On the implications of desexualizing vaccines against sexually transmitted diseases: reflections from a practicing pediatrician

De-Sexualizing Partner Notification: A Qualitative Study on Chinese Young Adults with Chlamydia

Background: Chlamydia is common amongst the sexually active population in Hong Kong. As most cases are asymptomatic, partner notification may be helpful in controlling chlamydia. This study examined attitudes towards partner notification for chlamydia among Hong Kong Chinese youths in order to inform a culturally appropriate, patient-empowering sexual health service. Methods: Sixteen individuals (aged 20 to 31) who received a confirmed diagnosis of chlamydia within the previous twelve months of data collection were recruited from two community-based organizations between June and December 2017. Semi-structured individual interviews were conducted by a health psychologist. Results: Nine participants notified a total of eleven current and ex-partners. Seven participants did not notify their sexual partner(s). Our findings revealed how participants struggled with the discrediting sexual aspect of their infection, and how de-sexualizing the infection and selected disclosure facilitated partner notification and social acceptance. Perceived stigma regarding chlamydia however did not dissipate with their disclosure. Participants did not perceive lasting impact of chlamydia on their well-being as they thought they have much control over whether and how to disclose to their (future) partners. All participants agreed there was a pressing need to raise public awareness on this silent but highly prevalent sexually transmitted infection. Conclusions: Our findings illustrate the complex struggle behind communicating about chlamydia to one’s sexual partner and how strategizing the disclosure process served to circumvent embarrassment and foster testing of sexual partners.

Chinese Vaccine Providers' Perspectives on the HPV Vaccine

China approved a human papillomavirus (HPV) vaccine in 2018. Recommendations from health care providers can positively impact vaccine receipt. This study characterized vaccine providers’ attitudes toward the HPV vaccine and contrasted attitudes by the providers’ demographic characteristics. In total, 120 vaccine providers in Shanghai, China, completed a questionnaire. Associations between essential characteristics of the HPV vaccine and providers’ urbanicity and working length were explored using the Kruskal-Wallis test. Doctors with ≤5 years’ work experience were more likely to think it important to emphasize that HPV is a sexually transmitted disease compared to doctors with longer work experiences (P = .0231). More suburban than urban providers thought that China should include the HPV vaccine into the publicly funded Expanded Program on Immunization (P = .0315). Differences in attitudes toward HPV could lead to variation in how providers talk to parents and adolescents about the HPV vaccine, with disparities in vaccine uptake as a result.

Knowledge of Human Papillomavirus (HPV), Attitudes and Practices Towards Anti-HPV Vaccination Among Israeli Pediatricians, Gynecologists, and Internal Medicine Doctors: Development and Validation of an Ad Hoc Questionnaire

Human papillomavirus (HPV) is a highly widespread virus which is responsible for one of the most common sexually transmitted infections. Two main preventative strategies exist: anti-HPV vaccination and cervical screening. Health-care workers play a key role in promoting public health campaigns; however, vaccine hesitancy is an often under-recognized challenge. To investigate the overall knowledge of HPV and HPV-related issues, as well as the attitudes and practices of health professionals towards recommending the anti-HPV vaccine, an ad hoc knowledge, attitudes, and practices (KAP) questionnaire was developed and validated in a sample of 139 Israeli pediatricians, gynecologists, and internal medicine doctors. The KAP questionnaire was found to be psychometrically valid and sound (with an rKR-20 coefficient of 0.74 for the second part and a Cronbach's alpha of 0.85 for the third part). Furthermore, the present study confirmed the importance of health-care providers in recommending the immunization practice. Parents that had been strongly advised by health-care providers to vaccinate their children accepted immunization for their girls (odds ratio (OR) 1.09 (95% CI 1.04-1.14)) and boys (OR 1.06 (95% CI 1.02-1.10)), had a lower probability of deciding to postpone the immunization appointment (OR 0.81 (95% CI 0.66-0.98)), had fewer doubts and concerns about the vaccine (OR 0.69 (95% CI 0.54-0.89)), and had a lower probability of refusing the vaccination (OR 0.93 (95% CI 0.86-0.99)). Interestingly, the use of new, emerging tools such as ad hoc websites, applications, and other interactive devices reduced vaccine hesitancy (OR 0.90 (95% CI 0.82-0.99)) and concerns about the side-effects of the vaccine (OR 0.92 (95% CI 0.86-0.99)). However, among Israeli health-care workers, knowledge was generally moderate, with updated information lacking in about 30% of surveyed health-care providers and approximately 20% of them not recommending the anti-HPV vaccine among boys. This study has practical implications for policy- and decision-makers in that they should be aware of the overall level of knowledge among health-care workers and should implement ad hoc educational interventions to address gaps in knowledge and help medical providers routinely recommend the anti-HPV vaccine both to male and female children and adolescents.