Abstract
In 2012, human papillomavirus (HPV) vaccination was introduced free of charge in the Swedish national school-based vaccination programme for 10-12-year-old girls, and as catch-up vaccination for young women. In Sweden, there is an ongoing discussion about including boys in the national vaccination programme. Few studies are undertaken about adolescents’ knowledge, beliefs and HPV vaccination status in relation to socioeconomic status and sexual experience. Thus, the aim was to examine HPV catch-up vaccination status in adolescents in relation to 1) socioeconomic factors, 2) beliefs and knowledge about HPV prevention, and 3) sexual behaviour. The Health Belief Model was used as a theoretical framework. Upper secondary school students (n = 832) aged 16, randomly chosen from a larger sample, were invited to participate in conjunction with the general health interview with the school nurse. A total of 751/832 (90.3%), girls (n = 391, 52%) and boys (n = 360, 48%) completed the questionnaire. HPV vaccination was associated with ethnicity and the mothers’ education level; i.e. girls with a non-European background and girls with a less educated mother were less likely to have received the vaccine (p<0.01 and p = 0.04 respectively). Vaccinated girls perceived HPV infection as more severe (p = 0.01), had more insight into women’s susceptibility to the infection (p = 0.02), perceived more benefits of the vaccine as protection against cervical cancer (p<0.01) and had a higher intention to engage in HPV-preventive behaviour (p = 0.01). Furthermore, boys and girls were almost equally sexually experienced, although fewer girls had used condom during first intercourse with their latest partner (p = 0.03). Finally, HPV vaccinated girls were less likely to have unprotected sex (p<0.01). In summary, catch-up HPV vaccination among young girls was associated with a European background and high maternal education level, as well as more favourable beliefs towards HPV prevention and less sexual risk-taking. Further preventive measures should therefore be directed at the migrant population.
Highlights
One decade has passed since the vaccines Gardasil and Cervarix against human papillomavirus (HPV) were introduced
The quadrivalent HPV vaccine Gardasil can potentially prevent a considerable number of condylomas and papillomas [2, 3]
We found that the intervention had favourable effects on the adolescents’ beliefs towards prevention of HPV and at follow-up after three months more girls in the intervention group were vaccinated than the controls [30]
Summary
One decade has passed since the vaccines Gardasil and Cervarix against human papillomavirus (HPV) were introduced These vaccines have primarily been developed to prevent infection with HPV types 16 and 18, the types responsible for roughly 70% of all cervical cancer, affecting more than 500 000 women annually [1]. A fear has been voiced that the vaccines may seduce young people into becoming more sexually adventurous and lose their moral values, or even that young people with excellent morals would not need such vaccines [5, 7] Their introduction has been challenged by the economic costs, and by compromised social acceptance of the vaccines in various geographical regions or among different communities [8,9,10]
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