Human Papillomavirus Vaccination Intention Research Articles

Factors Associated with Intention of Human Papillomavirus (HPV) Vaccine Initiation Among Females With and Without a History of Childhood Cancer.

Vaccination is available to prevent human papillomavirus (HPV) types that cause cervical and other cancers. This study aimed to describe and compare vaccine intention among young females with and without a cancer history, in addition to identifying factors associated with a HPV vaccination intention. Vaccine-naïve females (aged 18-26years, n = 120) and maternal caregivers with vaccine-naïve daughters (aged 9-17years, n = 197) completed surveys querying HPV vaccination intention, HPV knowledge, and communication, along with sociodemographic, medical, and health belief factors. Multivariable logistic regression was utilized to calculate odds ratio (OR) and 95% confidence intervals for HPV vaccination intention. No differences in vaccine intention were identified across cancer and comparison groups. Vaccine intention and predictors of intention among vaccine-naïve females differ by age, and there is variation in the factors which influence vaccine intention by age group. These results suggest interventions should be tailored based on developmental level.

HPV and HPV Vaccination Knowledge and Attitudes Among Medical Students in Alabama.

In addition to being the most common sexually transmitted infection, the human papillomavirus (HPV) is associated with six types of cancer in men and women. The HPV vaccine provides long-lasting, effective protection from high-risk HPV infection, thus serving as a means of cancer prevention. An effective healthcare provider recommendation is well-established as the most significant influence on HPV vaccine uptake, and, as emerging providers, it is critical that medical students receive comprehensive training in this area. However, the type and extent of such training for current medical students in the USA is unclear. An online survey assessing HPV and HPV vaccine knowledge, attitudes, and vaccine status was distributed to all medical students at an Alabama university. Scales were developed to assess composite HPV and HPV knowledge scores and HPV vaccination intentions. Of those age-eligible, 32.1% reported completion of the HPV vaccine series while 15.2% reported partial completion. Knowledge of both HPV and HPV vaccination significantly increased with program year (p < 0.0001 and p = 0.0069, respectively); however, there were knowledge gaps across all years regarding HPV-associated cancers. Attitudes and intentions showed a similar association, with more advanced students demonstrating more positive attitudes toward HPV vaccination (p = 0.0003). There is a need within the current curriculum to include more education and training on HPV, HPV vaccination, and counseling-particularly for students in the first 2years of their program. Implementation of a classroom module or interactive workshop would likely improve knowledge and attitudes, better preparing students for their future role as potential immunizers.

Factors Related to Chinese Parents' HPV Vaccination Intention for Children.

Objectives: Successful human papilloma virus (HPV) vaccine delivery depends heavily on parents' attitudes, perceptions, and willingness to have their children vaccinated. In this study, we assessed parental knowledge, attitudes, and beliefs about the HPV vaccine, and examine factors associated with willingness to have eligible children receive HPV vaccination. Methods: From a community health center serving Chinese members in the Greater Philadelphia area, 110 Chinese-American parents with at least one child aged 11 to 18 who had not received HPV vaccine were recruited. Data were collected in face-to-face interviews. Results: Chinese-American parents generally lacked knowledge on HPV and the HPV vaccine, yet had a moderately high level of intention to vaccinate their children against HPV. Ordinal logistic regression results indicated that knowledge, whether or not to involve children, doctor influence, and time lived in the United States were significantly and independently related to parental intention to have their children vaccinated against HPV. Conclusion: Interventions should make efforts to raise awareness of HPV and promote vaccination in doctors' offices. The lower level of parental intention among relatively recent immigrants indicated the necessity to target this population in public health campaigns and intervention efforts.

Predictors of human papillomavirus (HPV) vaccine intent and subsequent initiation among adolescent and young adult cancer survivors

Predictors of human papillomavirus (HPV) vaccine intent and subsequent initiation among adolescent and young adult cancer survivors

Intent and subsequent initiation of human papillomavirus vaccine among young cancer survivors.

Despite an increased risk of subsequent human papillomavirus (HPV)-related malignancies, HPV vaccine initiation rates among cancer survivors remain critically low. The purpose of this study was to determine the relationship between HPV vaccine intent and subsequent vaccine initiation among cancer survivors by linking data from a cross-sectional survey with state-based immunization registry records. Cancer survivors who were 9 to 26years old were surveyed 1 to 5years after their treatment to assess their HPV vaccine initiation status, HPV vaccine intent, sociodemographic factors, and vaccine-related health beliefs. HPV vaccine doses/dates were abstracted from the Georgia Registry for Immunization Transactions for 3.5years after survey participation. Logistic regression models identified factors associated with vaccine intent and subsequent vaccine initiation. Among survivors who were HPV vaccine-naive at survey participation (n=103), factors associated with vaccine intent included the following: 1) provider recommendation for the HPV vaccine (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.4-18.1; P=.014), 2) positive general attitude toward vaccines (OR, 4.8; 95% CI, 2.0-11.2; P<.001), and 3) perceived severity of HPV disease (OR, 3.5; 95% CI, 1.2-9.9; P=.02). Of the vaccine-naive patients, 28 initiated the HPV vaccine at a median of 1.1years after the survey. Initiation was more likely among survivors who had reported vaccine intent (OR, 3.9; 95% CI, 1.2-12.5; P=.02) and was less likely among older survivors (OR per year, 0.7; 95% CI, 0.6-0.9; P<.001). These findings suggest that provider recommendation for the HPV vaccine plays a role in establishing intent, which then translates into subsequent initiation.

Factors Influencing HPV Vaccination Intention in Mothers with Elementary School Daughters.

The purpose of this study was to identify the impacts of human papillomavirus (HPV) vaccination-related health belief, attitudes toward HPV vaccination, and subjective norms on HPV vaccination intent targeting mothers of elementary school daughters. The study use a correlative survey design. The subjects of the study were 121 mothers of elementary school daughters located in metropolitan city B. All subjects agreed to participate in the study. The data were collected from September 1 to October 18, 2018, and were analyzed using descriptive statistics, Independent t-test, ANOVA with a post hoc Scheffé test, Pearson's correlation coefficients, and stepwise multiple regression. Attitude toward HPV vaccination, subjective norms, vaccination plans for their children, and mother's vaccination status were significant factors influencing HPV vaccination intention. These factors accounted for 72% of the HPV vaccination intention. CONCLUSIONS: This study showed that factors affecting the intention of mothers of elementary school daughters to vaccinate against HPV were HPV vaccination attitudes, subjective norms, vaccination plans for their children, and mother's vaccination status. The biggest influencing factor was HPV vaccination attitudes. Therefore, in order to encourage mothers of elementary school daughters to vaccinate against HPVs, national-level policies should be implemented to create a social atmosphere of positive attitudes toward HPV vaccinations that also emphasizes how easy it is to get vaccinated against HPV. Based on this, mothers of elementary school daughters should be encouraged to have them vaccinated against HPV, thus contributing to improving the HPV vaccination rates of elementary school girls.

A Longitudinal KAP Study on HPV Immunised Adolescents’ in Malaysia

Introduction: Human Papilloma Virus (HPV) infection is the most frequently encountered sexually transmitted disease. Lack of HPV knowledge and vaccination intentions are the main concern for its high prevalence. The primary outcome measure were to assess the Knowledge, Attitude and Perception (KAP) levels among HPV vaccinated secondary school adolescents and estimate the impact of educational intervention through repeated measures. Methods: A longitudinal study was performed using pre-validated questionnaire and educational pamphlet as study and intervention tools. The survey was conducted in three phases, (0, .5 and 3-6 months). The scores were categorized based on original blooms cut-off scale. Descriptive statistics for categorical data and Friedman's test for repeated measures followed by pos hoc Wilcoxon signed rank test with Bonferroni correction (type-1 error) was used for inferential statistics. Result: The research findings showed significant differences (p<.001) in KAP scores, observed at all three phases (ph). The KAP scores were 58%, moderate at ph1, 67% good at ph2 and 59% good at ph3. The knowledge scores were, 63% poor at ph1, 64% good at ph2 and 64% good at ph3. An estimate for impact of intervention for knowledge gain revealed, a significant (p<.001) overall median knowledge score of 9(6) and 15(4) between ph1 and ph2, respectively. The knowledge retention showed significant differences (p<.001) in median scores, 9(6) and 15(7) between ph1 and ph3, respectively. Conclusion: Educational pamphlet significantly increased knowledge and KAP scores about HPV in the study population, regardless of socio-demographic characteristics among the study population. Effective, informative and appropriate educational protocols designed for the target population using 'Spaced Repetition-Based Educational Intervention' are particularly important for better and sustained outcomes.

Factors Associated with Human Papillomavirus Vaccination Among Diverse Adolescents in a Region with Low Human Papillomavirus Vaccination Rates.

Introduction: This study assesses the sociodemographic facilitators and barriers to human papillomavirus (HPV) vaccination for diverse teens in a region with low HPV vaccination rates.Materials and Methods: In this community-based participatory research study, we surveyed adult family members of teens aged 11–17 years from African American, African refugee, American Indian/Alaskan Native, Hispanic/Latino, and Native Hawaiian/Pacific Islander community groups in Salt Lake City, Utah. Bivariate analyses assessed associations between sociodemographic characteristics and, respectively, HPV vaccine receipt and intentions for vaccination. Barriers to vaccination were also investigated.Results: Only 20% of participants had vaccinated at least one of their children with at least one dose of the HPV vaccine. HPV vaccination was significantly related to caregiver age (p=0.035), race/ethnicity (p=0.001), educational attainment (p=0.006), annual household income (p=0.0454), years in the United States (p=0.023), and caregiver parent birthplace (p=0.008). Among caregivers with unvaccinated children, intention to vaccinate was significantly related to race/ethnicity (p=0.048 for daughters; p=0.003 for sons), caregiver parent birthplace (p=0.023 for sons), health insurance coverage (p=0.028 for daughters; p=0.047 for sons), and type of health insurance coverage (p=0.008 for sons). The most frequently cited barriers to HPV vaccination were lack of knowledge about the HPV vaccine, costs, side effects, and child not being sexually active.Conclusions: Our results show substantially lower HPV vaccine coverage than both national and state rates, signaling the urgent need for multipronged HPV vaccination interventions within these communities; strategies are discussed.

Factors Influencing Human Papillomavirus Vaccination Intention among Unvaccinated Nursing Students in Korea

Purpose: This study was performed to identify factors associated with human papillomavirus vaccination intention among unvaccinated nursing students. Methods: Two hundred-and-five female nursing students from three universities completed self-administered questionnaires including participants' characteristics, human papillomavirus-related knowledge, attitude toward human papillomavirus vaccination, and human papillomavirus-related health beliefs. Multivariate logistic regression analysis was used to determine significant independent predictors of human papillomavirus vaccination intention. Results: Of 205 participants, 134 (65.4%) reported an intention to obtain a vaccination against human papillomavirus. As a result of the analysis of the bivariate relationships, family history of cervix cancer, perceived needs, importance of prevention, perceived susceptibility, perceived benefit, and perceived barrier were significantly related to vaccination intention. A multivariate logistic regression model identified factors of human papillomavirus vaccination intention: higher importance of prevention (Adjusted Odds Ratio [AOR]: 4.20, 95% Confidence Interval [CI]: 1.73~10.19), higher perceived benefit (AOR: 6.94, 95% CI: 2.01~23.98), lower perceived barrier (AOR: 0.39, 95% CI: 0.20~0.73). Conclusion: The results of this study indicated significant factors influencing the intention to obtain human papillomavirus vaccination in unvaccinated nursing students. Also, the importance of prevention, perceived susceptibility, perceived benefit, and perceived barrier in obtaining human papillomavirus vaccination should be taken into account when developing educational programs.

Human Papillomavirus Vaccine Knowledge and Intention Among Adult Inmates in Kansas, 2016-2017.

To assess human papillomavirus (HPV) knowledge and vaccine awareness, intention, and uptake among adult inmates in Kansas jails. We administered a survey with questions adapted from the US National Cancer Institute's Health Information National Trends Survey to 571 adult inmates in 3 Kansas jails from October 10 to 12, 2016, and January 25 to 27, 2017, to assess HPV knowledge and vaccine awareness, intention, and uptake. Although most adults across demographic groups recognized HPV as causing cervical cancer, knowledge was lower about other HPV-related cancers. Vaccine awareness was higher for women (70%) than men (41%). Only 8% of age-eligible men reported ever receiving the vaccine. Most adults across demographic groups reported "definitely" wanting to get the vaccine if offered in jail at no cost. Low uptake of HPV vaccine and high interest in receiving the vaccine in jails may indicate that vaccination availability for jail populations needs to be reexamined. Public Health Implications. Expanding HPV vaccine programs or partnerships to facilitate vaccine provision in jails could increase inmates' knowledge of and intention to receive vital health services.

Persuasiveness of Statistics and Patients' and Mothers' Narratives in Human Papillomavirus Vaccine Recommendation Messages: A Randomized Controlled Study in Japan.

The human papillomavirus (HPV) vaccination percentage among age-eligible girls in Japan is only in the single digits. This signals the need for effective vaccine communication tactics. This study aimed to examine the influence of statistical data and narrative HPV vaccination recommendation massages on recipients' vaccination intentions. This randomized controlled study covered 1,432 mothers who had daughters aged 12-16 years. It compared message persuasiveness among four conditions: statistical messages only; narrative messages of a patient who experienced cervical cancer, in addition to statistical messages; narrative messages of a mother whose daughter experienced cervical cancer, in addition to statistical messages; and a control. Vaccination intentions to have one's daughter(s) receive the HPV vaccine before and after reading intervention materials were assessed. Statistical analysis was conducted using analysis of variance with Tukey's test or Games-Howell post hoc test, and analysis of covariance with Bonferroni correction. Vaccination intentions after intervention in the three intervention conditions were higher than the control condition (p < 0.001). A mother's narrative messages in addition to statistical messages increased HPV vaccination intention the most of all tested intervention conditions. A significant difference in the estimated means of intention with the covariate adjustment for baseline value (i.e., intention before intervention) was found between a mother's narrative messages in addition to statistical messages and statistical messages only (p = 0.040). Mothers' narrative messages may be persuasive when targeting mothers for promoting HPV vaccination. This may be because mothers can easily relate to and identify with communications from other mothers. However, for effective HPV vaccine communication, further studies are needed to understand more about persuasive differences in terms of statistics, narratives, and narrators. Directions for future research are also suggested.

National Trends in Parental Human Papillomavirus Vaccination Intentions and Reasons for Hesitancy, 2010-2015.

Human papillomavirus (HPV) vaccination uptake remains lower than other recommended adolescent vaccines in the United States. Parental attitudes are important predictors of vaccine uptake, yet little is known about how they have changed over time. Participants included US residents aged 13-17 years with documented vaccination status who had received <3 doses of HPV vaccine whose parents responded to the National Immunization Survey-Teen, 2010-2015. Of the 76971 participants, 63.0% were male, 58.8% were non-Hispanic white, and 14.4 years was the median age. The percentage of unvaccinated teens decreased from 2010 to 2015, yet, annually, parents of unvaccinated teens of both sexes most often reported that they were "not likely at all" to vaccinate their teen. The percentage decreased significantly from 41.5% to 31.2% (P < .001) for parents of unvaccinated females from 2010 to 2015 but did not change among parents of males from 2012 to 2015. Conversely, parents of undervaccinated teens of both sexes reported higher and increasing vaccination intent over time. In 2015, nearly one-third of parents of unvaccinated teens reported that the vaccine was "not needed/necessary." Concerns about vaccine safety and side effects declined among parents of unvaccinated females but increased among parents of males (7.3% to 14.8%; P < .001). Although parental vaccination intent and knowledge improved over time, intent remains low and many parents still have significant concerns about HPV vaccination, even after series initiation. Multiple strategies are needed to improve series initiation and completion in the United States.

Black mother's intention to vaccinate daughters against HPV: A mixed methods approach to identify opportunities for targeted communication

ObjectiveThe cervical cancer disparity continues to exist and has widened between Black and non-Hispanic White women. Human Papillomavirus (HPV) vaccines could potentially reduce this disparity, yet remain underused among Black female adolescents. We investigated psychosocial and cultural factors associated with Black mothers' intentions to vaccinate their daughters against HPV, and explored views toward a HPV vaccine mandate. MethodsIn this quantitative dominant, mixed methods study, cross sectional surveys (n=237) and follow-up semi-structured interviews (n=9) were conducted with Black mothers of daughters. A 2-step logistic regression determined factors associated with Black mothers' intention. Thematic content analysis determined emerging themes. ResultsPerceived susceptibility (p=.044), perceived barriers (p<.001), and subjective norms (p=.001) were significant predictors of maternal HPV vaccination intentions. Follow-up interviews provided insight into factors influencing mothers' intentions. Mothers with low intentions did not perceive their daughter to be currently sexually active or in near future, thus, not at HPV risk. Pediatricians were identified as the most influential person on maternal decision-making if there was a pre-existing relationship. However, many mothers had not received a pediatricians' recommendation for their daughters. Barriers influencing mother's decision-making include knowledge, daughters' age, and mistrust in pharmaceutical companies and physicians. Mothers were not in favor of the HPV vaccine mandate. ConclusionsFindings demonstrate the need to develop and evaluate physician-led interventions on HPV and vaccine importance, and engage these mothers in intervention development to build trust between physicians, researchers, and Black mothers to improve HPV vaccine uptake in Black female adolescents.

Cross-sectional associations between psychological traits, and HPV vaccine uptake and intentions in young adults from the United States.

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection worldwide and can lead to the development of genital warts, and cancers throughout the body. Despite the availability of HPV vaccines for over a decade, uptake in the United States among adolescents and young adults remains well below national targets. While most efforts to improve HPV vaccine uptake have rightly focused on adolescents, there is still a tremendous opportunity to improve vaccination among young adults who have not been vaccinated against HPV. To that end, we report an exploratory examination of associations between HPV vaccination status and intentions with psychological traits that may impact HPV vaccine uptake with a national, demographically diverse sample of young adults (N = 1358) who completed an online survey. These psychological traits conceptually mapped onto motivations to: 1) understand health-related information, 2) deliberate, 3) manage uncertainty, and 4) manage threats. We found notable gender differences for the association of these motivations and vaccination status. For women, higher interest in and ability to understand health-related information seemed to distinguish those who reported receiving the HPV vaccine from those who did not. For men, less need to deliberate and greater needs to manage threat and uncertainty seemed to be the distinguishing motives for those who reported receiving the HPV vaccine compared to those who did not. Results for vaccination intentions were less consistent, but there was some evidence to indicate that, regardless of gender, greater health-related information interest and understanding and need to manage uncertainty and threats were associated with increased intention to receive the HPV vaccine, while greater need to deliberate was associated with decreased vaccination intentions. These results suggest that there are psychological differences that are associated with HPV vaccination decisions and that these motivations should be considered in efforts to improve HPV vaccine uptake.

Outsmart HPV: Acceptability and short-term effects of a web-based HPV vaccination intervention for young adult gay and bisexual men

BackgroundEffective interventions to promote human papillomavirus (HPV) vaccination are needed, particularly among populations at increased risk of HPV-related disease. We developed and pilot tested a web-based intervention, Outsmart HPV, to promote HPV vaccination among young gay and bisexual men (YGBM). MethodsIn 2016, we recruited a national sample (n = 150) of YGBM ages 18–25 in the United States who had not received any doses of HPV vaccine. Participants were randomized to receive either standard HPV vaccination information (control) or population-targeted, individually-tailored content (Outsmart HPV intervention). We assessed between group differences in HPV vaccination attitudes and beliefs immediately following the intervention using multiple linear regression. ResultsThere were no differences in HPV vaccination attitudes, beliefs and intentions between groups at baseline. Compared to participants in the control group, intervention participants reported: greater perception that men who have sex with men are at higher risk for anal cancer relative to other men (b = 0.34); greater HPV vaccination self-efficacy (b = 0.15); and fewer perceived harms of HPV vaccine (b = −0.34) on posttest surveys (all p < .05). Overall, intervention participants reported high levels of acceptability and satisfaction with the Outsmart HPV intervention (all > 4.4 on a 5-point scale). ConclusionsFindings from this study provide preliminary support for a brief, tailored web-based intervention in improving HPV vaccination attitudes and beliefs among YGBM. An important next step is to determine the effects of Outsmart HPV on HPV vaccine uptake. Clinical trials registrationClinicalTrials.gov identifier NCT02835755.

Factors influencing Human Papillomavirus Vaccination intention in Female High School Students: Application of Planned Behavior Theory.

The purpose of this study was to identify effects of attitude, subjective norm, and perceived behavior control toward Human Papillomavirus (HPV) on HPV vaccination intention in female high school students. Subjects of this study were female students aged 16 to 17 years, the optimal age group of HPV vaccination, arbitrarily selected from three high schools in B city. A total of 140 students agreed to participate in this study. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation, and stepwise multiple regression. Attitude, subjective norm, and perceived behavior control toward HPV were factors influencing HPV vaccination intention of subjects. Perceived behavior control toward HPV vaccination was the most influential factor. These factors accounted for 49% of HPV vaccination intention. These results suggest a need to increase perceived behavior control to increase HPV vaccination intention. The government needs to establish a national policy system such as financial support for HPV vaccines and free vaccinations so that students are aware that HPV vaccines can be easily inoculated.

Determinants of Human Papillomavirus Vaccination Intention Among Female Sex Workers in Amsterdam, the Netherlands.

Female sex workers (FSWs) are at risk for human papillomavirus (HPV)-induced diseases but are currently not targeted by the HPV vaccination program in the Netherlands. We explored determinants of their intention to get vaccinated against HPV in case vaccination would be offered to them. In 2016, FSWs 18 years and older having a sexually transmitted infection consultation with the Prostitution & Health Center (P&G292) in Amsterdam, either at the clinic or at their working location, were invited to complete a questionnaire assessing sociopsychological determinants of HPV vaccination intention (scale ranging from -3 to +3). Determinants of HPV vaccination intention were assessed with univariable and multivariable linear regression. In addition, we explored the effect of out-of-pocket payment on intention. Between May and September 2016, 294 FSWs participated. The median age was 29 years (interquartile range, 25-37 years). Human papillomavirus vaccination intention was high (mean, 2.0; 95% confidence interval [CI], 1.8-2.2). In multivariable analysis, attitude (β = 0.6; 95% CI, 0.5-0.7), descriptive norm (β = 0.2; 95% CI, 0.1-0.3), self-efficacy (β = 0.2; 95% CI, 0.1-0.3), beliefs (β = 0.1; 95% CI, 0.0-0.2), and subjective norm (β = 0.1; 95% CI, 0.0-0.2) seemed to be the strongest predictors of HPV vaccination intention (R = 0.54). Human papillomavirus vaccination intention decreased significantly to a mean of 0.2 when vaccination would require out-of-pocket payment of &OV0556;350. The HPV vaccination intention among FSWs seems relatively high and is most strongly constituted in attitudinal, normative, and self-efficacy beliefs. Out-of-pocket payment will probably have a negative impact on their HPV vaccination acceptability.

Factors Influencing Intention for Human Papillomavirus Vaccination Among Parents with Elementary School Girls

Purpose: This descriptive research study aims to investigate influential factors on human papillomavirus vaccines, among parents who have elementary school daughters. Methods: This study was conducted with 210 parents whose children are elementary school girls, aged 9 to 12 years, in G Metropolitan City. Data were collected from August 17 to September 12, 2015 using structured questionnaires. A descriptive statistical analysis, a t-test, a ${chi}^2-test$, a Fisher's exact test, and a logistic regression using SPSS/WIN 21.0. Results: The influential factors on the human papillomavirus vaccination intention were confirmed to be three variables: cervical cancer knowledge, perceived sensitivity, and perceived barriers. Conclusion: An intervention program, both to increase the sensitivity of vaccination and to decrease barriers, should be developed so as to improve parents' health beliefs towards human papillomavirus vaccination.

Does Self-Efficacy Mediate the Relationships Between Social-Cognitive Factors and Intentions to Receive HPV Vaccination Among Young Women?

Drawing upon health behavior change theories, the current study examined whether self-efficacy mediated relationships between social-cognitive factors (i.e., perceived risk, perceived benefits, perceived barriers, perceived severity, and cue to action) and human papillomavirus (HPV) vaccination intentions among college women. Unvaccinated women (N = 115) aged 18 to 25 years attending a Midwestern university completed an anonymous web-based survey assessing study variables. Correlational analyses and mediation analyses were conducted. Self-efficacy mediated relationships between two social-cognitive factors (i.e., perceived barriers to HPV vaccination-indirect effect = -.16, SE = .06, 95% confidence interval [CI] = [-.31, -.06]-and perceived risk of HPV-related conditions-indirect effect = .16, SE = .09, 95% CI = [.01, .37]) and HPV vaccination intentions but was unrelated to the other three social-cognitive factors. Based on these findings, future research should test whether increasing self-efficacy through education on risk of HPV-related conditions and reducing barriers to HPV vaccination improves vaccine uptake in college women.

Chinese medical students' knowledge, attitude and practice towards human papillomavirus vaccination and their intention to recommend the vaccine.

The human papillomavirus (HPV) vaccine is effective in preventing cervical cancer, but its global uptake rate in vulnerable populations is unsatisfactory. Physician's recommendation is an important determinant for vaccine uptake, but we have limited understanding on the contributing factors of physician's recommendation. This study investigated whether the knowledge, attitudes and vaccination status of medical students would affect their intention to recommend HPV vaccination. This is a population-representative survey of medical schools in Hong Kong. Participants included 1022 Chinese medical students (46.9% of all in Hong Kong; 46.3% female). Better HPV-related knowledge and a more positive attitude towards HPV vaccination were important factors predicting vaccine uptake and intention to recommend. HPV vaccination status and intention to receive the vaccine were positively associated with intention to recommend among females. Better HPV-related medical education may be a feasible way to promote the HPV vaccine in regions without universal coverage. Medical students who have not received the HPV vaccine should also be encouraged to receive the vaccine.