Uptake of Human Papillomavirus Vaccine and Intention to Vaccinate among Healthy Pregnant Women in Serbia: A Cross-Sectional Study on Awareness, Knowledge, and Attitudes.

Ljiljana Markovic-Denic,Vladimir Nikolic,Miroslava Gojnic-Dugalic,Olivera Djuric,Srboljub Milicevic,Jovana Todorovic,Stefan Dugalic,Vuk Marusic,Brankica Vasiljevic

doi:10.3390/v13050727

Abstract

We aimed to assess awareness, knowledge, and attitudes of healthy pregnant women towards human papillomavirus (HPV), to estimate factors associated with a positive attitude towards HPV immunization and to assess the uptake of the vaccine among their children. A cross-sectional study was conducted at the University Clinic of Gynecology and Obstetrics, Belgrade, Serbia among pregnant women attending their regular gynecological check-ups at the 12th gestational week. Knowledge about HPV and HPV vaccine was assessed using a specifically designed 12-item and 5-item questionnaires. Out of total 265 included women, 79.3% had heard of HPV, and 37.5% knew that HPV vaccine exists. HPV vaccine knowledge score was associated with higher odds for a positive attitude towards vaccination of both female (OR = 4.10, 95% CI 1.50–11.29) and male (OR = 3.71, 95% CI 1.52–9.01) child. The number of children (OR = 1.32, 95% CI 1.04–1.67) and high vaccine knowledge score (OR = 1.64 95% CI 1.13–2.39) were independent predictors associated with willingness to vaccinate child against HPV. The gynecologist was the preferable point of reference for information seeking about the HPV vaccine. Despite relatively high HPV awareness and knowledge among pregnant women in Serbia, about one-third of them are HPV vaccine aware, and are willing to vaccinate their children against HPV.

Highlights

The aim of this study was to examine the human papillomavirus (HPV) and HPV vaccine-related knowledge among healthy pregnant women in Serbia, to assess factors associated with willingness to vaccinate their children, and to estimate the uptake of at least one dose of vaccine received by their children
The present study examined the awareness and knowledge of healthy pregnant women in their first trimester of pregnancy in Serbia on HPV, along with their attitudes on vaccination, factors associated with willingness to vaccinate their children, and actual uptake of the HPV vaccine
Our study showed that almost 80% of our participants stated that they have heard about HPV before, but much less, only just over a third was aware that there is an HPV vaccine

Summary

Introduction

Human papillomavirus (HPV) is considered to be the most common sexually transmitted infectious agent today [1]. The estimated worldwide prevalence of HPV infection in the general population is approximately 12% with significant regional differences [2]. Around 75% of sexually active people are infected with HPV at some point during their lifetime [2], the majority of HPV infections will resolve on their own and will be asymptomatic [2]. Some will be persistent and can lead to precancerous lesions and cancer [2]. The estimated prevalence of infection with HPV 16 and/or 18, that are associated with almost 70% of all cases of invasive cervical cancer, in Southern Europe, which Serbia belongs to, is around 3.8% [3]

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