Knowledge and attitudes about Human Papillomavirus and its prevention in Italian students, 2018

Abstract

Abstract Background Human Papillomavirus (HPV) infections show an estimated prevalence of 290 millions of cases worldwide, being the most common viral infection related to the reproductive tract and the main cause of cervical cancer. Being HPV vaccination currently recommended for both genders, we assessed knowledge and attitudes regarding HPV prevention among high school students in Udine, Northern Italy. Methods Between April and May 2018, a sexual and reproductive health anonymous questionnaire was proposed to first-year students in five academic, technical and vocational upper secondary schools of Udine. In particular, students were asked about HPV related diseases, whether they were vaccinated against HPV and how that decision was taken. Data were analyzed by school type and gender using Chi Square Test with α = 0.05. Results A total of 747 questionnaires were collected from 990 students; both genders had a mean age of 14.8±0.9 years, 59% of respondents were males. Technical high school students were 42% of the sample, while 30% came from vocational and 28% from academic high schools. Genital warts and cervical cancer were identified as HPV-related by 8% and 20% of students respectively, the latter more frequently in technical institutes (p = 0.0016) and in females (43% vs 13%, p < 0.001). Almost 54% of students did not know if they were immunized against HPV; academic school students and females declared more frequently to have received at least one vaccine dose compared to others (p < 0.001). Almost two thirds of respondents reported to have undergone vaccination due to a parental decision; parents discussed this choice more frequently with academic students (p = 0.0016) and females (22% vs 14%, p < 0.001). Conclusions Girls and technical school students are more informed about HPV, while adherence to immunization schedules is higher in females and those attending academic school. Parents appear to create a supportive environment for females. Key messages The different level of knowledge by gender can be explained by past vaccination campaigns, mainly focused on girls, and by parental proactivity towards females. There is room for improvement in HPV-related knowledge and prevention among both adolescents in general and males in particular as they can play an important role to reduce the burden of HPV.