Marginalized voices on HPV vaccination in India: exploring knowledge, attitudes, and acceptance.

Background: Despite having guidelines recommending vaccination against the human papillomavirus (HPV) and widespread coverage for the vaccine, HPV vaccination rates among U.S. Hispanic and island Puerto Rican (PR) girls are low. In 2012, only 16% of PR girls aged 11–18 and 42% of U.S. Hispanic girls aged 13-17 were vaccinated with all three HPV vaccine doses; far fewer than the Healthy People 2020 goal of 80%. Parents are crucial to the success of HPV vaccine uptake efforts. Few studies focusing on parents have examined possible differences in HPV knowledge and vaccine acceptability within ethnic groups. The purpose of the study is to assess potential differences in HPV knowledge, vaccine awareness, and acceptability between U.S. Hispanic and island PR women. Methods: We utilized data from the Health Information National Trends Survey (HINTS) 2007 and HINTS Puerto Rico 2009. For the current study, we restricted our analyses to female respondents in both surveys for a total sample of 792 women (n = 375; U.S. Hispanic HINTS 2007 and n = 417; Puerto Rican HINTS-PR 2009). Using the Wald chi-square test, we assessed if there were significant differences in HPV knowledge, vaccine awareness, and acceptability between U.S. Hispanics and island PR women. Results: Island PR women had significantly higher HPV vaccine awareness (66.9% vs. 61.0%; Wald X2 F(1, 97) = 16.03, p < .001) and were more accepting of the HPV vaccine for a real or hypothetical daughter (74.8% vs. 56.1%; Wald X2 F(2, 96) = 7.18, p < .001) compared to U.S. Hispanic women. Both groups were highly knowledgeable that HPV causes cancer (89.2% in both samples) and HPV is a sexually transmitted infection (78.1% [U.S. Hispanics] and 84.7% [PR]). Less than 10% of both groups recognized that HPV can go away on its own without treatment. Conclusions: Our study found that island PR women were more aware of and accepting of the HPV vaccine when compared to U.S. Hispanic women. Future research should further explore these in-group differences to determine what in the PR socio-cultural context or environment may have led to higher HPV vaccine awareness and acceptability. Findings may also assist in developing culturally appropriate health education programs and media to promote HPV vaccination among both groups. Citation Format: Daisy Y. Morales-Campos, Robin C. Vanderpool. Examining differences in HPV knowledge, vaccine awareness, and acceptability between U.S. Hispanic and island Puerto Rican women. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B88.

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections associated with a wide range of diseases and cancers that may affect both genders. Since 2007, the Spanish National Immunization Program includes HPV vaccination, and currently it only targets 12-year-old girls. The objective of our study is to assess differences in the knowledge of HPV and HPV vaccine acceptability according to different factors, and to identify the role of different sources of information. A cross-sectional, multicenter survey research was carried out in twenty-four pediatric offices in Spain, and included parents of children aged 9 to 14 years old. 1,405 valid survey-responses were considered for the analysis. Parental awareness of HPV and HPV vaccine, as well as vaccine acceptability, are still strongly associated with child gender (girls) and age (12–14 years old). HPV knowledge and HPV vaccine acceptability are related to parental gender, HPV vaccination status and having at least one daughter. Parents who consulted a healthcare source to obtain further information about HPV had greater HPV and HPV vaccine knowledge and acceptability. HPV and HPV vaccine awareness and acceptability are strongly associated with child gender and age, which correlates with the current immunization program.

The awareness and acceptance of HPV vaccines among parents of primary and junior high school students in China: a meta-analysis

Background: There is a growing need to provide digital access to accurate and up-to-date health information as millions of Americans now consider the internet their primary source of health information. Information on sexually transmitted infections (STIs), including Human Papillomavirus (HPV) and the HPV vaccine, is a health topic that receives a lot of attention among internet users. HPV is the most common STI in the United States and globally, and some oncogenic strains of the virus are causally linked to several anogenital cancers and oropharyngeal cancer. Three HPV vaccines have been licensed for use in preventing 70% to 90% of HPV strains associated with cervical cancer, and other anogenital cancers that affect both sexes. Yet, there are still gaps in HPV knowledge in the general population, and HPV vaccine uptake remains abysmally low, especially among males. There is a dearth of information on sociodemographic predictors of HPV and HPV vaccine knowledge among internet users. We aimed to fill this gap by examining racial and gender disparities in HPV and HPV vaccine awareness among US adults that use the internet as their primary source of health information. Methods: Data were obtained from the National Cancer Institute's 2014 the Health Information National Trends Survey Cycles 3 and 4 (HINTS; N=6,862), a cross-sectional random-digit-dialed telephone survey of noninstitutionalized adults aged 18 years or older. Excluding respondents who used other sources to seek health information resulted in a final sample size of 3,038 individuals who reported using the internet as their primary source. Descriptive statistics and multivariable logistic regression were used to assess racial/ethnic and gender disparities in HPV HPV vaccination awareness. Results: Approximately 70% of respondents used the internet to seek health information. Nearly 72% of internet users and 39% of non-internet users reported an awareness of HPV and the vaccination. In multivariate analyses, age, gender, race and education were significant predictors of HPV and HPV vaccine awareness. Older adults were less likely to be aware of HPV (OR=0.35; 95% CI: 0.21, 0.58) and the HPV vaccine (OR=0.33; 95% CI: 0.19, 0.59) compared to younger adults. Females were 3.31 (95% CI: 2.41, 4.56) times and 4.26 (95% CI: 3.10, 5.86) times more likely to be aware of HPV and HPV vaccination compared to males, respectively. Non-Hispanic Blacks (OR=0.43; 95% CI: 0.26, 0.69) were less likely to be aware of HPV vaccination than non-Hispanic Whites; but there was no statistically significant difference between non-Hispanic Blacks and non-Hispanic Whites regarding their awareness of HPV. There were no statistical differences between non-Hispanic Whites and Hispanics regarding their knowledge of HPV and the HPV vaccination. The likelihood of being aware of HPV and the HPV vaccine declined steadily across education levels. Individuals without a high school diploma reported the least awareness (OR=0.24; 95% CI: 0.10, 0.62) compared to those with a college degree or higher. Conclusion: Despite the large number of individuals who use the internet to seek health information, gaps remain in HPV and HPV vaccine awareness among internet users. Also, racial and gender disparities in HPV and HPV vaccine awareness persist even among internet users. Continued education and alternative information dissemination techniques are imperative to improve HPV and HPV vaccine awareness, and to eliminate gender and racial/ethnic disparities. Citation Format: Nosayaba Osazuwa-Peters, Betelihem B. Tobo, Rebecca M. Gordon, Eric Adjei Boakye. Sociodemographic predictors of HPV and HPV vaccine knowledge and awareness among Americans who use the Internet as their primary source of health information. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A52.

Knowledge and acceptance of human papillomavirus (HPV) and HPV vaccination in adolescent boys worldwide: A systematic review

Katagwa, Vian N.; Opio, Ronald O.; Niwasasira, Dickson N.; Onyege, Alex; Naisanga, Molly; Bongomin, Felix A.; Kitara, David L. Author Information

BackgroundRegardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11–13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability.MethodsWe conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention.ResultsA total of 506 parents participated. Before receiving the structured-educational intervention, parents’ awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p < 0.001). HPV vaccine’s acceptability increased from 74.3 to 87.4% (p < 0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r = 0.32 to 0.53, p < 0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine’s acceptability with OR 1.90 (95%CI:1.40–2.57) and OR 1.31(95%CI,1.05–1.63), respectively.ConclusionsA structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability.

Use of multimedia as an educational tool to improve human papillomavirus vaccine acceptability—A pilot study

Cervical cancer and HPV: Awareness and vaccine acceptability among parents in Morocco

PurposeHuman papillomavirus (HPV) vaccination has been included in the National Immunization Program in Korea since 2016. We aimed to evaluate changes in the awareness of and attitudes toward HPV vaccination, among adults in Korea since the first introduction of the vaccines in 2007.Materials and MethodsA nationwide population-based survey was conducted in 2016 for 1,200 nationally representative Korean men and women; the data obtained were compared with the data from the nationwide survey conducted in 2007.ResultsA significant increase in the awareness of HPV infection (35.8%) and vaccination (36.9%) was observed in 2016 from 13.3% and 8.6% in 2007, respectively. Willingness to be vaccinated against HPV decreased from 55.0% in 2007 to 25.8% in 2016, and the proportion of respondents expressing uncertainty increased from 28.3% in 2007 to 43.3% in 2016. Only 12.1% of men and 22.0% of women knew about the free national HPV vaccination program for girls, launched in June 2016. Younger women, with higher income level, awareness of the HPV vaccine, and perception of the seriousness of infections had a higher willingness to be vaccinated. A high education level, awareness of HPV infection and vaccination, and perception of the seriousness of infection were positively associated with the willingness of respondents to vaccinate their daughters.ConclusionRaising the awareness of HPV infection and vaccination with appropriate knowledge is necessary for the successful implementation of the national HPV vaccination program.

Awareness of and attitude towards human papillomavirus infection and vaccination for cervical cancer prevention among adult males and females in Korea: A nationwide interview survey

ObjectivesWe aimed to provide a detailed characterisation of human papillomavirus (HPV) vaccine awareness, knowledge and information sources in the HPV vaccine decision-making process of youth, both male and female, in...

Human papillomavirus awareness among foreign- and US-born Hispanics, United States, 2017-2018.

Background: Programs aimed at boosting awareness on Human Papillomavirus (HPV) and HPV vaccination are considered one of the most effective strategies for increasing vaccination uptake and eliminating HPV-associated cancers. Several US states have demonstrated a strong commitment to this effort through legislation and dedicated funds, however the impact of this intervention over time remains poorly studied. Methods: Using a nationally representative population of US adults from the Health Information National Trends Survey (HINTS), we examined for awareness of HPV and HPV vaccination between 2009 and 2018. Prevalence estimates and confidence intervals were calculated for HPV and HPV vaccination awareness. Further, we assessed awareness status after stratifying by key sociodemographic characteristics. Results: Overall, the awareness of HPV and HPV vaccination declined over time. This finding was consistent across gender and socioeconomic strata. The lowest rates of awareness were found among those with educational level at or below high school completion, those who earned less than $35,000 per annum, rural residents, and male adults, aged 60 years and older. Declines in awareness of HPV or HPV vaccination between 2014 and 2018 were more than 10% among male adults, those with educational level at or below high school completion and those who earned less than $35,000 per annum. Only 36.1% of adults with high school education or lower had ever heard of HPV vaccine in 2018, a 15.6% reduction from 2009. In 2018 awareness of HPV and HPV vaccine was highest among non-Hispanic whites (65.8% and 66.5%) and female adults (70.5% and 71.4%), however these figures represented declines of at least 5% from rates observed in 2009. Discussion: Amid a background of sub-optimal HPV vaccination uptake and a growing incidence of HPV-associated cancers in the US, the awareness of HPV and HPV vaccination within the general population has declined over time. This calls for stricter enforcement of legislature aimed at boosting HPV awareness, as well as frequent evaluations of government-funded HPV awareness programs. Citation Format: Onyema G. Chido-Amajuoyi, Inimfon Jackson, Robert Yu, Sanjay Shete. Declining awareness of HPV and HPV vaccination within the general US population [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1140.

We examined differences in HPV and HPV vaccine knowledge among individuals who use the Internet as their main source of health information versus those who do not. Data were obtained from the Health Information National Trends Survey Cycles 3 and 4 (N = 6862), a cross-sectional random-digit-dialed telephone survey of noninstitutionalized adults aged ≥18 years. Multivariate logistic regression models estimated correlates of HPV and HPV vaccine awareness and knowledge among both groups. Approximately 76% of respondents who use the Internet as their main source of health information and 56% of who do not, reported an awareness of HPV and the vaccine (p < .0001). In multivariate analyses, independent of Internet use for health information, females were significantly more likely to be aware of HPV and the vaccine than males. Among those who used the Internet as their primary information source, high school diploma holders were less likely to be aware of HPV and the vaccine, compared with college graduates. However, there was no educational difference among those who did not use the Internet. Overall, Internet users had a significantly increased knowledge and awareness of HPV and HPV vaccine compared with non-Internet users, however, both groups had gaps. Continued education and innovative information dissemination techniques are needed to improve HPV and HPV vaccine awareness among both individuals who use the Internet as their primary source of information and those who do not.