Awareness and knowledge of HPV, cervical cancer, and vaccines in young women after first delivery in São Paulo, Brazil - a cross-sectional study

Cristina H Rama,José Eluf-Neto,Maria A Andreoli,Adhemar Longatto-Filho,Maria C Costa,Aline L Aoki,Luisa L Villa,Sonia Pagliusi

doi:10.1186/1472-6874-10-35

Abstract

BackgroundThe success of HPV vaccination programs will require awareness regarding HPV associated diseases and the benefits of HPV vaccination for the general population. The aim of this study was to assess the level of awareness and knowledge of human papillomavirus (HPV) infection, cervical cancer prevention, vaccines, and factors associated with HPV awareness among young women after birth of the first child.MethodsThis analysis is part of a cross-sectional study carried out at Hospital Maternidade Leonor Mendes de Barros, a large public maternity hospital in Sao Paulo. Primiparous women (15-24 years) who gave birth in that maternity hospital were included. A questionnaire that included questions concerning knowledge of HPV, cervical cancer, and vaccines was applied. To estimate the association of HPV awareness with selected factors, prevalence ratios (PR) were estimated using a generalized linear model (GLM).ResultsThree hundred and one primiparous women were included; 37% of them reported that they "had ever heard about HPV", but only 19% and 7%, respectively, knew that HPV is a sexually transmitted infection (STI) and that it can cause cervical cancer. Seventy-four percent of interviewees mentioned the preventive character of vaccines and all participants affirmed that they would accept HPV vaccination after delivery. In the multivariate analysis, only increasing age (P for trend = 0.021) and previous STI (P < 0.001) were factors independently associated with HPV awareness ("had ever heard about HPV").ConclusionsThis survey indicated that knowledge about the association between HPV and cervical cancer among primiparous young women is low. Therefore, these young low-income primiparous women could benefit greatly from educational interventions to encourage primary and secondary cervical cancer prevention programs.

Highlights

The success of human papillomavirus (HPV) vaccination programs will require awareness regarding HPV associated diseases and the benefits of HPV vaccination for the general population
Eligible women were contacted by a health professional and asked whether they wanted to know about a study on prevention of cancer of the cervix; those interested had a post-natal visit scheduled within 43 to 60 days after delivery to be enrolled in the study
Among those who had heard of it, less than a quarter knew that HPV can cause cervical cancer; about half knew that HPV is a sexually transmitted infection (STI), and only two participants knew that it can cause genital warts

Summary

Introduction

The success of HPV vaccination programs will require awareness regarding HPV associated diseases and the benefits of HPV vaccination for the general population. Providing a vaccine “against cancer” to adolescent girls raises several challenges because many young unmarried girls and women face significant challenges in accessing the health care necessary to meet their sexual and reproductive health needs [5]. For this reason, in some countries school vaccination programs have been established as a strategy to vaccinate girls against HPV. The success of HPV vaccination programs will require improving awareness regarding HPV, cervical cancer, and the benefits of HPV vaccination for the general population Pregnant adolescents and girls of lower socio-economic status are more likely to drop out of school, opportunities for catch-up vaccination are valuable to improve coverage among the at risk young female population.

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