Awareness and knowledge of HPV and cervical cancer in female students: A survey (with a cautionary note)

Knowledge of Human Papillomavirus and Cervical Cancer Among Low-Income Women in New Jersey

OBJECTIVES

Although much research has been conducted on knowledge and awareness of the connection between human papillomavirus (HPV) and cervical cancer risk among university students, few studies have examined these associations among low-income populations. We examined knowledge of HPV and cervical cancer risk among racially and ethnically diverse low-income women.

METHODS

We used a cross-sectional study design to recruit and interview 476 low-income women in New Jersey from November 1, 2013, through February 28, 2016. We used multivariate logistic regression to determine whether knowledge of HPV and its association with cervical cancer risk differed by race and ethnicity.

RESULTS

Compared with non-Hispanic White women, Hispanic (odds ratio [OR] = 0.37; 95% CI, 0.18-0.77) and non-Hispanic Black (OR = 0.38; 95% CI, 0.19-0.77) women were significantly less likely to report having heard of HPV. Of women who had ever heard of HPV (n = 323), non-Hispanic Black women were significantly less likely (OR = 0.44; 95% CI, 0.21-0.89) than non-Hispanic White women to report knowing that HPV can be associated with cervical cancer.

CONCLUSIONS

Given the higher rates of HPV infection among non-Hispanic Black and Hispanic women, these results suggest a need to improve education about risks of HPV among low-income populations. These messages need to include information on the connection between HPV and cervical cancer and must be provided in culturally and linguistically appropriate ways.

HPV vaccination and cervical screening: the knowledge and attitudes of mothers of adolescent girls

OBJECTIVE

Mothers play a significant role in decision making about human papillomavirus (HPV) vaccination for their daughters and about cervical screening attendance for themselves. This study had three objectives, to explore: (1) mothers' knowledge and attitudes about HPV and HPV vaccination, (2) their knowledge and attitudes about cervical cancer and screening, and (3) whether their daughter's HPV vaccination invitation was an opportunity to nudge mothers to attend screening.

DESIGN

138 women from North Staffordshire completed a cross-sectional survey and 15 took part in follow-up focus groups.

RESULTS

Despite high self-reported engagement with both the cervical screening and HPV vaccination programmes, relatively low levels of knowledge and some uncertainty were evident. There was mixed opinion about the potential of using the vaccination invite as an opportunity to nudge mothers to attend cervical screening.

CONCLUSION

Even amongst women who do engage positively with the programmes, knowledge is not as complete and certain as it could be. Further research is needed with women who are less likely to accept the vaccination for their daughters. Women need to be better informed, which may go some way to reversing the decline in screening and maintaining high levels of vaccination.

"I don't think I have a chance to get it": International university student HPV knowledge and preventive behaviors

Objective: Half of new human papilloma virus ( (HPV)) infections occur between the ages of 15 and 24. As preventive measures are underutilized globally; international university students are at particular risk for HPV infection and sequelae. The study aim was to explore HPV knowledge and preventive behaviors in this population. Participants: Eighty-one undergraduate and graduate international university students (49 females, 32 males) at a southeastern university. Methods: Exploratory sequential mixed methods guided by the Health Belief Model. Results: Integrated qualitative/quantitative data revealed four themes mapped to relevant HBM constructs: Perceived susceptibility to HPV; Perceived benefits/Perceived barriers to HPV prevention; Cues to Action; and Likelihood of Engaging in Health-Promoting Behavior. Over half believed they were not at risk for HPV/sequelae. Only a quarter had received HPV vaccination. Conclusions: International university students represent an important catch-up population for HPV screening/vaccination. Results can be used to design and tailor interventions for this vulnerable population.

Awareness of the link between human papillomavirus and oral cancer in UK university students

Awareness of the link between human papillomavirus (HPV) and oral cancer varies across populations. Levels of awareness and factors may impact HPV vaccine uptake in women and the intent to obtain the vaccine in men if it becomes available. A cross-sectional survey of 1415 UK university students (495 men and 920 women) aged 18-25 years was conducted. Women who had and had not received the HPV vaccine were included. Vaccination was not available for men at the time of the survey. Seventy percent of participants had heard of oral cancer but only 25% were aware of the link between HPV and oral cancer. Women who ever engaged in sexual activity (adjusted odds ratio, aOR = 1.74; 95% CI: 1.12-2.72) or had at least one dose of the HPV vaccine (aOR = 1.71; 95% CI: 1.24-2.37) were more likely to be aware. Men who intend to receive the HPV vaccine in the future were more likely to be aware (aOR = 1.62; 95% CI: 1.04-2.53). Non-white women were less likely to be vaccinated (aOR = 0.56; 95% CI: 0.41-0.77). However, being aware was associated with HPV vaccine uptake in women (aOR = 1.65; 95% CI: 1.19-2.28) and borderline associated with the intent to obtain the HPV vaccine in men (aOR = 1.52; 95% CI: 0.99-2.35). Non-heterosexual men were more willing than heterosexuals to receive the vaccine. Following the UK gender-neutral HPV vaccination programme, there is an opportunity to increase awareness about the link between HPV and oral cancers aside from the cervical cancer link to influence HPV vaccine uptake.

The Interplay between Message Framing and Message Recipients' Regulatory Focus in Promoting HPV Prevention Strategies

Limited awareness and low uptake rate of Human papillomavirus (HPV) prevention strategies among females require the development of more effective educational interventions. Regulatory focus theory posits the matching of framing valence with the recipients' regulatory focus increases persuasiveness. Following regulatory focus theory, we examined how individual regulatory focus changed the effects of gain- and loss-framed messages on promoting consistent condom use and HPV DNA testing for HPV prevention. We also explored whether this interaction effect impacts the influences of target individuals' initial attitudes about condom use and HPV DNA testing on post attitudes and intentions. Results of Study 1 showed that, in general, the gain-framed message fit with regulatory focus (i.e., promotion focus) promoted more positive attitudes about consistent condom use than the gain-framed message nonfit with their regulatory focus (i.e., prevention focus).Nevertheless, the gain-framed message nonfit with regulatory focus (i.e., prevention focus) strengthened the negative relationship between initial attitudes and intentions, which promoted the intentions to use condom consistently among people who initially held negative attitudes toward consistent condom use. In Study 2, we did not observe a significant interaction effect of message framing and regulatory focus in the HPV DNA testing context. However, we observed that the gain-framed message nonfit with regulatory focus (i.e., prevention focus) led to the changes in the significance of the initial attitudes - post attitudes relationship from significant to non-significant. Thus, the reliance on initial negative attitudes about HPV DNA testing in decision-making decreased. Theoretical and practical implications of our research were discussed.

Cancer awareness in the general population varies with sex, age and media coverage: A population-based survey with focus on gynecologic cancers

OBJECTIVES

There is a need for more knowledge about the public awareness and attitudes towards gynecologic cancers. We employed a research-purpose population-based citizen panel to assess how often people recall gynecologic cancers compared to other cancer types and to explore the relative importance of different information channels in relaying cancer information.

STUDY DESIGN

We conducted an online survey using the Norwegian Citizen Panel (n = 1441 respondents), exploring associations between demographic factors and frequency of mentioning specific cancer types. We also searched The Norwegian Media Archive to assess the media coverage of different cancer types. Factors affecting likelihood of mentioning different cancers were assessed by multivariate regression.

RESULTS

Only 41 % of respondents listed one or more cancers in female genital organs. Of the gynecological cancers, cervical cancer was most frequently mentioned (28 %), followed by ovarian (12 %) and endometrial cancer (11 %). Female responders were more likely to mention cervical (OR 2.47, 95 % CI 2.16-2.78) and ovarian cancer (OR 2.09, 95 % CI 1.60-2.58) than male responders, but not endometrial cancer. Family and friends who have had cancer (50 %) and different types of media coverage (41 %) were reported as the most common sources of cancer information. The three most frequently mentioned cancer types in our survey were breast (77 %), hematologic (76 %) and lung cancer (75 %), which also were the cancer types having most media coverage.

CONCLUSIONS

Gynecological cancers are less frequently mentioned by Norwegian citizens when compared to several other cancer types such as breast-, hematologic- and lung cancer. Sex and age are important factors that affect awareness of cancer types. Media is likely to play an important role in what cancer types the public recalls.

Effectiveness of a Health Talk Education Program on Human Papillomavirus (HPV) Knowledge, Attitudes, and Intentions to Vaccinate Children Among Mothers of Secondary School Boys in Thua Thien Hue Province, Vietnam

Background

The incidence of cancer related to human papillomavirus (HPV) that affects males is rising throughout the world. Currently, Vietnamese boys are typically not vaccinated against HPV while girls are. There are only a few studies pertaining to HPV vaccination among boys in Asian countries where parents play the most important role in deciding on such vaccination. We present here the first study to assess the effectiveness of a health talk education program on HPV knowledge, attitudes and intention to vaccinate children among mothers of secondary school students in the Thua Thien Hue province, Vietnam.

Methods

This was a quasi-experimental study. Two secondary schools in the Thua Thien Hue province, Vietnam were selected by purposive sampling. A total of 288 mothers of male students of two secondary schools were selected to participate, n=144 as controls and n=144 for the intervention arm for every school. Mothers of male students were invited to answer interview questions. The questionnaires covered social demographics, health history, HPV knowledge and HPV vaccination perception and intention. The study ran from September 2019 to January 2020.

Results

In total, 279 mothers finished the questionnaires. At the baseline, HPV knowledge in both groups was at the same level (p>0.05). One month after receiving the HPV health talk education, mothers of male students had much higher HPV knowledge than those who did not receive such HPV health talk education. The intervention group also had a much higher HPV vaccination intention than the control group (p<0.05).

Conclusion

Health education was shown in this study to be an effective method to increase HPV knowledge and vaccination intention among mothers of boys in Vietnam.

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Knowledge about Cervical Cancer and Awareness of Human Papillomavirus (HPV) and HPV Vaccine among Female Students from Serbia

Background and objectives: Persistent infection with carcinogenic human papillomavirus (HPV) is the leading cause of cervical cancer. The study explored students’ knowledge about cervical cancer and awareness of human papillomavirus and the HPV vaccine. Materials and Methods: A questionnaire-based survey was carried out among 1616 first-year female college students at the University of Niš. It examined socio-demographic characteristics, measured the score of knowledge about cervical cancer, assessed awareness regarding HPV and the HPV vaccine and inquired about the source of information about cervical cancer and HPV. Results: The average cervical cancer knowledge score was 16.35 ± 7.92 (min 0, max 30), with medical professional education, parents’ education level, place of residence and relationship status having significant effects on the score. The awareness about HPV and the HPV vaccine was low, with only 14.2% of students having heard about both HPV and its vaccine. The most commonly reported sources of information were the media, while the most competent one was organized health education. Conclusions: Health promotion campaigns and educational programs are necessary in order to reduce cervical cancer burden and should be directed particularly towards those who have demonstrated low cervical cancer knowledge and low awareness regarding HPV and its vaccine.

Knowledge gaps and acquisition about HPV and its vaccine among Brazilian medical students

Objective

To analyze factors associated with knowledge gaps and acquisition about HPV and its vaccine among medical students.

Method

Cross-sectional and analytical study conducted at the University of São Paulo Medicine School, in 2016. A convenience sample of students completed a data collection instrument containing questions on knowledge about HPV and its vaccine, and vaccine acceptability. The level of knowledge and acceptability established as a "good level" was 80% of correct answers on the questionnaire. Internal validity was calculated with Cronbach's alpha value (α) = 0.74. Bivariate and multiple analyzes were performed using the Stata® program (Stata Corp, College Station, USA) 14.0.

Results

To evaluate the internal consistency of the instrument applied, the Cronbach's alpha equation was used, obtaining the alpha value (α) = 0.74 for this population. This value attests that the consistency of the answers obtained with this questionnaire is considered substantial and acceptable. Among the 518 medical students who completed the survey, the majority were men 312 (60.4%) with a mean age of 23 (± 2.8) years old; 199 (38.3%) of the students were in the final years of graduation (5th and 6th years). Students in the first, second and third year of study had a 51% higher risk of a knowledge gap when compared to students in the final years of graduation [PR 1.51 (1.3:1.8); p <0.001]. Men were at 22% higher risk of unsatisfactory knowledge than women are [PR 1.22 (1.07: 1.39). There was no knowledge acquisition during medical school in the following questions (p <0.05), indication of vaccine for individuals with HIV and contraindication in pregnant patients.

Conclusion

Male medical students, in the first year of medical school, and those who were not vaccinated had significant knowledge gaps about HPV. The novelty of the study includes the finding of non- acquisition of knowledge during the medical school graduation on safety and vaccination schedule and vaccine administration in specific populations.

Assessment of Knowledge, Attitudes, and Propensity towards HPV Vaccine of Young Adult Students in Italy

Background: Human Papillomavirus (HPV) is a common sexually transmitted infection (STI), representing the main cause of genital warts and cervical cancer. This cross-sectional study evaluated knowledge and attitudes about HPV infection, related diseases, and prevention and propensity towards HPV vaccine among undergraduate students. Methods: An online and written survey about HPV and its prevention, targeted to young adults of both genders, was addressed to students attending health sciences and other schools at Universities of Genoa and Bari. Results: The overall median knowledge and attitude scores were 56.3% (25–75 p = 40–68.8%) and four out of five (25–75 p = 4–5), respectively. In the multivariate analysis, attending a health sciences university, using social networks ≤2 h a day, a history of STI, having heard about HPV and HPV vaccine previously resulted as predictors of higher knowledge scores. Having heard about HPV previously also predicted a high attitude score, together with a perceived economic status as good. Having Italian and healthcare worker parents, being employed, and following a specific diet, instead, predicted lower attitude score. Conclusions: Poor knowledge and good attitudes were found among undergraduates about HPV. In order to increase HPV vaccine compliance and the counselling skills of future healthcare workers, the improvement of training on HPV is needed.

Awareness of the Signs, Symptoms, and Risk Factors of Cancer and the Barriers to Seeking Help in the UK: Comparison of Survey Data Collected Online and Face-to-Face

BACKGROUND

Cancer is the second leading cause of death globally, causing an estimated 9.6 million deaths in 2018. Low cancer symptom awareness has been associated with poor cancer survival for all cancers combined. The Cancer Awareness Measure (CAM) is a validated, face-to-face survey used since 2008 to measure the UK public's awareness of the symptoms and risk factors of cancer as well as the barriers to seeking help.

OBJECTIVE

The aim of this study is to explore whether online data collection can produce a representative sample of the UK population, compare awareness of cancer signs and risk factors and the barriers to seeking help between data collected online and face-to-face, and examine the relationships between awareness and demographic variables.

METHODS

Differences in awareness of cancer signs, symptoms, and risk factors among samples were explored while adjusting for demographic differences (age, gender, ethnicity, educational level, marital status, and country of residence) to distinguish the effect of data collection method. Multivariate logistic regression models were used to calculate adjusted odds ratios for recall and recognition of signs and symptoms, risk factors, and barriers to seeking help.

RESULTS

A total of 4075 participants completed the CAM, 20% (n=819) via face-to-face interviews and 80% online (n=3256; agency A: n=1190; agency B: n=2066). Comparisons of data collected using face-to-face interviews and online surveys revealed minor differences between samples. Both methods provided representative samples of the UK population with slight differences in awareness of signs, symptoms, and risk factors and frequency of help-seeking barriers reported.

CONCLUSIONS

These findings support a move to online data collection for the CAM. The flexibility afforded will enable the CAM to explore a wider range of issues related to the prevention, early diagnosis, and treatment of cancer.

Knowledge and Awareness of Cervical Cancer and Human Papillomavirus among Female Students in an Ethiopian University: A Cross-sectional Study

Background:

Cervical cancer is causing a huge burden in Sub-Saharan Africa (SSA). It mainly affects women in their young ages making female university students at risk of cervical cancer. Knowledge and awareness about cervical cancer and human papillomavirus (HPV) in SSA including Ethiopia is very poor. We aimed to assess the knowledge and awareness of cervical cancer and HPV in University of Gondar (UOG) medicine and health science female students. A cross-sectional study was done.

Methods:

This study was conducted from April 1 to May 30, 2016 at UOG, College of Medicine and Health Sciences, Gondar, Northwest Ethiopia. Undergraduate female students were included in the study. A 14-item self-administered questionnaire was then provided to each of the participants to measure their level of knowledge and awareness about cervical cancer and HPV.

Results:

A total of 267 female students participated in the study (mean age 20.58 ± 1.22). More than half of the participants (59.6%) did not know the main cause of cervical cancer, whereas just about a fifth of them (19.5%) identified HPV as the main cause of cervical cancer. As high as 83.9% of the participants did not know other causes of cervical cancer. Binary logistic analysis revealed that students from midwifery (adjusted odds ratios [AOR] = 14.14, P < 0.05), anesthesiology (AOR = 9.66, P < 0.05) and medicine (AOR = 5.84, P < 0.05) departments were associated with knowledge of the main cause of cervical cancer.

Conclusions:

Knowledge about cervical cancer and its causes were found to be inadequate among higher education female students. Hence, awareness about cervical cancer, causes and its prevention, importance of screening and vaccination should be promoted through university's campaign, curricular changes, and community and research projects.

HPV Vaccination in Correctional Care: Knowledge, Attitudes, and Barriers Among Incarcerated Women

Incarcerated women are at increased risk of developing cervical cancer and have high rates of human papillomavirus (HPV) infection, an important cause of cervical cancer. However, many correctional facilities do not offer HPV vaccination to female inmates. This pilot survey study, conducted with incarcerated women aged 18 to 26 at a facility that does not offer the vaccine, assessed attitudes and knowledge about HPV and the HPV vaccine, acceptability of and barriers to in-prison HPV vaccination, and self-reported HPV vaccination rates. Most participants reported that they had not received the HPV vaccine but had positive attitudes toward it and would be willing to get it in prison. Correctional facilities should consider offering this preventive service to this vulnerable population.

Knowledge, attitudes and awareness of the human papillomavirus amongst primary care practice nurses: an evaluation of current training in England

Background

The incorporation of Human papillomavirus (HPV) testing into the English cervical screening programme has been met with fear and anxiety. Healthcare professionals need to be adequately informed about HPV to help alleviate patient concerns. The aim of this study was to evaluate the HPV training provided to practice nurses (PNs) and determine their level of HPV knowledge.

Method

A web-based survey was distributed to 147 General Practice surgeries in the Leicester, Leicestershire and Rutland regions, between May and July 2015. The survey explored four broad areas; demographics/level of experience, HPV knowledge, attitudes towards the HPV vaccine and self-perceived adequacy of HPV knowledge.

Results

A total of 128 surveys were completed, with 94 complete responses. Overall awareness of basic HPV facts was adequate; however, detailed, and in some cases basic, knowledge was lacking. 9.6% failed to identify that HPV can cause cervical cancer and 62.8% believed that HPV requires treatment. Not all PNs felt adequately informed about HPV and a need to improve the provision of training was identified.

Conclusion

PNs play a key role in increasing public awareness of HPV and implementing cervical cancer screening. The provision of education to PNs needs to be a priority and current methods of training need to be re-evaluated.

Attitudes towards and knowledge about Human Papillomavirus (HPV) and the HPV vaccination in parents of teenage boys in the UK

The incidence of cancers attributable to Human Papillomavirus (HPV) that affect males is on the rise. Currently in the UK teenage boys are not vaccinated against HPV while teenage girls are. The rationale for not vaccinating boys is that vaccinating girls should provide herd immunity to boys, however this does not protect men who have sex with men or men who have sex with unvaccinated women. The issue of whether to vaccinate boys or not is a controversial one with considerable lobbying taking place to change the existing policy. On one side of the debate are financial considerations while on the other side health equality is important. One avenue that has not been presented is the parental perspective. The current study uses a self-report questionnaire to explore what parents of teenage boys know about HPV and the vaccine and whether they want the vaccine for their sons. Only half of the parents had heard of HPV prior to completing the survey. Of those who had heard of HPV, knowledge about the health sequelae of HPV for men was poor relative to their knowledge about its impact on female health. Parents who would be willing to vaccinate their sons had higher levels of knowledge about HPV than those parents who would be unwilling or unsure. Irrespective of whether they had previously heard of HPV or not, once provided with a brief description of HPV, the majority of parents thought that boys should be offered the vaccination. There is a pressing need for public education about the potential impact of HPV on male health in order to facilitate uptake of the vaccine in the event of the vaccination programme being extended to men or to facilitate informed decision making about seeking the vaccine privately in the event that it isn't.

Predictors of Adults' Knowledge and Awareness of HPV, HPV-Associated Cancers, and the HPV Vaccine: Implications for Health Education

High human papillomavirus (HPV) prevalence and low HPV vaccine uptake are significant public health concerns. Disparities in HPV-associated cancers and HPV vaccine uptake rates suggest the need for additional research examining factors associated with vaccine acceptance. This study assessed HPV awareness and knowledge and identified sociodemographic characteristics associated with HPV knowledge at the population level. Data from adult men ( n = 1,197) and women ( n = 1,906) who participated in the National Cancer Institute's 2014 Health Information National Trends Survey were analyzed. Multivariable regression was used to identify predictors of four HPV knowledge categories: (1) general knowledge, (2) cervical cancer knowledge, (3) "other" cancer knowledge (i.e., anal, oral, penile), and (4) vaccine knowledge. Significant gender differences in awareness and knowledge of HPV and the HPV vaccine were revealed. Most participants (>70%) knew that HPV could cause cervical cancer, but fewer (14.9% to 31.5%) knew of the association between HPV and "other" cancers. Women were more likely to report that a health care provider recommended vaccination. Significant predictors of general HPV and HPV vaccine knowledge included gender, education, income, race, and other sociodemographic characteristics. Age and income predicted cervical cancer knowledge. Knowledge of "other" HPV-associated cancers was predicted by having a child under 18 years in the household and relationship status. HPV knowledge appears to be socially patterned. Low HPV knowledge among men and some racial minorities suggests a need for further intervention. Health education should emphasize risks of noncervical HPV-associated cancers. Patient-provider communication that includes education, counseling, and clear recommendations favoring vaccination may improve uptake.

Development of a cross-cultural HPV community engagement model within Scotland

OBJECTIVE

To examine cultural barriers and participant solutions regarding acceptance and uptake of the human papillomavirus (HPV) vaccine from the perspective of Black African, White-Caribbean, Arab, Indian, Bangladeshi and Pakistani young people.

METHODS

In total, 40 young people from minority ethnic communities in Scotland took part in a qualitative study, involving seven focus groups and four paired interviews, to explore their views and experiences of the HPV vaccine. Using critical discursive psychology, the analysis focused on young people's accounts of barriers and enablers to information, access and uptake of the HPV vaccination programme.

RESULTS

Participants suggested innovative strategies to tackle intergenerational concerns, information design and accessibility, and public health communications across diverse contexts. A cross-cultural community engagement model was developed, embracing diversity and contradiction across different ethnic groups. This included four inter-related strategies: providing targeted and flexible information for young people, vaccine provision across the life-course, intergenerational information and specific cross-cultural communications.

CONCLUSION

This is the first HPV cross-cultural model inductively derived from accounts of young people from different ethnic communities. We recommend public health practitioners and policymakers consider using the processes and strategies within this model to increase dialogue around public engagement, awareness and receptivity towards HPV vaccination.

Knowledge, attitudes, and perception towards human papillomavirus among university students in Pakistan

This cross-sectional study comprises a questionnaire-based survey regarding knowledge about human papillomavirus and its vaccine among students in different educational fields at public and private universities in the city of Lahore in Pakistan. A 26-item questionnaire was used to attain the objective of this study. The reliability of this tool was assessed using Cronbach's alpha (0.79) and the Kaiser-Meyer-Olkin value was 0.827. The response rate to the survey was 78.0%, of whom the majority (74.9%) were females and 308 (79%) were single (median age=23 years). While assessing the respondents' knowledge about HPV, 223(57%) students reported that they had already heard of HPV (human papillomavirus) and nearly 215 (55%) reported that HPV causes cervical cancer and can infect both men and women. Gender and field of study were two main factors found influencing the respondents' knowledge about HPV. Moreover, students' understanding about the mode of transmission of HPV was cursory: 40.51% said they did not know how HPV is transmitted, 133 (34.10%) stated that HPV spreads through the exchange of bodily fluids, and 22 (5.64%) selected cough/sneezing. In terms of prevention, 175 (44.87%) students stated that HPV can be prevented by vaccination, 30.0% reported sexual abstinence, 21.54% using condoms, and nearly 5.38% disclosed use of antibiotics. Addressing the knowledge of students regarding HPV vaccine, nearly 53% stated there is no vaccine against HPV and almost 64% rejected the statement that HPV vaccine prevents cervical cancer. In addition, students reported that they will be more than willing to get vaccinated for HPV if their physician recommend them (RII=0.74) followed by parents (RII=0.69). The results of this study revealed a poor understanding among respondents about the health problems associated with HPV, its prevention, modes of transmission and arability of HPV vaccine in Pakistan.

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University students in Lahore, Pakistan have poor understanding of health problems associated with HPV.

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Students lack of awareness about the availability of the HPV vaccine and modes of transmission of HPV indicate an immediate need for a national HPV awareness campaign.

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Moreover, regardless of the field of education and gender, students understanding about preventing HPV and chances of reoccurrence after vaccination was poor.

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Recommendations from a friends, parents or physician were found to be influence the students decision to get vaccinated for HPV.