.05). Having done one vaccination dose and intention to receive vaccines were significantly influenced by good KAP. Conclusions KAP had inter-association to successful CC and HPV prevention programs, and socio-demographical characteristics are critical to influencing better KAP.
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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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Patel IS, Dongara AR, Mungala BM, Chapla A, Phatak AG, Nimbalkar SM. Knowledge and attitude about cervical cancer and human papillomavirus vaccine among medical and paramedical students of a university. J Family Med Prim Care 2021; 10:462-467. [PMID: 34017771 PMCID: PMC8132775 DOI: 10.4103/jfmpc.jfmpc_625_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/10/2020] [Accepted: 10/24/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Every year, globally 570,000 women are diagnosed with cervical cancer, out of which around 311,000 die. India contributes to about 132,000 new cases and 74,000 deaths yearly. One of the major risk factors for cervical cancer is infection with some types of human papillomavirus (HPV). This is both preventable (by vaccination) and detectable early (routine screening programs). OBJECTIVE The objective of this study is to assess the knowledge and attitude in medical and paramedical students about cervical cancer and HPV vaccination. MATERIAL AND METHODS A cross-sectional survey was conducted, using predesigned and validated questionnaire. It was segregated into three parts: Q1-demographic details, Q2a-questions assessing knowledge, Q2b-questions assessing attitude. Our target population was female students (18-25 years) studying in medical, nursing, and physiotherapy colleges. Descriptive statistics of data was analyzed using SPSS 16.0. RESULTS We had 73% response rate. Most participants belonged to upper middle and upper socioeconomic class, were pursuing MBBS, resided in villages, had educated parents, and had good health-care-seeking behavior. School education, television, and printed advertisements appeared to be underutilized. Around 50% of the participant had received chickenpox and typhoid vaccine, but only 8% had received HPV vaccine. The mean knowledge score was 5.19 ± 2.24, with 0.00 minimum and 11.0 maximum, out of a maximum possible score of 17. Only, place of residence appeared to effect the knowledge score. CONCLUSION The study shows the dismal knowledge levels about HPV amongst students. Participants were interested in seeking knowledge; consider HPV vaccination provided they were provided with sufficient knowledge.
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Affiliation(s)
- Ishani S. Patel
- Department of Pediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India
| | | | - Bhavdeep M. Mungala
- Department of Pediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Apurva Chapla
- Department of Pediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Ajay G. Phatak
- Central Research Services, Charutar Arogya Mandal, Karamsad, Gujarat, India
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Wang Q, Zhang W, Cai H, Cao Y. Understanding the perceptions of Chinese women of the commercially available domestic and imported HPV vaccine: A semantic network analysis. Vaccine 2020; 38:8334-8342. [PMID: 33190947 DOI: 10.1016/j.vaccine.2020.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/08/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND A domestic human papillomavirus (HPV) vaccine, Cecolin, that protects against HPV strains 16 and 18 was introduced to the Chinese market at a relatively low price in May 2020.This study has explored Chinese women's perceptions of both domestic and imported HPV vaccines, which differ in price and valency. METHODS Sentiment analysis and semantic network analyses were performed based on a sample of 45,729 domestic HPV vaccine-related posts from females on the Sina Weibo between April 17 and May 2, 2020. The geographic distribution was also analyzed based on the users' locations, which were retrieved from the database. RESULTS Most of the posts were positive and neutral (85%), although 15% were negative (e.g., expressions of anger, sadness, fear and disgust). Semantic analyses of the negative posts revealed that Chinese women generally had positive attitudes towards the HPV vaccine and were willing to be vaccinated. However, obvious geographical variations were identified. Women who lived in economically developed areas expressed a stronger desire to obtain imported quadrivalent or nonavalent vaccines due to concerns regarding effectiveness and quality. The women expressed disgust and anger mainly regarding difficulties in making an appointment, age restrictions for the nonavalent vaccine and gender restrictions. However, the population targeted by the domestic vaccine, namely women who lived in economically undeveloped areas and had relatively low incomes, had a low awareness of the HPV vaccine. CONCLUSION Government should provide programs, which educate females that bivalent HPV vaccine can offer protection against the majority of high-risk HPV types. Increasing awareness of the domestic vaccine among the population in economically undeveloped areas and provision of free domestic bivalent HPV vaccination/screening for low-income high-risk women would help to prevent cervical carcinoma. This issue also depends on rebuilding trust and repairing damage to the relationship between government/domestic vaccine manufacturers and the public.
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Affiliation(s)
- Qi Wang
- School of Industrial Design, Hubei University of Technology, 28 Nanli Road, Wuhan 430068, PR China
| | - Wen Zhang
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Wuhan 430073, PR China.
| | - Hongning Cai
- Department of Gynecological Oncology, Hubei Maternal and Child Health Care Hospital, Wuhan 430070, Hubei, PR China
| | - Yuan Cao
- Cloud-clone Diagnostic Reagents Institute, Wuhan 430056, Hubei, PR China
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Shu NE, Abiola AHO, Akodu BA, Bassey BA, Misago N. Knowledge, attitudes and preventive practices for human Papilloma virus infection among female sex workers in Lagos metropolis. Pan Afr Med J 2020; 36:278. [PMID: 33088407 PMCID: PMC7545971 DOI: 10.11604/pamj.2020.36.278.17912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 06/25/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction risky and hard-to-reach populations like female sex workers (FSW) face a huge burden with sexually transmitted infections (STIs) among which is human Papilloma virus (HPV) infection. This study was conducted to evaluate the knowledge, attitudes and preventive practices for HPV infection among FSW in Lagos, Nigeria. Methods a descriptive cross-sectional study was carried out among 403 respondents. The sampling units were FSW in brothels in two urban communities of Lagos. A multistage sampling technique was used for selection of respondents. Pre-tested, validated questionnaire was used for data collection. Responses to knowledge, attitude and practice questions were scored graded as poor (<50%) and good (≥50%). Bivariate analysis were carried out using Chi-square, Fisher exact test and student t-test. Logistic regression model was used for multivariate analysis. P-value < 0.05 was considered statistically significant. Results the mean age of the respondents was 32.97 ± 8.43. Majority of the respondents were within the age range of 18-34 years (51.61%), christians (51.12%), single (42.93%) and had secondary education (52.61%). Among the respondents 51.61% had good knowledge, 97.27% had good attitude and 62.28% had good preventive practice. FSW belonging to the age group 35-51 or 52-68 years, were more likely to have a good knowledge compared to those between 18-34 years. FSW with no formal education or living with a relative are less likely to have a good knowledge, compared to those having primary education or living alone. FSW with traditional or other religious beliefs are less likely to have good preventive practices against HPV compared to christian religious belief. Having tertiary education or married makes a FSW less likely, while being widowed makes her more likely to have good preventive practice. FSW living with friends are more likely to be exposed to good preventive practices compared to those living alone. Conclusion there is a need for regular health education program on HPV for FSW in order to increase their awareness and encourage best preventive practices against HPV.
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Affiliation(s)
- Nforbih Emile Shu
- Department of Community Health and Primary Care, University of Lagos, Lagos, Nigeria.,Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.,Batié Medical Health Centre, Batié, Western Region, Cameroon
| | - Abdul-Hakeem Olatunji Abiola
- Department of Community Health and Primary Care, University of Lagos, Lagos, Nigeria.,Lagos University Teaching Hospital, Lagos, Nigeria
| | - Babatunde Abdulmajeed Akodu
- Department of Community Health and Primary Care, University of Lagos, Lagos, Nigeria.,Lagos University Teaching Hospital, Lagos, Nigeria
| | - Benjamin Afahakan Bassey
- Department of Community Health and Primary Care, University of Lagos, Lagos, Nigeria.,University of Uyo Teaching Hospital, Uyo, Nigeria
| | - Nadine Misago
- Department of Community Health and Primary Care, University of Lagos, Lagos, Nigeria.,Faculty of Medicine, University of Burundi, Bujumbura, Burundi
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Le XTT, Nguyen PTN, Do TTT, Nguyen TH, Le HT, Nguyen CT, Ha GH, Hoang CL, Tran BX, Latkin CA, Ho RC, Ho CS. Intention to Pay for HPV Vaccination among Women of Childbearing Age in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093144. [PMID: 32365964 PMCID: PMC7246945 DOI: 10.3390/ijerph17093144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022]
Abstract
The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in an urban and a rural district (Dong Da and Ba Vi) of Hanoi, Vietnam. The vast percentage of our respondents expressed a firm intention to vaccinate, especially women in rural areas (over 90.0%). However, on being informed of the current price of the HPV vaccine, their intention to vaccinate dropped to about one-fifth of overall respondents, i.e., only 4.4% of women in rural areas. It was also observed that the initial intention to get the HPV vaccination among women in the rural district was about ten times higher than that of women living in the metropolitan district. Those participants who had greater knowledge of cervical cancer and HPV vaccinations also had a significantly higher intention to vaccinate. Our findings underscore the need to develop a well-designed vaccination program in Vietnam and other countries in a similar situation to increase the adoption of HPV vaccination.
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Affiliation(s)
- Xuan Thi Thanh Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Phuong Thi Ngoc Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Toan Thi Thanh Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Thang Huu Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
- Correspondence: ; Tel.: +84-86-9548-561
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (C.L.H.); (R.C.M.H.)
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Roger C.M. Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (C.L.H.); (R.C.M.H.)
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
| | - Cyrus S.H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
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Dönmez S, Öztürk R, Kısa S, Karaoz Weller B, Zeyneloğlu S. Knowledge and perception of female nursing students about human papillomavirus (HPV), cervical cancer, and attitudes toward HPV vaccination. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:410-417. [PMID: 29979917 DOI: 10.1080/07448481.2018.1484364] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/09/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
Objective: The researchers aimed to evaluate the knowledge and perceptions of first-year female nursing students about human papillomavirus (HPV), cervical cancer (CC), and HPV vaccination. Participants: The sample included 690 female nursing students from sampled universities between April and June 2015. Methods: Students were surveyed by using a pretested HPV and CC awareness questionnaire. Results: More than half of the students (65.1%) answered questions incorrectly with a mean HPV knowledge score of 6.085 ± 3.38. The majority of students (82.6%) did not hear HPV vaccine. Only, 2.8% of the students had been vaccinated. A statistically significant relationship was found between HPV knowledge score and hearing about HPV vaccine (U = 28280.500, p = .015), and believing HPV vaccine protectiveness (χ2 = 14.153, p = .001). Conclusions: This study highlights the lack of knowledge and low level of awareness about HPV, CC, and HPV vaccination among first-year nursing college students.
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Affiliation(s)
- Sevgül Dönmez
- a Department of Nursing , Gaziantep University, Faculty of Health Sciences , Gaziantep, Turkey
| | - Ruşen Öztürk
- b Ege University, Faculty of Nursing , İzmir , Turkey
| | - Sezer Kısa
- c Department of Nursing and Health Promotion , Oslo Metropolitan University, Faculty of Health Sciences , Oslo , Norway
| | - Banu Karaoz Weller
- d Department of Nursing , Izmir University, Faculty of Health Sciences , İzmir, Turkey
| | - Simge Zeyneloğlu
- a Department of Nursing , Gaziantep University, Faculty of Health Sciences , Gaziantep, Turkey
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Yuanyue L, Baloch Z, Shanshan L, Yasmeen N, Xiaomei W, Khan JM, Xueshan X. Cervical Cancer, Human Papillomavirus Infection, and Vaccine-Related Knowledge: Awareness in Chinese Women. Cancer Control 2019; 25:1073274818799306. [PMID: 30213198 PMCID: PMC6144517 DOI: 10.1177/1073274818799306] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cervical cancer (CC) has a high incidence and mortality and is accompanied by lack of organized CC screening programs, lack of health-care facilities, and a lack of human papillomavirus (HPV) vaccination among female population in the world, particularly China. We recruited 487 females who visited the outpatient department of the First People’s Hospital of Yunnan Province from November 2015 to January 2016 to complete a standardized-designed questionnaire. We found that only 39.6% of the females knew about the role of HPVs in the development of cervical cancer. Moreover, none of the females knew that HPV could cause penile carcinomas, perianal carcinomas, and head and neck carcinomas. The majority of the participants acquired information about cervical cancer, HPV, and the HPV vaccine from medical workers. Only 15.6% of the recruited females had heard about the HPV vaccine. The overall HPV vaccine acceptance rate was higher (91.2%) if the vaccine was available free of cost. In this study, we found high acceptability of the HPV vaccine in Chinese women and high awareness about cervical cancer. However, very low levels of knowledge about HPVs and their role in cancer development among the recruited women is alarming. Therefore, it is very important to initiate educational programs to raise awareness and knowledge about cervical cancer, HPV, and the HPV vaccine in this region.
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Affiliation(s)
- Li Yuanyue
- 1 Faculty of Environmental Science and Engineering and Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, People's Republic of China.,Li YuanYue and Li Shanshan contributed equally
| | - Zulqarnain Baloch
- 2 College of Veterinary Medicine, South China Agricultural University, Guangzhou, People's Republic of China
| | - Li Shanshan
- 3 School of Humanities and Law, South China Agricultural University, Guangzhou, People's Republic of China.,Li YuanYue and Li Shanshan contributed equally
| | - Nafeesa Yasmeen
- 4 Faculty of Veterinary Medicine, Agriculture University, Faisalabad, Pakistan
| | - Wu Xiaomei
- 5 Department of Gynecology, the First People's Hospital of Yunnan Province. Kunming, People's Republic of China
| | - Jamal Muhammad Khan
- 6 Department of Path-Biology, Collage of Animal Sciences, The Islamia University of Bahawalpur, Pakistan
| | - Xia Xueshan
- 1 Faculty of Environmental Science and Engineering and Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, People's Republic of China
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Immunomics Datasets and Tools: To Identify Potential Epitope Segments for Designing Chimeric Vaccine Candidate to Cervix Papilloma. DATA 2019. [DOI: 10.3390/data4010031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Immunomics tools and databases play an important role in the designing of prophylactic or therapeutic vaccines against pathogenic bacteria and viruses. Therefore, we aimed to illustrate the different immunological databases and web servers used to design a chimeric vaccine candidate against human cervix papilloma. Initially, cellular immunity inducing major histocompatibility complex class I and II epitopes from L2 protein of papilloma 58 strain were predicted using the IEDB, NetMHC, and Tepi tools. Then, the overlapped segments from the above analysis were used to calculate efficiency on interferon-gamma and humoral immunity production. In addition, the allergenicity, antigenicity, cross-reactivity with human proteomes, and epitope conservancy of elite segments were determined. The chimeric vaccine candidate (SGD58) was constructed with two different overlapped peptide segments (23–36) and (29–42), adjuvants (flagellin and RS09), two Th epitopes, and amino acid linkers. The results of homology modeling demonstrated that SGD58 have 88.6% of favored regions based on Ramachandran plot. Protein–protein docking with Swarm Dock reveals SGD58 with receptor complex have −54.74 kcal/mol of binding energy with more than 20 interacting residues. Docked complex are stable in 100ns of molecular dynamic simulation. Further, coding sequences of SGD58 also show elevated gene expression in E. coli. In conclusion, SGD58 may prompt vaccine against cervix papilloma. This study provides insight of vaccine design against different pathogenic microbes as well.
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Kaliamurthi S, Selvaraj G, Chinnasamy S, Wang Q, Nangraj AS, Cho WC, Gu K, Wei DQ. Exploring the Papillomaviral Proteome to Identify Potential Candidates for a Chimeric Vaccine against Cervix Papilloma Using Immunomics and Computational Structural Vaccinology. Viruses 2019; 11:E63. [PMID: 30650527 PMCID: PMC6357041 DOI: 10.3390/v11010063] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/03/2019] [Accepted: 01/10/2019] [Indexed: 02/06/2023] Open
Abstract
The human papillomavirus (HPV) 58 is considered to be the second most predominant genotype in cervical cancer incidents in China. HPV type-restriction, non-targeted delivery, and the highcost of existing vaccines necessitate continuing research on the HPV vaccine. We aimed to explore the papillomaviral proteome in order to identify potential candidates for a chimeric vaccine against cervix papilloma using computational immunology and structural vaccinology approaches. Two overlapped epitope segments (23⁻36) and (29⁻42) from the N-terminal region of the HPV58 minor capsid protein L2 are selected as capable of inducing both cellular and humoral immunity. In total, 318 amino acid lengths of the vaccine construct SGD58 contain adjuvants (Flagellin and RS09), two Th epitopes, and linkers. SGD58 is a stable protein that is soluble, antigenic, and non-allergenic. Homology modeling and the structural refinement of the best models of SGD58 and TLR5 found 96.8% and 93.9% favored regions in Rampage, respectively. The docking results demonstrated a HADDOCK score of -62.5 ± 7.6, the binding energy (-30 kcal/mol) and 44 interacting amino acid residues between SGD58-TLR5 complex. The docked complex are stable in 100 ns of simulation. The coding sequences of SGD58 also show elevated gene expression in Escherichia coli with 1.0 codon adaptation index and 59.92% glycine-cysteine content. We conclude that SGD58 may prompt the creation a vaccine against cervix papilloma.
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Affiliation(s)
- Satyavani Kaliamurthi
- Center of Interdisciplinary Science-Computational Life Sciences, College of Food Science and Engineering, Henan University of Technology, Zhengzhou 450001, China.
- College of Chemistry, Chemical Engineering and Environment, Henan University of Technology, Zhengzhou 450001, China.
| | - Gurudeeban Selvaraj
- Center of Interdisciplinary Science-Computational Life Sciences, College of Food Science and Engineering, Henan University of Technology, Zhengzhou 450001, China.
- College of Chemistry, Chemical Engineering and Environment, Henan University of Technology, Zhengzhou 450001, China.
| | - Sathishkumar Chinnasamy
- The State Key Laboratory of Microbial Metabolism, College of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Qiankun Wang
- The State Key Laboratory of Microbial Metabolism, College of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Asma Sindhoo Nangraj
- The State Key Laboratory of Microbial Metabolism, College of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - William Cs Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong.
| | - Keren Gu
- Center of Interdisciplinary Science-Computational Life Sciences, College of Food Science and Engineering, Henan University of Technology, Zhengzhou 450001, China.
- College of Chemistry, Chemical Engineering and Environment, Henan University of Technology, Zhengzhou 450001, China.
| | - Dong-Qing Wei
- Center of Interdisciplinary Science-Computational Life Sciences, College of Food Science and Engineering, Henan University of Technology, Zhengzhou 450001, China.
- The State Key Laboratory of Microbial Metabolism, College of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China.
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Jradi H, Bawazir A. Knowledge, attitudes, and practices among Saudi women regarding cervical cancer, human papillomavirus (HPV) and corresponding vaccine. Vaccine 2018; 37:530-537. [PMID: 30503079 DOI: 10.1016/j.vaccine.2018.11.065] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/13/2018] [Accepted: 11/16/2018] [Indexed: 10/27/2022]
Abstract
AIM To our knowledge there are no studies exploring Saudi women's understanding of the importance of the human papillomavirus (HPV) vaccine. In the present study, we examined the awareness of HPV and women's attitudes toward the HPV vaccine. METHOD Nine focus groups were formed in Riyadh City, Saudi Arabia, including 77 women between the ages of 18 and 45 years old. Face-to-face interviews were conducted in 58 female healthcare providers to examine women's awareness of cervical cancer, HPV, barriers, acceptance, beliefs, and attitudes towards the HPV vaccine. RESULTS Focus group discussions revealed a lack of knowledge and awareness of cervical cancer, HPV, and the HPV vaccine. Cultural concerns regarding screening and vaccinating for a conventionally known sexually transmitted infection were an emerging theme in addition to not perceiving cervical cancer screening as necessary because women with no signs and symptoms considered themselves not at risk for developing cervical cancer. Approximately 30% of healthcare providers other than physicians were unaware of prevention methods, and 63.3% did not practice any screening methods for cervical cancer and attributed the lack of screening to "no specific reasons at all". CONCLUSION Because of the unfavorable knowledge and attitude of HPV infection and the associated vaccine from the women in the present study, emphasis should be directed to educate and promote awareness of women to the risk factors of cervical cancer and to the need for screening programs and the administration of the vaccine.
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Affiliation(s)
- Hoda Jradi
- Public and Environmental Health, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Amen Bawazir
- Public and Environmental Health, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia.
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Determinants of Human Papillomavirus Vaccination Intention Among Female Sex Workers in Amsterdam, the Netherlands. Sex Transm Dis 2018; 44:756-762. [PMID: 28876303 DOI: 10.1097/olq.0000000000000676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Female sex workers (FSWs) are at risk for human papillomavirus (HPV)-induced diseases but are currently not targeted by the HPV vaccination program in the Netherlands. We explored determinants of their intention to get vaccinated against HPV in case vaccination would be offered to them. METHODS In 2016, FSWs 18 years and older having a sexually transmitted infection consultation with the Prostitution & Health Center (P&G292) in Amsterdam, either at the clinic or at their working location, were invited to complete a questionnaire assessing sociopsychological determinants of HPV vaccination intention (scale ranging from -3 to +3). Determinants of HPV vaccination intention were assessed with univariable and multivariable linear regression. In addition, we explored the effect of out-of-pocket payment on intention. RESULTS Between May and September 2016, 294 FSWs participated. The median age was 29 years (interquartile range, 25-37 years). Human papillomavirus vaccination intention was high (mean, 2.0; 95% confidence interval [CI], 1.8-2.2). In multivariable analysis, attitude (β = 0.6; 95% CI, 0.5-0.7), descriptive norm (β = 0.2; 95% CI, 0.1-0.3), self-efficacy (β = 0.2; 95% CI, 0.1-0.3), beliefs (β = 0.1; 95% CI, 0.0-0.2), and subjective norm (β = 0.1; 95% CI, 0.0-0.2) seemed to be the strongest predictors of HPV vaccination intention (R = 0.54). Human papillomavirus vaccination intention decreased significantly to a mean of 0.2 when vaccination would require out-of-pocket payment of &OV0556;350. CONCLUSIONS The HPV vaccination intention among FSWs seems relatively high and is most strongly constituted in attitudinal, normative, and self-efficacy beliefs. Out-of-pocket payment will probably have a negative impact on their HPV vaccination acceptability.
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Xiang F, Guan Q, Liu X, Xiao H, Xia Q, Liu X, Sun H, Song X, Zhong Y, Yuan CH, Xiang Y. Distribution characteristics of different human papillomavirus genotypes in women in Wuhan, China. J Clin Lab Anal 2018; 32:e22581. [PMID: 29862560 PMCID: PMC6220820 DOI: 10.1002/jcla.22581] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 05/08/2018] [Indexed: 01/07/2023] Open
Abstract
Background Human papillomaviruses (HPVs) are strongly associated with the development of cervical carcinoma, and the distribution of HPV genotypes varies regionally. Methods To investigate the distribution characteristics of different genotypes of HPV infection in women in Wuhan, China, a total of 13 775 patients were enrolled over 2 years. Results Of these, 2436 patients were infected with HPVs, and the total infection rate was 17.68%. The infection rate of high‐risk HPV (HR‐HPV) was significantly higher (13.96%) than that of single low‐risk HPV (LR‐HPV; 3.72%). Among the HR‐HPV infections, the most common genotype was HPV 52 with an infection rate of 4.23%, followed by HPVs 16, 58, 39, and 51. The most common LR‐HPV genotype was HPV 81, followed by HPVs 6, 11, and 44. Patients under the age of 25 years were found to have the highest HPV infection rate (P < .05). After the age range of 51‐55 years, a downward trend in total HPVs and HR‐HPVs was observed. The HPV infection rate for a single genotype was higher than that for multiple HPVs (P < .01), and the detection rates in summer and winter were significantly higher than those in spring and autumn. Conclusions The results demonstrate that the distribution characteristics of various HPV genotype infections are associated with region and age and may be related to season. These data could be the basis for further epidemiological analysis into the control and prevention of HPV infection in this region.
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Affiliation(s)
- Feiyan Xiang
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Guan
- Department of Laboratory Medicine, Xiangyang Central Hospital, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Xinwen Liu
- Department of Nursing, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Han Xiao
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Xia
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Xiuzhen Liu
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Sun
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojie Song
- Department of Gynecology and Obstetrics, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Zhong
- Department of Gynecology and Obstetrics, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Chun-Hui Yuan
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Xiang
- Department of Laboratory Medicine, Wuhan Medical and Health Center for Women and Children, Huazhong University of Science and Technology, Wuhan, China.,The State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
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Szwarcwald CL, de Almeida WDS, Damacena GN, de Souza-Júnior PRB, Ferreira-Júnior ODC, Guimarães MDC. Changes in attitudes, risky practices, and HIV and syphilis prevalence among female sex workers in Brazil from 2009 to 2016. Medicine (Baltimore) 2018; 97:S46-S53. [PMID: 29893747 PMCID: PMC5991537 DOI: 10.1097/md.0000000000009227] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The present study aims at investigating the progress made toward controlling the human immunodeficiency virus (HIV)/AIDS epidemic among female sex workers (FSW) from 2009 to 2016. METHODS The baseline of respondent-driven sampling (RDS) study among FSW was carried out in 2009, in 10 Brazilian municipalities. In 2016, information on FSW were collected in 12 municipalities. The analyses took into account the dependence among observations, resulting from the recruitment chains, and the unequal probabilities of selection, resulting from the different network sizes. We analyzed changes in attitudes and risky behavior practices as well as variations in HIV and syphilis prevalence based on the comparison of 95% confidence intervals for each estimate. RESULTS Information on 2523 (2009) and 4245 (2016) FSW were analyzed. Commercial sex debut shifted to younger ages: while in 2009 the proportion of women who started sex work under 18 years old was 28.3%, in 2016 this percentage rose to 38.3%. The proportion of FSW affiliated to a nongovernmental organization (NGO) in defense of their rights (14.0%), in 2009, decreased to 7.8%, in 2016, as well as the proportion of FSW who received counseling on sexually transmitted infections (STI) in the past 6 months, from 47.5% to 24.4%. Relevant improvements were found for HIV testing in the last 12 months (from 20.3% to 39.3%). The proportions of those who were never tested for syphilis dropped from 57.9% to 48.5%. However, an opposite decreasing trend was found for the Pap smear examination in the last 12 months, decreasing from 43.6% to 31.5%. Regular condom use with clients significantly increased in the period. Regarding HIV prevalence, the 5% level was sustained and no significant differences were found, but syphilis prevalence was found to be more than 3 times higher in 2016 (8.5%) than in 2009 (2.4%). DISCUSSION Many are the challenges to be faced in attempting to reverse the upward trend of syphilis among FSW in Brazil. Despite the progress in condom distribution free of charge, it is necessary to increase awareness campaigns, emphasize the use, reaffirm STI counseling, and reiterate the need of regular syphilis screening in this key population group.
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Affiliation(s)
- Célia Landmann Szwarcwald
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation
| | - Wanessa da Silva de Almeida
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation
| | - Giseli Nogueira Damacena
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation
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Shiferaw S, Addissie A, Gizaw M, Hirpa S, Ayele W, Getachew S, Kantelhardt EJ, Assefa M, Jemal A. Knowledge about cervical cancer and barriers toward cervical cancer screening among HIV-positive women attending public health centers in Addis Ababa city, Ethiopia. Cancer Med 2018; 7:903-912. [PMID: 29441700 PMCID: PMC5852347 DOI: 10.1002/cam4.1334] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 12/09/2017] [Accepted: 12/15/2017] [Indexed: 12/21/2022] Open
Abstract
Screening rate for cervical cancer among HIV‐infected women and among women overall is low in Ethiopia despite the high burden of the disease and HIV infection, which increases cervical cancer risk. In this paper, we assessed knowledge about cervical cancer symptoms, prevention, early detection, and treatment and barriers to screening among HIV‐positive women attending community health centers for HIV‐infection management in Addis Ababa. A cross‐sectional survey of 581 HIV‐positive women aged 21–64 years old attending 14 randomly selected community health centers without cervical cancer screening service in Addis Ababa. We used univariate analysis to calculate summary statistics for each variable considered in the analysis, binary logistic regression analysis to measure the degree of association between dependent and independent variables, and multiple regressions for covariate adjusted associations. Statistical significance for all tests was set at P < 0.05. We used thematic analysis to describe the qualitative data. Of the 581 women enrolled in the study with mean age 34.9 ± 7.7 years, 57.8% of participants had heard of cervical cancer and 23.4% were knowledgeable about the symptoms, prevention, early detection, and treatment of the disease. In multivariate analysis, higher educational attainment and employment were significantly associated with good knowledge about cervical cancer. In addition, only 10.8% of the participants ever had screening and 17% ever received recommendation for it. However, 86.2% of them were willing to be screened if free of cost. Knowledge about cervical cancer is poor and cervical cancer screening rate and provider recommendation are low among HIV‐positive women attending community health centers for management and follow‐up of their disease in Addis Ababa. These findings underscore the need to scale up health education about cervical cancer prevention and early detection among HIV‐positive women as well as among primary healthcare providers in the city.
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Affiliation(s)
| | - Adamu Addissie
- College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Muluken Gizaw
- College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Selamawit Hirpa
- College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondimu Ayele
- College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sefonias Getachew
- College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva J Kantelhardt
- Department of Gynecology, Institute of Clinical Epidemiology, Martin Luther University, Halle and der Saale, Germany
| | - Mathewos Assefa
- Radiotherapy Center, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Santhanes D, Wong CP, Yap YY, San SP, Chaiyakunapruk N, Khan TM. Factors involved in human papillomavirus (HPV) vaccine hesitancy among women in the South-East Asian Region (SEAR) and Western Pacific Region (WPR): A scoping review. Hum Vaccin Immunother 2018; 14:124-133. [PMID: 28933635 PMCID: PMC5791566 DOI: 10.1080/21645515.2017.1381811] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/19/2017] [Accepted: 09/15/2017] [Indexed: 01/23/2023] Open
Abstract
A scoping review was performed to identify factors that may lead to human papillomavirus (HPV) vaccine hesitancy among women in low- and middle-income countries in South East Asian Region (SEAR) and Western Pacific Region (WPR). A systematic search of English and non-English articles using Pubmed, EMBASE, PsycINFO, Cochrane, MEDLINE, and CINAHL plus was conducted. Only 63 studies conducted in SEAR and WPR were included from inception until December 2016. Results of these studies have shown that poor awareness and knowledge of practices on cervical cancer prevention was evident in both SEAR and WPR. Concerns on safety and efficacy of the vaccine, and costs in getting vaccinated were significant barriers. Most women stated that they needed more information, and strongly welcomed a physician's recommendation in both geographical regions. Women also felt they have a low risk of acquiring HPV infection and cervical cancer. Most women in SEAR and WPR were unable to decide on whether to accept HPV vaccination.
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Affiliation(s)
- Diviya Santhanes
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Che Pui Wong
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Yan Ye Yap
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Saw Pui San
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
- School of Pharmacy, University of Wisconsin, Madison, WI, USA
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Tahir Mehmood Khan
- School of Pharmacy, Department of Pharmacy Practice, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- College of Pharmacy, Department of Pharmacy, Abasyn University, Peshawar, Pakistan
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23
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Xu S, Tang YY, Yu YX, Yun Q, Yang JP, Zhang H, Peng Q, Sun X, Yang LL, Fu S, Wu JB. Novel composite drug delivery system as a novel radio sensitizer for the local treatment of cervical carcinoma. Drug Deliv 2017; 24:1139-1147. [PMID: 28797171 PMCID: PMC8241059 DOI: 10.1080/10717544.2017.1362676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 07/28/2017] [Accepted: 07/29/2017] [Indexed: 01/07/2023] Open
Abstract
In this study, we investigated in vivo radiosensitizing effects of a gel-based dual drug delivery system (DDS) (PECE/DDP + mPEG-PCL/PTX, or PDMP) in a cervical cancer model, and determined its possible mechanisms of action. A xenograft cervical cancer model was used to investigate the radio sensitization effect of PDMP. Mice underwent paclitaxel (PTX) + cisplatin (DDP), PECE, or PDMP treatment followed by single radiation doses ranging from 0 Gy to 20 Gy. Radio sensitization was analyzed by tumor regrowth delay (TGD). The sensitization enhancement ratio (SER) was calculated by the doses needed to yield TGD when using radiation treatment alone and when using radiation plus drug treatment. The impact of irradiation and drugs on TGD was determined, and an optimum radiation dose was chosen for further evaluation of radio sensitizing effects. The data showed that PDMP yielded the highest radio sensitization (SER was 1.3) and a radiation dose of 12 Gy was chosen for further investigation. PDMP + radiotherapy treatment was most effective in inhibiting tumor growth, prolonging survival time, decreasing expression of CD31, CD133, and aldehyde dehydrogenase 1 (ALDH1), inducing G2/M phase arrest, apoptosis, and expression of Ataxia telangiectasia mutated (ATM) and histone H2AX phosphorylation (γ-H2AX). Thus, our data indicated that PDMP is a promising anti-tumor and radio sensitization reagent for the treatment of cervical carcinoma.
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Affiliation(s)
- Shan Xu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
- Department of Oncology, MianYang Central Hospital, Mianyang, Sichuan Province, China
| | - Yu Ying Tang
- MianYang Central Hospital, Mianyang, Sichuan Province, China
| | - Yan Xin Yu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Qin Yun
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Jing Pin Yang
- Department of Oncology, The First People's Hospital of Guangyuan, Guangyuan, Sichuan Province, China
| | - Heng Zhang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Qiuxia Peng
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Xiaoyang Sun
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Ling Lin Yang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - ShaoZhi Fu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Jing Bo Wu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
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24
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Liu T, Li S, Ratcliffe J, Chen G. Assessing Knowledge and Attitudes towards Cervical Cancer Screening among Rural Women in Eastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14090967. [PMID: 28846616 PMCID: PMC5615504 DOI: 10.3390/ijerph14090967] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 08/23/2017] [Accepted: 08/23/2017] [Indexed: 02/08/2023]
Abstract
There is a heavy burden of cervical cancer in China. Although the Chinese government provides free cervical cancer screening for rural women aged 35 to 59 years, the screening rate remains low even in the more developed regions of eastern China. This study aimed to assess knowledge and attitudes about cervical cancer and its screening among rural women aged 30 to 65 years in eastern China. A cross-sectional study was conducted in four counties of Jining Prefecture in Shandong Province during August 2015. In total, 420 rural women were randomly recruited. Each woman participated in a face-to-face interview in which a questionnaire was administered by a trained interviewer. A total of 405 rural women (mean age 49 years old) were included in the final study. Among them, 210 (51.9%) participants had high knowledge levels. An overwhelming majority, 389 (96.0%) expressed positive attitudes, whilst only 258 (63.7%) had undergone screening for cervical cancer. Related knowledge was higher amongst the screened group relative to the unscreened group. Age, education and income were significantly associated with a higher knowledge level. Education was the only significant factor associated with a positive attitude. In addition, women who were older, or who had received a formal education were more likely to participate in cervical cancer screening. The knowledge of cervical cancer among rural women in eastern China was found to be poor, and the screening uptake was not high albeit a free cervical cancer screening program was provided. Government led initiatives to improve public awareness, knowledge, and participation in cervical cancer screening programs would likely be highly beneficial in reducing cervical cancer incidence and mortality for rural women.
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Affiliation(s)
- Tongtong Liu
- School of Health Care Management, Shandong University, Jinan 250012, China.
- Key Laboratory of Health Economics and Policy Research, NHFPC (Shandong University), Jinan 250012, China.
| | - Shunping Li
- School of Health Care Management, Shandong University, Jinan 250012, China.
- Key Laboratory of Health Economics and Policy Research, NHFPC (Shandong University), Jinan 250012, China.
| | - Julie Ratcliffe
- Institute for Choice, Business School, University of South Australia, Adelaide 5000, Australia.
| | - Gang Chen
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia.
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25
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Ashtarian H, Mirzabeigi E, Mahmoodi E, Khezeli M. Knowledge about Cervical Cancer and Pap Smear and the Factors Influencing the Pap test Screening among Women. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2017; 5:188-195. [PMID: 28409172 PMCID: PMC5385241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although the Pap smear is known as one of the effective methods to detect the cervical cancer, a large group of women are reluctant to do the test because of various reasons. Therefore, we carried out this study to determine the level of knowledge about cervical cancer and Pap smear and the factors influencing the Pap test screening among women. METHODS In this cross-sectional study, 355 women referred to the health centers of Gilan-e gharb city were randomly recruited in 2015. The participants asked to complete a self-administered questionnaire including five parts (questions about: demographic factors, knowledge about cervical cancer and Pap smear, Pap smear performance, barriers and facilitators related to Pap smear and the sources of information). Data were analyzed through SPSS version 19, using descriptive statistics, Independent T-test, and logistic regression. RESULTS The mean age of the participants was 34.08±7.81 years. Almost 50.4% of the subjects had a history of Pap smear test. Pap test performance was significantly higher in those who had higher knowledge (P<0.001). Knowledge about cervical cancer, Pap smear and age was the most important predictors of the Pap test performance (P<0.001). The most important barrier and facilitator to Pap smear test were inadequate knowledge and the recommendations received from family, friends and healthcare professionals (44.3% and 40.2%, respectively). CONCLUSION Knowledge about Pap smear and cervical cancer was important in predicting Pap test doing. In addition, inadequate knowledge was introduced as the most important barrier to screening test from the perspective of women. Therefore, we suggest that health education and health promotion studies as interdisciplinary and targeted interventions should be implemented to improve the women's knowledge.
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Affiliation(s)
- Hossein Ashtarian
- Department of Health Education, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran;
| | - Elaheh Mirzabeigi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elham Mahmoodi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Khezeli
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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26
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Lafort Y, Greener R, Roy A, Greener L, Ombidi W, Lessitala F, Skordis-Worrall J, Beksinska M, Gichangi P, Reza-Paul S, Smit JA, Chersich M, Delva W. Sexual and reproductive health services utilization by female sex workers is context-specific: results from a cross-sectional survey in India, Kenya, Mozambique and South Africa. Reprod Health 2017; 14:13. [PMID: 28103896 PMCID: PMC5247811 DOI: 10.1186/s12978-017-0277-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 01/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Female sex workers (FSWs) are extremely vulnerable to adverse sexual and reproductive health (SRH) outcomes. To mitigate these risks, they require access to services covering not only HIV prevention but also contraception, cervical cancer screening and sexual violence. To develop context-specific intervention packages to improve uptake, we identified gaps in service utilization in four different cities. METHODS A cross-sectional survey was conducted, as part of the baseline assessment of an implementation research project. FWSs were recruited in Durban, South Africa (n = 400), Mombasa, Kenya (n = 400), Mysore, India (n = 458) and Tete, Mozambique (n = 308), using respondent-driven sampling (RDS) and starting with 8-16 'seeds' identified by the peer educators. FSWs responded to a standardised interviewer-administered questionnaire about the use of contraceptive methods and services for cervical cancer screening, sexual violence and unwanted pregnancies. RDS-adjusted proportions and surrounding 95% confidence intervals were estimated by non-parametric bootstrapping, and compared across cities using post-hoc pairwise comparison tests with Dunn-Šidák correction. RESULTS Current use of any modern contraception ranged from 86.2% in Tete to 98.4% in Mombasa (p = 0.001), while non-barrier contraception (hormonal, IUD or sterilisation) varied from 33.4% in Durban to 85.1% in Mysore (p < 0.001). Ever having used emergency contraception ranged from 2.4% in Mysore to 38.1% in Mombasa (p < 0.001), ever having been screened for cervical cancer from 0.0% in Tete to 29.0% in Durban (p < 0.001), and having gone to a health facility for a termination of an unwanted pregnancy from 15.0% in Durban to 93.7% in Mysore (p < 0.001). Having sought medical care after forced sex varied from 34.4% in Mombasa to 51.9% in Mysore (p = 0.860). Many of the differences between cities remained statistically significant after adjusting for variations in FSWs' sociodemographic characteristics. CONCLUSION The use of SRH commodities and services by FSWs is often low and is highly context-specific. Reasons for variation across cities need to be further explored. The differences are unlikely caused by differences in socio-demographic characteristics and more probably stem from differences in the availability and accessibility of SRH services. Intervention packages to improve use of contraceptives and SRH services should be tailored to the particular gaps in each city.
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Affiliation(s)
- Yves Lafort
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium.
| | - Ross Greener
- MatCH Research Unit (Maternal, Adolescent and Child Health Research Unit), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | | | - Letitia Greener
- MatCH Research Unit (Maternal, Adolescent and Child Health Research Unit), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Wilkister Ombidi
- International Centre for Reproductive Health-Kenya, Mombasa, Kenya
| | - Faustino Lessitala
- International Centre for Reproductive Health-Mozambique, Maputo, Mozambique
| | | | - Mags Beksinska
- MatCH Research Unit (Maternal, Adolescent and Child Health Research Unit), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Peter Gichangi
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium.,International Centre for Reproductive Health-Kenya, Mombasa, Kenya.,University of Nairobi, Nairobi, Kenya
| | | | - Jenni A Smit
- MatCH Research Unit (Maternal, Adolescent and Child Health Research Unit), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Matthew Chersich
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium.,Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Wim Delva
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium.,The South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch, Stellenbosch, South Africa.,Center for Statistics, Hasselt University, Diepenbeek, Belgium
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27
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Jun SY, Kim SI, Lim MC, Lee JY, Lee SH, Song YJ, Chun KC, Kim JW, Park SY. Knowledge of HPV and Surgery among Women Who Underwent Cervical Conization: A Korean Multi-Center Study. Yonsei Med J 2016; 57:1222-9. [PMID: 27401655 PMCID: PMC4960390 DOI: 10.3349/ymj.2016.57.5.1222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 01/27/2016] [Accepted: 02/17/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Human papillomavirus (HPV) infection is a well-known cause of cervical cancer, which, along with its precursors, can be diagnosed and treated with cervical conization (CC). This study aimed to assess HPV- and procedure-related knowledge among women who had undergone CC. MATERIALS AND METHODS Between February and May 2014, consecutive women who had undergone CC at five different educational hospitals were recruited. All patients had undergone a loop electrosurgical excision procedure as the method of CC. A survey was conducted with a self-developed, 29-item questionnaire, measuring knowledge related to HPV and CC. We analyzed the responses of 160 patients who completed the questionnaire. RESULTS Mean total knowledge scores (±standard deviation) for HPV and CC were 5.2±3.0 of a possible 13.0 and 8.3±4.2 of a possible 16.0, respectively. While 73% of the patients knew that HPV is the main cause of cervical cancer, only 44% knew that HPV is sexually transmitted. The purpose of CC was correctly identified by 71% of the patients. However, 35% failed to indicate the anatomical area resected at the time of CC in the schematic diagram. Women who were younger (p<0.001), had higher education level (p<0.001), and higher family income (p=0.008) had higher knowledge scores. In contrast, neither interval from CC to survey nor disease severity were associated with total knowledge score. CONCLUSION The level of knowledge related to HPV and CC was unexpectedly low in women who had undergone CC. Intuitive educational resources may improve this knowledge, and further cohort studies are warranted.
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Affiliation(s)
- So Yeun Jun
- Center for Uterine Cancer and Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Se Ik Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Myong Cheol Lim
- Center for Uterine Cancer and Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
| | - Jung Yun Lee
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - San Hui Lee
- Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Yong Jung Song
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kyoung Chul Chun
- Department of Obstetrics and Gynecology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Jae Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Yoon Park
- Center for Uterine Cancer and Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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28
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Doshi D, Reddy BS, Karunakar P, Deshpande K. HPV, Cervical Cancer and Pap Test Related Knowledge Among a Sample of Female Dental Students in India. Asian Pac J Cancer Prev 2016. [PMID: 26225687 DOI: 10.7314/apjcp.2015.16.13.5415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study was designed to ascertain knowledge about HPV, cervical cancer (CC) and the Pap test among female dental students of Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. MATERIALS AND METHODS A self-administered questionnaire covering demographic details, knowledge relating to human papilloma virus (HPV) (8 items), cervical cancer (4 items) and the Pap smear (6 items) was employed. Responses were coded as "True, False and Don't Know". Mean and standard deviation (SD) for correct answers and levels of knowledge were determined. RESULTS Based on the year of study, significant differences in knowledge of HPV were noted for questions on symptoms (p=0.01); transmission from asymptomatic partners (p=0.002); treatment with antibiotics (p=0.002); start of sexual activity (p=0.004); and recommended age for HPV vaccination (p=0.01). For knowledge regarding CC, significance was observed for the age group being affected (p=0.008) and symptoms of the disease in early stages (p=0.001). Indications for Pap smear tests like symptoms' of vaginal discharge (p=0.002), marital status (p=0.01) and women with children (p=0.02) had significant difference based on the year of study. Based on religion, transmission of HPV via pregnancy, HPV related diseases except CC and preventive measures except condom use and oral contraceptives showed significant differences. However, significant variation with religion was observed only for two preventive measures of CC (Pap test; p=0.004) and HPV vaccination (p=0.003). Likewise, only the frequency of Pap test showed a significant difference for religion (p=0.001). CONCLUSIONS This study emphasizes the lack of awareness with regard to HPV, CC and screening with pap smear even among health professionals. Hence, regular health campaigns are essential to reduce the disease burden.
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Affiliation(s)
- Dolar Doshi
- Public Health Dentistry, Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India E-mail :
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29
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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: 69] [Impact Index Per Article: 8.6] [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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30
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Su S, Chow EPF, Muessig KE, Yuan L, Tucker JD, Zhang X, Ren J, Fairley CK, Jing J, Zhang L. Sustained high prevalence of viral hepatitis and sexually transmissible infections among female sex workers in China: a systematic review and meta-analysis. BMC Infect Dis 2016; 16:2. [PMID: 26732281 PMCID: PMC4702370 DOI: 10.1186/s12879-015-1322-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 12/12/2015] [Indexed: 02/06/2023] Open
Abstract
Background The 1980’s economic boom has been associated with a rapid expansion of China’s sex industry over the past three decades. Consequently, the spread of sexually transmitted infections (STIs) and hepatitis infections among female sex workers (FSW) has become an important public health issue in China. This study identifies prevalence and risks of hepatitis and STIs in Chinese FSWs. Method Four electronic databases were searched for Chinese and English language peer-reviewed studies conducted between 01/2000-12/2011 that reported prevalence of hepatitis and STIs (excluding HIV) among Chinese FSW. Following the PRISMA guidelines, meta-analysis was used to estimate pooled prevalence and 95 % confidence intervals for each infection. Result Three hundred and thirty nine articles (34 in English and 305 in Chinese) investigating 603,647 FSWs in 29 Chinese provinces were included in this review. Over the period 2000–2011, the seroprevalence of active hepatitis B and hepatitis C among FSW were 10.7 % (7.3–15.5 %) and 1.0 % (0.7–1.3 %), respectively. The most prevalent STI was human papillomavirus (HPV, 27.0 % [10.1–55.1 %]), followed by herpes simplex virus-2 (HSV-2, 15.8 % [11.7–20.9 %]), chlamydia (13.7 % [12.1–15.4 %]), gonorrhoea (6.1 % [5.3–7.0 %]), syphilis (5.2 % [4.8–5.7 %]), genital warts (3.3 % [2.5–4.2 %]) and Trichomonas vaginitis (2.1 % [1.5–24.2 %]). Disease burden of both hepatitis and STI among FSW were concentrated in South Central and Southwest China. In particular, chlamydia and syphilis demonstrated a significant declining trend during the studied period (P < 0.05). Compared with the general Chinese population, FSW had significantly higher prevalence of all STIs except Trichomonas vaginitis. Further, compared to the general FSW population, HIV-positive FSW had significantly higher prevalence of syphilis, chlamydia, HSV-2 and Trichomonas vaginitis. Conclusion Prevalence of hepatitis and STIs remained high and mostly stable among Chinese FSW over the period of 2000–2011. Targeted STI and hepatitis surveillance and interventions should be strengthened among Chinese FSWs, especially those who are HIV-positive. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1322-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shu Su
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Kathryn E Muessig
- The University of North Carolina Project-China, Guangzhou, China. .,Department of Health Behaviour, Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Lei Yuan
- The School of Sociology and Population Studies, Renmin University of China, Beijing, China.
| | - Joseph D Tucker
- The University of North Carolina Project-China, Guangzhou, China. .,London School of Hygiene and Tropical Medicine, London, UK.
| | - Xiaohu Zhang
- China Food and Drug Administration Institute of Executive Development, Beijing, China. .,Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
| | - Jiehui Ren
- The School of Sociology, Tsinghua University, Beijing, China.
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Jun Jing
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
| | - Lei Zhang
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. .,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. .,Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, 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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Pan XF, Zhao ZM, Sun J, Chen F, Wen QL, Liu K, Song GQ, Zhang JJ, Wen Y, Fu CJ, Yang CX. Acceptability and correlates of primary and secondary prevention of cervical cancer among medical students in southwest China: implications for cancer education. PLoS One 2014; 9:e110353. [PMID: 25360743 PMCID: PMC4215919 DOI: 10.1371/journal.pone.0110353] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/14/2014] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To understand knowledge about, and acceptability of, cervical cancer screening and HPV vaccines among medical students; and to explore potential factors that influence their acceptability in China. METHODS We conducted a survey among medical students at six universities across southwest China using a 58-item questionnaire regarding knowledge and perceptions of HPV, cervical cancer, and HPV vaccines. RESULTS We surveyed 1878 medical students with a mean age of 20.8 years (standard deviation: 1.3 years). Of these, 48.8% and 80.1% believed cervical cancer can be prevented by HPV vaccines and screening respectively, while 60.2% and 71.2% would like to receive or recommend HPV vaccines and screening. 35.4% thought HPV vaccines ought to be given to adolescents aged 13-18 years. 32% stated that women should start to undergo screening from the age of 25. 49.2% felt that women should receive screening every year. Concern about side effects (38.3% and 39.8%), and inadequate information (42.4% and 35.0%) were the most cited barriers to receiving or recommending HPV vaccination and cervical cancer screening. Females were more likely to accept HPV vaccines (OR, 1.86; 95% CI: 1.47-2.35) or cervical cancer screening (OR, 3.69; 95% CI: 2.88-4.74). Students with a higher level of related knowledge were much more willing to receive or recommend vaccines (P<0.001) or screening (P<0.001). Students who showed negative or uncertain attitudes towards premarital sex were less likely to accept either HPV vaccines (OR, 0.67; 95% CI: 0.47-0.96), or screening (OR, 0.68; 0.47-0.10). Non-clinical students showed lower acceptability of cervical screening compared to students in clinical medicine (OR, 0.74; 95% CI: 0.56-0.96). CONCLUSIONS The acceptability of HPV vaccines and cervical cancer screening is relatively low among medical students in southwest China. Measures should be taken to improve knowledge about cervical cancer and awareness of HPV vaccines and screening among medical students at university.
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Affiliation(s)
- Xiong-Fei Pan
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Zhi-Mei Zhao
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Jing Sun
- Department of Pathology, Development and Regeneration Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Feng Chen
- Department of Preventive Healthcare and Hospital Infection Control, Deyang People's Hospital, Deyang, China
| | - Qing-Lian Wen
- Department of Oncology, the Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - Kang Liu
- Institute of Tissue Engineering and Stem Cells, The Second Clinical Hospital of North Sichuan Medical College, Nanchong, China
| | - Gui-Qin Song
- Department of Biology, North Sichuan Medical University, Nanchong, China
| | - Jing-Jing Zhang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Ying Wen
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Chun-Jing Fu
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Chun-Xia Yang
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
- * E-mail:
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Khan GJ, Naeem HS, Khan S, Jamshaid T, Sajid MI, Bashir I, Jamshaid M. Understanding and Responsiveness Level about Cervical Cancer and its Avoidance among Young Women of Pakistan. Asian Pac J Cancer Prev 2014; 15:4877-83. [DOI: 10.7314/apjcp.2014.15.12.4877] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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