Preferences for Sexually Transmitted Infection and Cancer Vaccines in the United States and in China.

OBJECTIVES: This study assessed preferences for hypothetical vaccines for children in 2 large vaccine markets according to how the vaccine-preventable disease is transmitted via a discrete choice experiment. METHODS: Surveys in China (N = 1350) and the United States (N = 1413) were conducted from April to May 2021. The discrete choice experiment included attributes of cost, age at vaccination, transmission mode of the vaccine-preventable disease, and whether the vaccine prevents cancer. Preference utilities were modeled in a Bayesian, multinomial logistic regression model, and respondents were grouped by vaccine preference classification through a latent class analysis. RESULTS: Individuals favored vaccines against diseases with transmission modes other than sexual transmission (vaccine for sexually transmitted infection [STI] vs airborne disease, in the United States, odds ratio 0.71; 95% credible interval 0.64-0.78; in China, odds ratio 0.76; 95% credible interval 0.69-0.84). The latent class analysis revealed 6 classes: vaccine rejecters (19% in the United States and 8% in China), careful deciders (18% and 17%), preferring cancer vaccination (20% and 19%), preferring vaccinating children at older ages (10% and 11%), preferring vaccinating older ages, but indifferent about cancer vaccines (23% and 25%), and preferring vaccinating children at younger ages (10% and 19%). Vaccine rejection was higher with age in the United States versus more vaccine rejection among those at the age of 18 to 24 and ≥ 64 years in China. CONCLUSION: The public had strong preferences against giving their child an STI vaccine, and the class preferring a cancer vaccine was less accepting of an STI vaccine. Overall, this study points to the need for more education about how some STI vaccines could also prevent cancers.

Awareness of HPV and HPV vaccines, acceptance to vaccination and its influence factors among parents of adolescents 9 to 18 years of age in China: A cross-sectional study.

BACKGROUND: Vaccination uptake rates for adolescents are still low in China despite safe and effective human papillomavirus vaccines being available. The awareness and attitudes of parents to HPV vaccines play a decisive role in adolescents' HPV vaccination uptake. METHODS: A cross-sectional study was conducted from March, 2022 to May, 2022 using an anonymous questionnaire among parents of 9 to 18 years of age from 73 cities in 23 provinces in mainland China. Demographic characteristics of parents, their knowledge and attitudes about HPV and HPV vaccination, as well as factors influencing HPV vaccination in adolescents were assessed. RESULTS: More than two-thirds of parents heard of HPV (75.5%) and HPV vaccines (84.7%). Of these participants, mothers (83.8%) were in the majority. Parents willing to vaccinate themselves and their children against HPV were 84.9% and 87.6%, respectively. Parents were more likely to vaccinate their daughters against HPV than their sons (P < 0.001). Parents who had heard of the HPV vaccines (P = 0.028) or had vaccinated themselves (P < 0.001) were more likely to have HPV vaccination for their children. Parents who accepted the price of the HPV vaccines (P = 0.005) were more likely to have their children vaccinated against HPV. CONCLUSIONS: Children's gender, awareness of the HPV vaccines, parental HPV vaccination, and the price of the HPV vaccines are likely to be the reason for parents' vaccine hesitancy for adolescents. PRACTICE IMPLICATIONS: Nurses have a critical role in identifying parental hesitancy and providing individualized education to expand the parental awareness and knowledge and encourage on-time adolescents vaccination.

Investigating Media Coverage and Public Perceptions of the HPV Vaccine in China - A Content Analysis of Weibo Posts.

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The HPV vaccination has been widely advocated around the world since the vaccine is beneficial in avoiding diseases, including some sexually transmitted diseases, brought on by HPV infections. For most Chinese, the HPV vaccine is still a relatively new concept, having only been made available to the general public in 2016. Despite the vaccine's increased prominence, there is still a lack of investigation about how the public is influencing the conversation about HPV vaccines and the public's perception of this vaccine. With the theoretical construct of the Health Belief Model, this study conducts both quantitative and qualitative content analysis to investigate the existing media narratives around HPV vaccines in China and the changes in public opinion by looking at users' contributions on Weibo, one of China's most popular social networking sites. It was found that different groups of Weibo users had contributed to diverse narratives surrounding HPV vaccination. Though the public awareness of HPV vaccination had been improved along with increasingly active communication practices and enhanced public health services, public knowledge about HPV remains inadequate. Therefore, to facilitate the popularisation of HPV related knowledge, more effort should be invested in tailoring and disseminating messages that communicate responsive and comprehensive HPV related information.

Knowledge, Attitudes and Behaviors of Women who have or have not had human papillomavirus vaccine in Turkey about the Virus and the vaccine.

The awareness of Human Papillomavirus (HPV), the most common sexually transmitted disease in the world, and the frequency of vaccination vary across countries. In Turkey, the rate of HPV vaccination is quite low even amongin women, and there is not much data on the frequency of vaccination among men. This study aimedto investigate the difference in knowledge and attitude between Turkish women who had HPV vaccination and those who did not. Women between 18 and 65 living in a province in the central region of Turkey were included. Participants (n = 856) were selected by snowball sampling and with an online questionnaire. The collected data were analyzed by the SPSS programme. Descriptive statistical analysis, chi-square test, T-test for independent samples and one-way ANOVA was used. 67.3% of the participants had heard of HPV and 55.4% had heard of the HPV vaccine. The HPV vaccination rate was 3.6%. The most important source of information for those who reported getting vaccinated on HPV was their family physician. Additionally, the HPV Knowledge Scale total scores of those who received information from family physicians and gynecologists were higher than the others. The most frequent reasons they cited for not getting vaccinated were a lack of information and not having the vaccine covered by social security. It is important to include it in the national vaccination scheme in order to increase the HPV vaccination rate in low-income countries such as Turkey. Also, these findings show the prominence of family physicians in public education.

Social media engagement association with human papillomavirus and vaccine awareness and perceptions: Results from the 2017 US Health Information National Trends Survey.

Due to social media's ability to publicize misinformation about vaccines, there is a need to study associations between social media engagement (SME) with human papillomavirus (HPV) and vaccine-related awareness and beliefs. Therefore, the study objectives were to (1) describe the SME of a nationally representative sample of US adults, and (2) determine the associations between SME and HPV-related awareness, HPV-related knowledge, HPV vaccine-related awareness, and perceived HPV vaccine efficacy. In 2019, we completed a secondary analysis of the 2017 Health Information National Trends Survey (Cycle 5.1). We created the SME index from 5 social media items. For each outcome variable, 3 models using binary and multinomial logistic regression were estimated. SME in the sample (n = 3171) was low (M = 0.9; range: 0-2). Respondents with higher SME had higher odds of HPV awareness (AOR = 1.56; 95% CI = 1.23, 1.99). Higher SME was associated with awareness of the HPV vaccine (AOR = 1.46; 95% CI = 1.16, 1.85). Respondents with higher SME had higher odds of perceiving HPV vaccine to be "not at all successful" (AOR = 2.22; 95% CI = 1.16, 4.24), "a little successful" (AOR = 1.99; 95% CI = 1.35, 2.94), "pretty successful" (AOR = 1.40; 95% CI = 1.04, 1.89), and "very successful" (AOR = 1.40; 95% CI = 1.02, 1.92) compared to those who selected "don't know" after adjusting for demographics and internet use. Our study highlights novel findings using a comprehensive SME index with a national sample providing insight to leverage existing consumer behaviors to better connect and disseminate accurate HPV information in a more strategic manner.

Factors Associated with Initiation of HPV Vaccination Among Young Women and Girls in Urban and Suburban New Orleans.

Vaccination coverage against human papilloma virus (HPV) in the United States remains low. This study aimed to identify factors associated with initiation of HPV vaccination among young women and girls in New Orleans, Louisiana. The study was conducted in Pediatrics and Obstetrics & Gynecology clinics in New Orleans between 2014 and 2017. Surveys were administered to women ages 18 through 26, and guardians of girls ages 12 through 17. Demographics, health history, sources of medical information, knowledge of HPV and HPV vaccination, opinions on vaccination, expected support for vaccination, and systems-level barriers were assessed. Participants self-reported discussion of the vaccine with a healthcare provider, and whether they or their child had been vaccinated. Participants were predominantly black and low-income. Among young adults, 61/121 (50%) had received any doses of the HPV vaccine; 71/94 (75%) of girls had received it (p < 0.01). In both groups, knowledge of the HPV vaccine, believing the vaccine was available from their usual healthcare provider, and having discussed the vaccine with their provider were associated with increased odds of vaccination. Among young adults, additional factors associated with vaccination were younger age, distance from a healthcare center, knowledge of HPV, and expectation of support from parents. Among guardians, holding negative views on vaccination was associated with decreased odds of vaccination. Discussion of the vaccine with a healthcare provider was the factor most strongly associated with initiation of HPV vaccination in both groups. The results provided actionable items to increase HPV vaccination uptake in these populations.

Factors Affecting Delivery of the HPV Vaccination: A Focus Group Study With NHS School-Aged Vaccination Teams in London.

This study sought to identify barriers and facilitators to delivery of human papillomavirus (HPV) vaccination in schools. Four focus groups were conducted with 28 staff members, from four National Health Service school-aged vaccination (SAV) teams in London. Data were analyzed using thematic analysis. School engagement and support, and understanding and education about the vaccination (or conversely, a lack of) were identified as both barriers and facilitators. Limited school and team resources, fear of the vaccination, and poor consent form return were identified as barriers. Explanations for why some girls do not complete the vaccination series were provided. Individualizing approaches used to promote and encourage the vaccination was identified as a facilitating factor. Optimal delivery of the HPV vaccination program is dependent on school engagement and the allocation of time for SAV teams to promote vaccination uptake. Immunization program providers should work with schools to improve understanding and support of the HPV vaccination program.

Health and Economic Impact of a Tender-Based, Sex-Neutral Human Papillomavirus 16/18 Vaccination Program in the Netherlands.

Background: Uptake of human papillomavirus (HPV) vaccine among girls in the Dutch immunization program has plateaued at around 60%. Vaccinating boys may be an appealing complementary strategy for the prevention of HPV-related diseases, especially since tender negotiations and reduced dosing schemes have driven down the cost of vaccination. Methods: We expanded a previously published Bayesian synthesis framework to account for all vaccine type-related cancers and herd immunity effects from vaccinating girls and boys. We evaluated the efficiency of vaccinating boys relative to increasing vaccine uptake among girls and assessed the cost-effectiveness of a sex-neutral program. Results: Vaccinating 40% of boys along with 60% of girls yielded the same gain in life-years (LYs) as increasing the uptake in girls from 60% to 80%. The incremental cost-effectiveness ratio (ICER) of vaccinating boys was €9134/LY (95% credible interval [CrI], €7323/LY-€11231/LY) under 3% discounting. The ceiling vaccination costs at which the ICER remained below the per capita gross domestic product threshold was €240 (95% CrI, €200-€280) per vaccinated boy. If girls' uptake increased to 90%, the ceiling costs decreased to €70 (95% CrI, €40-€100) per vaccinated boy. Conclusions: Vaccinating boys along with girls is only modestly less efficient than increasing uptake among girls and highly likely to be cost-effective under current vaccine costs and uptake in the Netherlands.

Leveraging machine learning-based approaches to assess human papillomavirus vaccination sentiment trends with Twitter data.

BACKGROUND: As one of the serious public health issues, vaccination refusal has been attracting more and more attention, especially for newly approved human papillomavirus (HPV) vaccines. Understanding public opinion towards HPV vaccines, especially concerns on social media, is of significant importance for HPV vaccination promotion. METHODS: In this study, we leveraged a hierarchical machine learning based sentiment analysis system to extract public opinions towards HPV vaccines from Twitter. English tweets containing HPV vaccines-related keywords were collected from November 2, 2015 to March 28, 2016. Manual annotation was done to evaluate the performance of the system on the unannotated tweets corpus. Followed time series analysis was applied to this corpus to track the trends of machine-deduced sentiments and their associations with different days of the week. RESULTS: The evaluation of the unannotated tweets corpus showed that the micro-averaging F scores have reached 0.786. The learning system deduced the sentiment labels for 184,214 tweets in the collected unannotated tweets corpus. Time series analysis identified a coincidence between mainstream outcome and Twitter contents. A weak trend was found for "Negative" tweets that decreased firstly and began to increase later; an opposite trend was identified for "Positive" tweets. Tweets that contain the worries on efficacy for HPV vaccines showed a relative significant decreasing trend. Strong associations were found between some sentiments ("Positive", "Negative", "Negative-Safety" and "Negative-Others") with different days of the week. CONCLUSIONS: Our efforts on sentiment analysis for newly approved HPV vaccines provide us an automatic and instant way to extract public opinion and understand the concerns on Twitter. Our approaches can provide a feedback to public health professionals to monitor online public response, examine the effectiveness of their HPV vaccination promotion strategies and adjust their promotion plans.

The potential impact of prophylactic human papillomavirus vaccination on oropharyngeal cancer.

The incidence of oropharyngeal cancer (OPC) is significantly increasing in the United States. Given that these epidemiologic trends are driven by human papillomavirus (HPV), the potential impact of prophylactic HPV vaccines on the prevention of OPC is of interest. The primary evidence supporting the approval of current prophylactic HPV vaccines is from large phase 3 clinical trials focused on the prevention of genital disease (cervical and anal cancer, as well as genital warts). These trials reported vaccine efficacy rates of 89% to 98% for the prevention of both premalignant lesions and persistent genital infections. However, these trials were designed before the etiologic relationship between HPV and OPC was established. There are differences in the epidemiology of oral and genital HPV infection, such as differences in age and sex distributions, which suggest that the vaccine efficacy observed in genital cancers may not be directly translatable to the cancers of the oropharynx. Evaluation of vaccine efficacy is challenging in the oropharynx because no premalignant lesion analogous to cervical intraepithelial neoplasia in cervical cancer has yet been identified. To truly investigate the efficacy of these vaccines in the oropharynx, additional clinical trials with feasible endpoints are needed. Cancer 2016;122:2313-2323. © 2016 American Cancer Society.

Population-based trends in high-grade cervical lesions in the early human papillomavirus vaccine era in the United States.

BACKGROUND: Cervical intraepithelial neoplasia grade 2, 3, and adenocarcinoma in situ (CIN2+) lesions can be monitored as early indicators of human papillomavirus (HPV) vaccine impact. Changes to screening utilization will affect observed reductions in CIN2+ rates and complicate the interpretation of vaccine impact. METHODS: From 2008 to 2012, 9119 cases of CIN2+ among 18- to 39-year-old residents of catchment areas in California, Connecticut, New York, and Oregon were reported to the HPV-IMPACT Project, a sentinel system for monitoring the population impact of HPV vaccine. Age-stratified CIN2+ incidence rates were calculated for each catchment. Annual cervical screening was estimated for California, New York, and Oregon catchments with administrative and survey data. The Cochran-Armitage test was used to examine trends. RESULTS: From 2008 to 2012, the incidence of CIN2+ significantly decreased among 18- to 20-year-olds (California, from 94 to 5 per 100,000 women; Connecticut, from 450 to 57 per 100,000 women; New York, from 299 to 43 per 100,000 women; and Oregon, from 202 to 37 per 100,000 women; Ptrend < .0001) and among 21- to 29-year-olds in Connecticut (from 762 to 589 per 100,000 women) and New York (from 770 to 465 per 100,000 women; Ptrend < .001); rates did not differ among 30- to 39-year-olds. During the same period, screening rates also declined, with the largest decreases among 18- to 20-year-olds (from 67% in Oregon to 88% in California) and with smaller declines among 21- to 29-year-olds (13%-27%) and 30- to 39-year-olds (3%-21%). CONCLUSIONS: The declines in CIN2+ detection in young women were likely due to reduced screening but could also reflect the impact of vaccination. These data illustrate challenges in interpreting CIN2+ ecologic trends in the new era of cervical cancer prevention and emphasize the importance of information such as HPV types detected in lesions to assess the impact of HPV vaccine on cervical precancers.

[Human papillomavirus vaccine. Efficacy and safety]. / Vacuna frente al virus del papiloma humano. Eficacia y seguridad.

Human papillomavirus (HPV) related disease remains a major cause of morbidity and mortality worldwide. Prophylactic vaccines have been recognized as the most effective intervention to control for HPV-related diseases. This article reviews the major phaseii/iii trials of the bivalent (HPVs16/18), quadrivalent (HPVs6/11/16/18), and the recently approved 9-valent vaccine (HPVs6/11/16/18/31/33/45/52/58). Large trials have been conducted showing the safety, immunogenicity and high efficacy of the bivalent and quadrivalent vaccines in the prevention of pre-invasive lesions and infection, especially when administered at young ages before exposure to HPV. Trials of the 9-valent vaccine have also demonstrated the safety, immunogenicity and efficacy of the vaccine in the prevention of infection and disease associated with the vaccine types, and its potential to substantially increase the overall prevention of HPV-related diseases. Post-licensure country reports have shown the recent and early impact of these vaccines at population level after the implementation of established HPV vaccination programs, including decreases in the prevalence of vaccine HPV types, the incidence of genital warts, and the incidence of high-grade cervical abnormalities. If widely implemented, current HPV vaccines may drastically reduce the incidence of cervical cancer and other HPV-related cancers and diseases.

Exploring the relationship between adverse childhood experiences and HPV vaccination in a national sample of adults.

BACKGROUND: Over 60 % of U.S. adults report adverse childhood experience (ACE), which correlate with risky health behaviors and lower utilization of healthcare preventive measures, potentially leading to chronic diseases in later life. OBJECTIVE: This study investigates the relationship between ACEs and human papillomavirus (HPV) vaccination in a national U.S. adult sample. PARTICIPANTS AND SETTING: We used data from selected states from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System collected in years 2019 (Mississippi, South Carolina, and Tennessee), 2020 (Georgia, Mississippi, North Dakota, South Carolina), 2021 (Mississippi), and 2022 (Arkansas) (N = 3578, 4392, 904, and 810, respectively). METHODS: We conducted descriptive, univariate, and multivariable regression analysis using SAS 9.4. Independent and dependent variables were ACEs and HPV vaccination, respectively. RESULTS: Individuals with ≥4 ACEs, versus no ACEs, were significantly more likely to report HPV vaccination in 2019, 2020, and 2021 (OR = 1.40, 1.77, 2.80, all p < 0.05 respectively), except in 2022 (OR = 1.54, p = 0.165). In 2019, specific ACE types, emotional abuse, and household mental illness were associated with HPV vaccination, whereas in 2021, emotional abuse, household mental illness, incarcerated household member, and substance abuse in household, and in 2022, emotional abuse was associated with HPV vaccination. CONCLUSIONS: We found mostly positive association between ACEs and HPV vaccination, particularly in initial three years. However, findings in 2022 were not significant, except for emotional abuse. Diverse patterns in relationship between ACEs and HPV vaccination was observed overtime, highlighting the need for consistency in ACEs and HPV vaccination data collection, including vaccination timing, to better understand the underlying mechanisms and plan for interventions to prevent HPV-related cancers among these populations.

Beliefs, behaviors and HPV vaccine: correcting the myths and the misinformation.

OBJECTIVE: Human papillomavirus (HPV) vaccine uptake in many countries has been sub-optimal. We examine several issues associated with non-vaccination that have received particular attention, including fears about sexual risk compensation, concerns about vaccine safety, inadequate vaccination recommendations by health care providers (HCPs), and distrust due to the perceived "newness" of HPV vaccines. METHODS: Selective review of behavioral and social science literature on HPV vaccine attitudes and uptake. RESULTS: There is no evidence of post-vaccination sexual risk compensation, HPV vaccines are quite safe, and they can no longer be considered "new". Nonetheless, research findings point to these issues and, most importantly, to the failure of HCPs to adequately recommend HPV vaccine as major drivers of non-vaccination. CONCLUSION: Most fears related to HPV vaccine are more related to myth than reality. In the absence of major health policy initiatives, such as those implemented in Canada, the U.K., and Australia, a multi-level, multi-faceted approach will be required to achieve high rates of HPV vaccination. It will be essential to focus on the education of HCPs regarding indications for HPV vaccination and approaches to communicating most effectively with parents and patients about the safety and benefits of vaccination and the risks associated with non-vaccination.

The impact of ethnicity on awareness and knowledge of and attitudes towards the human papillomavirus and vaccine among adult women.

OBJECTIVE: To determine whether ethnicity affects awareness, knowledge, and attitudes regarding the human papillomavirus (HPV) and the HPV vaccine. METHODS: English speaking women (n = 172) aged 18 and older were recruited from an outpatient gynaecology clinic to complete a self-administered cross-sectional questionnaire that gathered information about (1) virus awareness and knowledge, (2) vaccine awareness and knowledge, (3) attitudes towards the vaccine and (4) participant demographics. Subjects received a virus knowledge score (0 to 6), a vaccine knowledge score (0 to 10) and an attitudes score (8 to 40), with a higher score indicating more positive attitudes towards the vaccine. RESULTS: Virus and vaccine awareness was significantly higher in Caucasian respondents than in non-Caucasian respondents: 93% versus 69% (P < 0.001) and 94% versus 64%, (P < 0.001), respectively. In a multivariate logistic regression model, the Caucasian ethnic group, higher education status, and greater number of years in Canada each emerged as independent predictors of vaccine awareness. Both virus and vaccine knowledge scores were significantly higher in Caucasian than non-Caucasian women: 4.6 versus 3.89 (P = 0.001) and 7.2 versus 6.4, (P = 0.042), respectively. Caucasian women had significantly higher (more positive) attitudes towards the vaccine than non-Caucasians (31.4 vs. 29.2, P = 0.021). Higher HPV vaccine knowledge was positively associated with an interest in vaccination (r(2) = 0.26, P < 0.01) and a more positive vaccine attitudes score (r(2) = 0.40, P < 0.001). CONCLUSION: Virus and vaccine awareness were both higher in Caucasian women than in non-Caucasian women. Improving HPV vaccination knowledge has the potential to improve attitudes and vaccine uptake.

Objectif : Déterminer si l'ethnicité affecte la sensibilisation au virus du papillome humain (VPH) et au vaccin anti-VPH, ainsi que les connaissances et les attitudes à leur égard. Méthodes : La participation de femmes d'expression anglaise (n = 172) de 18 ans ou plus a été sollicitée au sein d'une clinique externe de gynécologie; nous leur avons demandé de remplir un questionnaire transversal autoadministré visant la collecte de données au sujet (1) de la sensibilisation au virus et des connaissances à cet égard; (2) de la sensibilisation au vaccin et des connaissances à cet égard; (3) des attitudes envers le vaccin; et (4) des caractéristiques démographiques des participantes. Celles-ci se sont vu attribuer un score sur les connaissances au sujet du virus (de 0 à 6), un score sur les connaissances au sujet du vaccin (de 0 à 10) et un score sur les attitudes (de 8 à 40), l'obtention d'un score accru indiquant des attitudes plus positives à l'égard du vaccin. Résultats : La sensibilisation au virus et au vaccin était considérablement plus élevée chez les répondantes de race blanche que chez les répondantes d'autres origines ethniques : 93 % vs 69 % (P < 0,001) et 94 % vs 64 %, (P < 0,001), respectivement. Dans le cadre d'un modèle de régression logistique multivariée, le groupe ethnique de race blanche, un niveau de scolarité supérieur et un nombre supérieur d'années passées au Canada ont tous constitué des facteurs prédictifs indépendants de la sensibilisation au vaccin. Les scores sur les connaissances au sujet du virus et du vaccin ont tous deux été considérablement plus élevés chez les répondantes de race blanche que chez les répondantes d'autres origines ethniques : 4,6 vs 3,89 (P = 0,001) et 7,2 vs 6,4, (P = 0,042), respectivement. Les répondantes de race blanche ont obtenu des scores sur les attitudes considérablement plus élevés (attitudes plus positives) en ce qui concerne le vaccin que les répondantes d'autres origines ethniques (31,4 vs 29,2, P = 0,021). Le fait de disposer de plus vastes connaissances au sujet du vaccin anti-VPH a été positivement associé au fait de s'intéresser à la vaccination (r2 = 0,26, P < 0,01) et à l'obtention d'un score sur les attitudes à l'égard du vaccin plus positif (r2 = 0,40, P < 0,001). Conclusion : La sensibilisation au virus et au vaccin était plus élevée chez les répondantes de race blanche que chez les répondantes d'autres origines ethniques. L'amélioration des connaissances au sujet de la vaccination anti-VPH a le potentiel d'entraîner l'amélioration des attitudes et de la mesure dans laquelle le vaccin est utilisé.

Evaluation of Polish Adolescents' Knowledge About Human Papillomavirus and Vaccines.

Purpose: Human papillomavirus (HPV) vaccination can prevent more than 90% of cancers caused by HPV. However, they are still not common in Poland. The aim of the study was to evaluate Polish youths' knowledge of HPV vaccine and sexually transmitted diseases (STD). Methods: The cross-sectional study was performed with the use of an anonymous and voluntary survey distributed among 610 graduate high-school students, and 491 (81%) responded. Results: Only 24% were aware of potential oncological risk of HPV infection. Nearly all responders indicated HIV/AIDS as STD, while only 14% indicated HPV as well. In the opinion of 94% participants, vaccines are effective and safe, however, only 8% of girls and 5% of boys claimed that they were vaccinated against HPV. Simultaneously, 43% declared the will to vaccinate their own child in the future. As a barrier in performing HPV vaccinations, participants indicated first of all lack of enough knowledge (64%) and lack of awareness of the need to be vaccinated (51%). The main sources of knowledge about health were internet (93%) and school (67%). Only 10% of the participants had discussed the HPV and vaccine with a doctor. These adolescents had more knowledge about cervical cancer (P = 0.0002) and its relation to HPV infection (P = 0.0001). Conclusions: Polish adolescents present positive attitude toward HPV vaccines but their knowledge is still unsatisfactory. Schools and professional health providers should pay more attention to patient's education as well as developing online campaigns.

Awareness about Human Papillomavirus Vaccine and Its Uptake among Women from North India: Evidence from a Cross-Sectional Study.

OBJECTIVE: This study aims to estimate the prevalence of human papillomavirus (HPV) vaccine usage and determine the factors for awareness about HPV vaccine among women in reproductive age group. METHODS: This is a cross-sectional survey under a cervical cancer prevention study. The sample size was 1020 women, aged 15-49 years [550 in Delhi and 470 in Rohtak]. Bivariate analysis and Fisher exact test along with binary logistic regression analysis were used to determine the factors for awareness. RESULT: About 18.0 % [Delhi: 24.2 % and Rohtak: 10.9 %] of the respondents had heard about the vaccine against cervical cancer. The women aged more than 30 years [AOR: 1.35; CI: 0.94, 1.94] were more likely to be aware of cervical cancer vaccine as compare to women of 30 years and less. However, the women from Rohtak [AOR: 0.90; CI: 0.48, 1.66] were less likely to be aware of vaccine against cervical cancer in reference to women aged 30 years and more [AOR: 1.61; CI: 1.01, 2.56] from Delhi. About 0.6 % [Delhi: 1.1 % and Rohtak: 0.0 %] of the respondents had received HPV vaccine. CONCLUSION: Women tend to have limited knowledge about cervical cancer vaccine and immunisation practices. The women's demographic makeup varied significantly between the two sites, i.e , Rohtak and Delhi, which had an impact on how well they understood and utilised the cervical cancer vaccination. It is worth mentioning that none of the women from Rohtak had received the immunisation. The awareness of the cervical cancer vaccine among women from the Rohtak was lower than the Delhi women.

Knowledge and Awareness of Polish Parents on Vaccination against Human Papillomavirus.

Background: Human papillomavirus (HPV) vaccinations are rare among Polish children, and the reasons are scant. The objective was to evaluate the knowledge, attitude and awareness of parents about HPV vaccination to investigate reasons for low HPV vaccination coverage. Methods: 387 parents of children hospitalized at the Children's Hospital were asked to participate in an anonymous and voluntary survey study. Three hundred and two surveys were returned. Results: Only 54% of participants have heard about HPV, while 26% know that it is a sexually transmitted disease. According to 71% of responders, vaccines are generally effective, and 63% claim that they are safe. However, only 5% of daughters and 4% of sons are vaccinated against HPV. A total of 25% of parents spoke with their doctor about HPV-related diseases and prevention methods. A higher level of education (p = 0.01), knowledge of sexually transmitted diseases (p < 0.0001), perceiving vaccination as an effective and safe prophylactic method (p < 0.0001), and conversations with a doctor (p < 0.0001) are strong motivators to vaccinate children against HPV. This decision is free of religious beliefs, origin, age, gender and the number of children. Conclusions: Polish parents have a positive attitude towards vaccination. They recognize the limitations of their knowledge and express a desire to further it. Educational activity is an important element of physicians' work.

The Prevalence of High-Risk Human Papillomavirus in Hungary-A Geographically Representative, Cross-Sectional Study.

Background: The estimated age-standardized incidence and mortality rates of cervical cancer in Hungary are substantially higher than the European average. In many countries, human papillomavirus (HPV) testing is the first-line method of cervical cancer screening in women >30 years. According to the European guidelines, evidence-based improvement of a national prevention strategy requires the monitoring of representative data. Methods: ThinPrep cervical samples were collected over a period of 8 months at 84 sampling sites, including 4,000 eligible samples with valid laboratory results from the screening target population of females aged 25-65 years, with addresses in the representative geographic area (19 counties and four major settlement types). Genotyping of high-risk HPV (hrHPV) was performed using the Confidence HPV-X (Neumann Diagnostics) and Linear Array HPV Genotyping (Roche) tests. Demographic data were collected using a questionnaire, enabling the analysis of hrHPV genotype distribution by age, geography, education, and HPV vaccination. Results: Overall, 446 samples were hrHPV-positive, showing a prevalence of 11.15% (9.73% age-representative), similar to the world average, higher than the European average, and lower than the Eastern-European average. After age standardization, no significant geographic differences were found, except for low hrHPV prevalence in villages (p = 0.036) and in those with elementary education (p = 0.013). Following genotypes 16 and 31, in order of frequency, certain non-vaccine hrHPV genotypes (HPV51, 66, 56) showed unexpectedly higher prevalence than international data. Conclusion: Our study provides the first geographically representative genotype-specific hrHPV prevalence baseline database in Hungary to support policy-making efforts. Significant correlations with demographic data have transferable conclusions.

Human Papillomavirus Vaccination Status and Parental Endorsement Intentions among Undergraduate Student Nurses.

We identified factors associated with student nurses' Human Papillomavirus Vaccine (HPV) vaccination status and their intention to counsel parents on HPV vaccination. Undergraduate student nurses (N = 153) from a large university in the south participated. Descriptive statistics, chi-squared tests, and independent t-tests (p ≤ 0.05) were used to characterize the students' vaccination status. Logistic regression was used to identify factors associated with vaccination status. HPV vaccination rates were low. Students who were older and married or living with a partner were less likely to have completed the HPV vaccine series. The most commonly cited reason for non-initiation and non-completion was the lack of provider endorsement. Vaccination status did not differ significantly according to race/ethnicity, religion, skills, or intention to counsel parents. While intentions to counsel parents on HPV vaccination are high among student nurses, interventions to improve vaccination rates among student nurses are needed.