Disproportionate preponderance of HPV genotypes associated with anogenital warts among HIV-positive MSM.

Background: In this study, we characterized the HPV genotype distribution in a population of 489 adults already positive for HPV DNA. The study population was divided into two groups: 244 HIV-positive (HIV+) men who have sex with men (MSM) undergoing routine anal screening for sexually transmitted diseases (STDs) and 245 women undergoing routine cervical cancer screening. Acknowledging the fact that women and MSM represent two independent circles of sexual practices, which are-largely-exclusive of each other, we were interested in determining if particular genotypes of human papillomavirus (HPV) disproportionately predominate in one of these circles compared to the other. Results: HIV+ MSM are significantly more likely to be infected with multiple genotypes at a time, with an odds ratio (OR) of 9.30 (95% confidence interval [CI]: 3.91-22.1) and a p-value of <0.001. In addition, multivariable-adjusted logistic regression analysis showed that anal swab samples were significantly more likely to harbor lrHPV infections, with an OR of 6.67 (95% CI: 2.42-18.4) and a p-value of <0.001, in particular, HPV 6, with an OR of 8.92 (95% CI: 3.84-20.7) compared to cervical samples of screening women. Conclusion: Given the significant impact of recurrent anogenital warts (AGWs) on quality of life and the accompanying predisposition to invasive anal cancer, our data underscore the critical need for HPV vaccination. This includes expanding vaccination eligibility to include both boys and adults within high-risk populations.

A systematic review of student vaccine attitudes and vaccine policy on college and university campuses, 2000-2022.

Objective: To summarize the literature 1) evaluating college student knowledge and attitudes toward vaccines and 2) examining associations between vaccine uptake and school-dependent variables. Methods: We reviewed all U.S.-based English-language primary literature published between January 1, 2000 and September 20, 2022 available online in PubMed/MEDLINE and SCOPUS databases. The initial search included studies mentioning college/university, vaccine/immunization, and one of the following terms: prevention, delivery, acceptance, uptake, or policy. Study screening, quality assessment, and data extraction were performed by author pairs using Covidence, a web-based screening and data extraction tool for conducting systematic reviews. Results: Out of 58 studies, 37 (64%) used survey methodology and 5 (9%) were randomized controlled trials. Forty studies focused on HPV vaccines. Easy access to vaccines, perceived vulnerability to disease, self-efficacy, and social norms influenced vaccine decision-making. Conclusion: While studies assessing student awareness, social norms, and message framing for vaccine uptake on campuses exist, mostly for the HPV vaccine, few have evaluated college vaccine policy.

VaxBot-HPV: A GPT-based Chatbot for Answering HPV Vaccine-related Questions.

Background: HPV vaccine is an effective measure to prevent and control the diseases caused by Human Papillomavirus (HPV). This study addresses the development of VaxBot-HPV, a chatbot aimed at improving health literacy and promoting vaccination uptake by providing information and answering questions about the HPV vaccine. Methods: We constructed the knowledge base (KB) for VaxBot-HPV, which consists of 451 documents from biomedical literature and web sources on the HPV vaccine. We extracted 202 question-answer pairs from the KB and 39 questions generated by GPT-4 for training and testing purposes. To comprehensively understand the capabilities and potential of GPT-based chatbots, three models were involved in this study : GPT-3.5, VaxBot-HPV, and GPT-4. The evaluation criteria included answer relevancy and faithfulness. Results: VaxBot-HPV demonstrated superior performance in answer relevancy and faithfulness compared to baselines (Answer relevancy: 0.85; Faithfulness: 0.97) for the test questions in KB, (Answer relevancy: 0.85; Faithfulness: 0.96) for GPT generated questions. Conclusions: This study underscores the importance of leveraging advanced language models and fine-tuning techniques in the development of chatbots for healthcare applications, with implications for improving medical education and public health communication.

Are HPV Vaccines Well Accepted among Parents of Adolescent Girls in China? Trends, Obstacles, and Practical Implications for Further Interventions: A Five-Year Follow-Up Study.

BACKGROUND: In 2020, the WHO proposed the global strategic goal of accelerating the elimination of cervical cancer (CC). One of the key strategies is that, by 2030, 90% of girls will complete HPV vaccination by age 15. In 2017, HPV vaccines were first marketed in China. OBJECTIVES: This study aimed to explore the changes in parents' knowledge about CC, HPV, HPV vaccines, and acceptance of HPV vaccination 5 years after the introduction of HPV vaccines into China. Associated factors and reasons for refusal by parents were also explored. METHODS: A school-based follow-up study was conducted among parents in China from May 2018 to May 2023. Comparison using Chi-square tests was performed to measure the changes. Univariate and multivariate analyses were used to explore factors associated with HPV vaccination among teenage girls. RESULTS: The overall cognitive level in terms of CC- and HPV-related knowledge among parents increased, and they expressed more willingness to vaccinate their daughter (35.4% in 2018 vs. 56.6% in 2023). The HPV vaccination rate among teenage girls remained at a low level (4.4% in 2018, 9.8% in 2023). The main obstacles reported by parents were limited knowledge (42.0%), scarcity of the HPV vaccine (29.2%), waiting until their daughter was older (27.5%), safety concerns (14.7%), high cost (9.0%), and effectiveness concerns (4.6%). Parents who are elderly, local residents, have received HPV vaccines themselves, have had experience of vaccinating their children with influenza vaccines, and have a higher knowledge level of CC, HPV and HPV vaccines are more likely to vaccinate their children with HPV vaccines. CONCLUSIONS: Although we observed an increment in parents' knowledge level in terms of CC, HPV, HPV vaccines, and HPV vaccine uptake over the past 5 years, the HPV vaccine coverage among girls still falls short of the WHO's 2030 target. Comprehensive intervention strategies, including tailored health education among adolescents and their parents, doctor recommendations, and providing financial subsidies or free HPV vaccines are needed in China.

A Review of Human Papillomavirus Vaccination and Associated Ethical Concerns.

Since its Fast-Track approval by the Federal Drug Administration, the human papillomavirus (HPV) vaccine has been marked by controversies. Unconfirmed reports of adverse events in both Japan and Denmark led to suspensions of national vaccination programs, which setback the fight against cervical cancer and associated mortality and morbidity. Despite follow-up studies of vaccine adverse reports, additional randomized control trials, and review reports from both the World Health Organization and the European Commission, there is still a great deal of hesitancy around the vaccine. While all three version of the HPV vaccine have been shown to be efficacious and safe, additional ethical dilemmas deserve to be considered as well.

HPV Vaccination Rates in Military Females: The Need for a Multi-Level and Evidence-Based Approach.

To mitigate the impact of personal and structural barriers hindering HPV vaccination in military women, multiple research studies have advocated for adding the HPV vaccine to the mandatory list for enlistees. Intervention Mapping (IM) is a systematic and stepwise theory-based approach that has been used to inform the development of health promotion interventions and implementation strategies in community and clinical settings at national, regional, and global levels. Development and evaluation of effective strategies and multi-level interventions using IM may increase the uptake of the HPV vaccine among military females who are at-risk of HPV infections and associated co-morbidities.

A Cross-Sectional Observational Study Analyzing the Knowledge, Attitude, and Practice of Young Female Nursing Officers and Female Doctors About the Human Papillomavirus Vaccine.

Background Cervical cancer (CC) is the second most common cancer among Indian women and is caused by a human papillomavirus (HPV) infection. To achieve its global commitment to the elimination of CC, India is planning to include the HPV vaccine in its national immunization program. The success of the prevention of CC mostly depends on the level of awareness and knowledge among healthcare providers about different aspects of the disease and the vaccine. We aimed to evaluate the knowledge, attitudes, and practices (KAP) regarding CC, HPV, and the HPV vaccine in first-contact young female doctors and nursing officers. Methodology This cross-sectional study was conducted at the All India Institute of Medical Sciences, Kalyani, between February and June 2024 among young female health workers aged between 20 and 35 years. To evaluate KAP we used a validated, self-administered questionnaire. Results There were a total of 204 participants, whose median age was 26 (interquartile range = 25 to 29) years; among them, 114 (55.9%) were nursing officers and 90 (44.1%) were junior doctors. Good knowledge was found among 85.5% of doctors and 70.2% of nursing officers (p < 0.01). A positive attitude was found in 81.1% of doctors and 67.5% of nursing officers (p < 0.01). The overall good practice score was low (31.3%). A higher level of education was associated with good knowledge (ß = -1.16, 95% confidence interval (CI) = -1.76, -0.55, p < 0.01) and positive attitude (ß = -0.53, 95% CI = -0.9, 0.16, p = 0.005) toward HPV, CC, and the HPV vaccine. Conclusions Our cohort showed good knowledge and attitude toward CC, HPV, and the HPV vaccine, but poor HPV vaccine uptake and practice. Therefore, health education programs focused on increasing awareness and uplifting confidence are needed to accept and recommend the HPV vaccine in developing countries like India.

Primary Prevention in Cervical Cancer-Current Status and Way Forward.

The effect of cancer in women has varied effects. Overall malignancies of the breast, cervix, and ovary account for over 43% of all cancer cases in India. Globally, cervical cancer is fourth cancer in terms of incidence among women, following breast, lung, and colorectal cancer. However, this illness primarily affects women in India, where it is the second most frequent malignancy after breast cancer. HPV-related cervical cancer is a serious public health issue that has a solution. In 2020, the World Health Organization (WHO) launched a global initiative to eliminate cervical cancer which set targets for three important strategies: HPV vaccination, cervical cancer screening, and treatment. The WHO's "Best Buys" recommendations for cancer sub-set place vaccination of females between the ages of 9 and 14 at the top of the list. In India, efforts are underway to increase the number of teenage girls receiving the human papillomavirus (HPV) vaccine. The nation granted licenses for bivalent and quadrivalent HPV vaccinations in 2008, and in 2018, a nonavalent vaccine was approved. It is important to keep in mind that the cervical carcinoma vaccination is not a quick fix; thus, screening for the disease should continue. Any nation can potentially significantly lower the incidence of cervical cancer by carefully combining economical, high-coverage vaccinations with well-organized screening programs. Since 9-14 years is the ideal age range before sexual debut in today's world, this is the key vaccine age range. Estimates of vaccine effectiveness for younger adolescents, those between the ages of 9 and 14 years, varied from roughly 74 to 93%. Let us envision an India of the future where girls grow up with one fewer cancer threatening their life and a place where cervical cancer has been eradicated.

Development of a Study Tool to Measure Awareness of Human Papillomavirus Vaccine Among Cancer Patients and Their Intention to Recommend the Vaccine.

Background: Literature suggests that there is poor awareness and uptake of the Human Papillomavirus (HPV) vaccine in India. The role of cancer patients as potent advocates for HPV vaccine in their community is vital due to their first-hand experience with the turmoil that accompanies cancer. Hence, we have developed a study tool to measure the psychometric constructs "Awareness" of HPV vaccine among cancer patients and "Intention" to recommend the vaccine. Methods: The theoretical concepts of the Health Belief Model were applied, feedback from oncologists at Basavatarakam Indo-American Cancer Hospital and Research Institute and public health experts at Indian Institute of Public Health to develop the study tool. A 24 items study tool was finalized following pre-testing and content validation. A sample size of 5:1 (participant:item) was considered adequate to conduct exploratory factor analysis (EFA). The pilot study tool was administered for validation to 150 cancer patients visiting the hospital during June-July 2023. The data were analysed using Jamovi (Version2.3). Results: The McDonald's omega was 0.8, which indicates good internal consistency of the data. EFA using parallel analysis with maximum likelihood extraction method and Promax oblique rotation with factor loadings above 0.4 revealed a 3-factor solution with 21 items. Factors were named "Capability", "Awareness" and "Risk perception" respectively. The correlation between "Awareness" and "Risk Perception" was 0.28; between "Capability" and "Risk perception" 0.47. "Awareness" and "Capability" had a weak negative correlation(-0.02). Conclusions: The study tool could effectively measure individual constructs of awareness and intention. Notably, our findings indicate a weak correlation between awareness and one component of intention (capability), within this population. This aspect, rigorously measured and validated by our study tool, holds significance as it implies that despite a low level of awareness in this population, they may still be considered as potentially influential advocates for the HPV vaccine. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-024-01950-4.

Improving United States HPV vaccination rates: Factors predictive of parental attitudes towards middle school entry requirements.

Although the human papillomavirus (HPV) vaccine is effective at preventing infection and certain types of cancer, uptake is suboptimal. HPV vaccine requirements for school entry are an underutilized strategy to increase HPV vaccine uptake among adolescents. The purpose of this study was to understand the factors that are predictive of parents' attitudes toward schools requiring the HPV vaccine for entry into middle school. Parents of adolescents ages 11-12 y were recruited to participate in an online survey via Qualtrics. Descriptive frequencies were obtained, and sequential regression analyses were conducted controlling for demographic characteristics. A total of 1,046 participants were included in the analysis. The mean age was 40.3 y (SD = 6.3) and the majority of participants were White (74.4%) and had some college education or higher (80.9%). Participant's gender, political affiliation, urban/rural setting, and education level were significantly associated with attitudes toward school entry requirements. Adding psychosocial items related to perceptions of benefits, risks, and social norms significantly increased the amount of variance explained in the model [(ΔR2 = .312, F(5, 1036) = 132.621)]. Perceived social norms was the strongest predictor of attitudes [ß = 0.321]. The results of this study can be used to inform policy changes around school-entry requirements in the United States. Further studies are needed to assess the influence of perceived social norms in vaccine hesitant groups.

Influential factors and willingness to advocate for HPV vaccination among male nursing interns in China.

BACKGROUND: Human papillomavirus (HPV) infection significantly contributes to the global cancer burden. Understanding the factors influencing male clinical interns' willingness to promote HPV vaccination is crucial for developing effective public health strategies in China. METHODS: This study employed a stratified random sampling method to select 1,980 male clinical interns from five provinces in China between January and March 2024. Data were collected on participants' demographic characteristics, HPV-related clinical experience, and knowledge. The Theory of Planned Behavior framework, encompassing attitudes, subjective norms, and perceived behavioral control, was used to examine factors influencing the willingness to promote the HPV vaccine. Logistic regression analyses were conducted to identify factors associated with the willingness to promote the HPV vaccine. RESULTS: Among the respondents, 72.29% were willing to encourage others to receive the HPV vaccine. Significant factors influencing this willingness included older age (OR = 3.065, P ≤ 0.001), higher monthly household income (OR = 1.449, P = 0.025), participation in the diagnosis and treatment of HPV-related diseases (OR = 3.458, P ≤ 0.001), positive attitude towards the vaccine (OR = 13.503, P = 0.004), and strong perceived behavioral control (OR = 2.364, P = 0.006). CONCLUSION: This study highlights the critical role of practical experience and targeted education in promoting HPV vaccination among male clinical interns in China. Enhancing the training and education of this group is essential for improving HPV vaccine advocacy and supporting public health efforts to reduce HPV-related diseases.

Human papillomavirus vaccination status among university students in Southern Thailand: A cross-sectional study.

Objective: Human papillomavirus (HPV) commonly causes transmissible diseases worldwide; however, HPV vaccines are not available among some at-risk populations. Since 2017, HPV vaccination has been recommended for females aged 11-12 years in Thailand. However, studies on the coverage and HPV vaccination prevalence are limited. This study aimed to explore the prevalence and factors associated with HPV vaccination among Thai university students. Methods: Data for this cross-sectional study were randomly collected using paper-based questionnaires from university students aged 18-26 years during October 17-27, 2023. Results: Of 1,093 participants, 57.6 % were female, and 53.5 % were from non-urban areas. The median age was 20 years. One-third of the participants were from low-income families. The overall HPV vaccine coverage rates were 7.51 % and 0.87 % in female and male students, respectively. Female sex, being from a high-income family, studying in health science faculties, originating from an urban area, having one or both parents completing university educations, and having healthcare providers as family members increased the odds of receiving the HPV vaccine. The accuracy of HPV vaccine literacy among participants who reported that they "know about the HPV vaccine" was adequate, except for the fact that HPV vaccine was sex-neutral. Conclusions: The HPV vaccine coverage rate among Thai university students was low owing to several factors. HPV and HPV vaccine education should be provided to populations that can still benefit from receiving the HPV vaccine.

Factors influencing HPV vaccine hesitancy among university students in China: A cross-sectional survey utilizing the 3Cs model.

The HPV vaccine, which has been demonstrated to be an effective method of reducing the risk of developing cervical cancer, is still being underutilized among college students in China. To assess the current status of HPV vaccine hesitancy among college students in Guangdong Province after the COVID-19 outbreak, and to systematically analyze the influencing factors of HPV vaccine hesitancy and construct a prediction model based on the WHO 3Cs model. A cross-sectional web-based survey was conducted in June 2023 among female college students in four cities in Guangdong Province. The data were analyzed using binary logistic regression with a focus on the 3Cs model: Complacency, Convenience, and Confidence. LASSO regression was employed to analyze the variables deemed to be of significance and to construct predictive models. Out of 1399 participants, 86.5% expressed no hesitancy toward HPV vaccination. However, 11.9% exhibited hesitancy, and 1.6% refused vaccination altogether. Factors such as trust in vaccine efficacy, perception of HPV infection risk, price considerations, and constraints like distance or time were significant contributors to hesitancy. Knowledge of the HPV vaccine, socio-demographic characteristics, and the educational level of participants' mothers also played a role in vaccine hesitancy. It is recommended that targeted interventions be implemented within educational institutions with the aim of raising awareness of cervical cancer and HPV vaccines, simplifying the scheduling of vaccination appointments, and increasing affordability through the implementation of strategic purchasing measures or subsidy schemes.

Human papillomavirus vaccination and Pap test uptake, awareness, and barriers among young adults in Gulf Cooperation Council countries: A comparative cross-sectional survey.

BACKGROUND: Human papillomavirus (HPV) vaccination and Pap tests are recognized as effective preventive measures to reduce the incidence of HPV-related diseases among young adults. The objective of this study was to assess HPV vaccination and Pap test uptake, awareness, and barriers among young adults in the Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, the Kingdom of Saudi Arabia (KSA), and the United Arab Emirates (UAE). METHODS: A comparative cross-sectional study was conducted from January to April 2024, involving 831 young adults aged 18-39 residing in GCC countries. The main outcome measures were HPV vaccination and Pap test uptake rates, awareness of the HPV vaccine and Pap testing, and barriers to vaccination. Data were collected using online platforms. The Chi-square test and Fisher's exact test were used for data analysis. RESULTS: The UAE had the highest vaccination rate at 18.9% (50/264), followed by Qatar at 5.8% (6/104), and KSA at 4.6% (10/216), p < 0.001. Individuals with health insurance had higher vaccination rates than those without (11% vs. 5.4%, p = 0.006). Awareness of the HPV vaccine was highest in the UAE (49.6%) and KSA (58.8%), while awareness of Pap smear testing among females was similarly high in these countries (62.4% and 65.9%, respectively). However, actual Pap smear testing rates were highest in Bahrain (15.9%) and Qatar (13.4%). The main barriers to vaccination cited by participants were lack of knowledge (53.6%) and the absence of medical recommendations (13.2%). CONCLUSION: The study's findings suggest the need of targeted educational campaigns to increase HPV vaccine uptake among both genders and Pap test participation among females. Additionally, incorporating HPV screening and vaccination into routine national programs in GCC countries and emphasising the crucial role of healthcare providers in influencing vaccination decisions are recommended strategies.

A novel therapeutic multiepitope vaccine based on oncoprotein E6 and E7 of HPV 16 and 18: An in silico approach.

Introduction: The current vaccine strategies to prevent cervical cancer are effective only for individuals unexposed to HPV, lacking therapeutic effects against pre-existing infections. Multiepitope vaccines, using an immunoinformatic approach, are promising against tumors and viral infections because of their high specificity, safety, and stability, as well as the cheap cost of development. Methods: This study employed computer-based immunoinformatic analysis to design therapeutic multiepitope vaccines against cervical cancer using oncoproteins E6 and E7 of HPV 16 and 18. Several immunoinformatic tools were applied to analyze potential vaccine constructs capable of stimulating immune responses against both oncoproteins. Results: The constructed vaccine exhibited antigenic, immunogenic, nonallergenic, nontoxic, stable, and soluble characteristics. Additionally, it effectively interacted with TLR2 and TLR4, showing high binding capacity. Computational analysis indicated the vaccine could induce immune responses through the elevation of cytokine levels after the third injection, antibody production, activation of memory B and T cells, and promotion of increased dendritic cell counts. Conclusion: The novel multiepitope vaccine based on E6 and E7 presented as a promising candidate for combating HPV infections and associated cervical cancer. Further in vitro and in vivo studies were essential to validate the efficacy and safety of the vaccine.

Adolescent Self-Consent for the HPV Vaccine and the Effects on Vaccine Rates.

The adolescent development age is the period between 10 and 19 years when a child becomes a young adult and learns to make important health decisions independently. Adolescents consenting to receive a vaccine without parental or legal guardian consent is adolescent self-consent. Adolescent self-consent for the human papillomavirus (HPV) vaccine is a health policy issue that could increase vaccine uptake rates. Adolescent self-consent for the vaccine may increase adolescents' autonomy with their healthcare decisions. Pediatric advanced practice nurses and other healthcare providers should advocate for adolescents and encourage parents to allow adolescents to be more active regarding the HPV vaccine.

Knowledge, Attitude, and Perception Regarding the Human Papillomavirus (HPV) Vaccine Among Parents at Al-Madinah Al-Munawwar: A Cross-Sectional Study.

BACKGROUND:  Human papillomavirus (HPV) is the leading cause of cervical cancer in reproductive-age Saudi women. Parents' understanding and attitude regarding HPV vaccination in young girls are vital to preventing cervical cancer. OBJECTIVE: This study aims to assess the knowledge, attitudes, and perceptions of parents in Al-Madinah Al-Munawwara towards the HPV vaccine and identify factors influencing their decision to vaccinate their children. METHODS: A cross-sectional survey was conducted among 500 parents in Al-Madinah Al-Munawwara. A structured questionnaire was used to collect data on demographics, knowledge about HPV and the HPV vaccine, attitudes towards vaccination, and perceptions of vaccine safety and efficacy. Data were analyzed using Statistical Product and Service Solutions (SPSS, version 21; IBM SPSS Statistics for Windows, Armonk, NY). RESULTS: Parents have 57.6% knowledge about HPV, 69.2% perceive it as dangerous, and 29.8% know its link to cervical cancer. Physicians are the primary source, and 81.2% believe the vaccine protects HPV. Key predictors of vaccine acceptance included higher educational levels, awareness of HPV-related health risks, and recommendations from healthcare professionals. CONCLUSION: The study reveals a lack of knowledge about HPV infection and vaccines among Saudi Arabian parents, with only 7.2% having vaccinated their children, emphasizing the need for education and screening programs.

Assessing knowledge and awareness levels regarding cervical cancer and HPV vaccination in the Jammu regions.

Background and Objectives: Cervical cancer global burden is highly skewed towards poor countries primarily due to lack of awareness, poor screening, and low uptake of prophylactic vaccines. The purpose of our study is to educate and raise awareness among young girls and women about the importance of cervical screening and HPV vaccination. Materials and Methods: The present study, conducted from January 2023 to December 2023, focused on students, teachers, housewives, and healthcare professionals in the Jammu region to assess their awareness of cervical cancer and the HPV vaccine. HPV DNA testing was carried out using the Truenat Real-Time PCR method at Swastik Diagnostic Laboratory, Jammu. Results: Knowledge of cervical cancer, awareness of the HPV virus, and the vaccination status of women were assessed in survey. In the HPV screening test, out of 2,400 women, 106 tested positive for HPV. Among these 106 women, 19% had a high viral load (Ct < 20), 11% had a low viral load (25 ≤ Ct < 30), indicating a low relative concentration of HPV viruses, 40% had a medium viral load (20 ≤ Ct < 25), and 30% had very low viral loads (Ct ≥ 30). Conclusion: These findings highlight the importance of routine cervical screenings, such as Pap smears and HPV tests, for the early detection of cervical cancer. There is an urgent need to implement cervical cancer screening and vaccination programs in the Jammu region.

Corrigendum: Actions speak louder than words; pediatricians, gynecologists, nurses, and other mothers' perspectives on the human papillomavirus vaccine: an Istanbul multicenter study.

[This corrects the article DOI: 10.3389/fpubh.2024.1361509.].