Knowledge of Human Papillomavirus Among Publicly and Privately Insured Women

Abstract

The purpose of this study was to identify characteristics associated with high and low levels of human papillomavirus (HPV) knowledge among women presenting for HPV vaccination. Surveys were administered to women presenting for HPV vaccination at 2 distinct clinics: a private obstetrics and gynecology office with predominantly privately insured patients and a resident clinic with primarily Medicaid-insured patients. Nine outcome measures were collected in addition to open-ended response questions regarding motivation for vaccination. Forty-six women were recruited from the resident clinic, and 39 women were recruited from the private clinic. Knowledge scores differed significantly between the 2 recruitment sites: mean score of 19.7 at the resident clinic compared to a mean score of 24.9 at the private clinic (P < .0001, power = 80%). After controlling for age, zip code poverty prevalence, educational attainment, and parental educational attainment, clinical site was no longer independently associated with knowledge score. Rather, having attended at least 1 year of college was the only measured item independently associated with a higher HPV knowledge score. Reported condom use, having a regular sexual partner, history of an abnormal Papanicolaou (Pap) test, and having received a Pap test within the previous year were not independently associated with knowledge scores. Themes for motivation to vaccinate include protection from cervical cancer and prevention of HPV infection. Knowledge of HPV among women presenting for vaccination was significantly associated with educational attainment of some college. Common themes of low knowledge include the viral etiology of cervical cancer, the clinical presentation of HPV infection, and the lack of complete protection against cervical cancer with the HPV vaccine.