Introduction: Human papillomavirus (HPV) is the most common sexually transmitted infection and causes 529.000 cases of cervical cancer every year. Nowadays, there are vaccines available to prevent infection. Knowledge of HPV influence the attitude towards the vaccine and is therefore a factor of accepting the vaccine. Aim: The aim of this study was to examine the knowledge of HPV and attitudes towards HPV-vaccine among Thai female university students. Method:  Descriptive and cross-sectional study with quantitative method using a questionnaire. Purposive sampling was used. The sample consisted of students from two different universities in Bangkok, Thailand and out of the 201 students whom filled in the questionnaire, 192 questionnaires were used. Result: There were 64.6% of the participants that had heard of HPV previously. Of these, the most common source of information was health professionals. The HPV-vaccine was known by 42.6% of the participants and 17.4% had taken the vaccination. Over 90% of the participants had a poor or moderate knowledge of HPV. In total, most of the participants in the sample were found to have a positive level of attitude towards the vaccine (72.4%). Almost all participants wanted to know more about HPV and the HPV-vaccine and 88.5% thought it was necessary for them to get the vaccination. Conclusion: As some gaps in knowledge among the participants were shown, the information to young women should be improved and aim to increase the motivation towards the use of preventive methods, such as taking the HPV-vaccine.

In Canada, parental acceptance and uptake of the HPV vaccine has been low. There is a need for more effective HPV vaccination health messages for parents. Whether a message is framed in terms of the benefits of engaging in the behaviour (gain frame), the costs of failing to engage in the behaviour (loss frame) or both the benefits and the costs (mixed frame) has potential to impact parents’ decision making. The appropriate frame of a message may depend on the recipient’s sex and involvement with the health issue. The purpose of this study was to investigate the persuasiveness of gain-, loss- and mixed-framed messages on mothers’ and fathers’ intentions to have their young son or daughter vaccinated against HPV. The study used a 3 Frame x 2 Sex of Parent x 2 Sex of Child design. We randomly assigned participants (n=367) to read a framed message and then complete a 29-item questionnaire assessing theoretical determinants of parental consent for vaccination. ANCOVAs revealed a three-way interaction for intentions to speak to a doctor about the HPV vaccine, F(2, 342)=3.66, p =.03, perceived severity of HPV, F(2, 347) = 3.10, p = .05, and for anxiety about their child contracting HPV, F(2, 342)=3.58, p=.02. Effect size comparisons revealed that gain-framed messages seem to persuade parents who are the opposite sex to the child for whom they are considering the vaccine. In turn, loss- and mixed-framed messages may persuade parents who are the same sex as the child for whom they are considering the vaccine. Perceived severity of HPV and anxiety about HPV mediated the relationship between message frame and intentions for some parent-child dyads. Findings have implications for constructing effective messages encouraging parents to consider having their child vaccinated against HPV. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2010-07-07 23:06:25.757

Background: The qHPV vaccine has the potential to significantly reduce the burden of HPV-related diseases, including cervical cancer. However, a recent systematic review of clinical trials has suggested that the risk of bronchospasm may be increased by this vaccine, and a large observational study has reported an increased risk of anaphylaxis. Objectives: To determine whether qHPV vaccination increases the risk of incident asthma, asthma exacerbation, and anaphylaxis. Methods: A population-based retrospective cohort of grade 8 girls eligible for Ontario’s HPV immunization program between 2007 and 2011 was identified using the province’s administrative health and immunization databases. Cohort members were followed from September 1st of their grade 8 year until their date of death or end of study (March 31st, 2012). The self-controlled case series method, a self-matched, case-based analysis was used to assess the effect of qHPV vaccination on the risk of SRREs, and rate ratios (RRs) and 95% confidence intervals for each outcome was estimated using conditional Poisson regression. Results: The cohort consisted of 125,575 girls with a mean age of 13.2 years, 57.7% of whom received at least one dose of the qHPV vaccine. During an average of 2.5 years of follow-up, 1473 cases of incident asthma, 901 of asthma exacerbation and 38 of anaphylaxis were identified. HPV vaccination was not associated with an increased risk of incident asthma or asthma exacerbation (RRadj 0.76, 95% CI 0.37-1.54 and RRadj 0.74, 95% CI 0.27-2.00, respectively), and these associations were unchanged by the presence of risk factors and time since vaccination. There was also no evidence of an increased risk of anaphylaxis following qHPV vaccination as demonstrated by an absence of cases of anaphylaxis occurring on the day of vaccination. Conclusions: This large, population-based study provides strong evidence that the qHPV vaccine does not increase the risk of developing or exacerbating asthma, and additional evidence for the lack of an increased risk of anaphylaxis in the younger populations targeted by HPV immunization programs. These findings add to the growing body of evidence on the safety of the qHPV vaccine. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2014-04-16 19:20:41.019

Though vaccine uptake and public support have risen since the release of the first HPV vaccines, the United States has far lower initiation and completion rates for the HPV vaccine series in comparison to other vaccines indicated for youth. Disparities are even greater in the Appalachian regions. Understanding factors contributing to these discrepancies is vital to improving raise vaccine rates in Appalachia. A comprehensive literature search identified all articles pertaining to HPV vaccination in children and adolescents living in Appalachia. The final 15 articles were included in a systematic review of the topic. Findings: HPV disease and HPV vaccine-related knowledge and communication were low in Appalachian communities, and vaccine uptake was lower in all areas of Appalachia as compared to non-Appalachian U.S. Moreover, large variations in uptake existed among Appalachian subregions. Many variables appear to contribute to this variation, including vaccine acceptance for younger adolescents, local and press-driven critical reports of the vaccine, physician communication, and views of the family matriarchs. Targeting the Appalachian subregions, specific campaigns or intervention may be more impactful than viewing the region as a homogenous whole.

Background: Worldwide efforts have been made by some countries to offer HPV vaccination since its introduction in 2006. Population effectiveness of HPV vaccines is presently an active area of research. We review available evidence on the effectiveness of HPV vaccine uptake among female adolescents to prevent HPV infection. Methods: A comprehensive search of published and grey literature was conducted in several electronic databases using a pre-defined search strategy related to HPV prevalence following vaccination. The database searches were complemented by hand-searches of reference lists of eligible studies. Data were extracted onto a purpose-designed data extraction form, pooled in a meta-analysis and stratified by continent considering vaccine type, cross protective and (high/low) risk HPV types as subgroups. Results: Our search yielded 1680 studies, of which thirteen met with our inclusion criteria (8332 vaccinated women aged 12 to 34 years from across the world). The pooled HPV (comprising types 6, 11, 16 and 18) prevalence among vaccinated female adolescents was 7% (95% Confidence Interval (CI): 5% to 9%, 13 studies, n=8,332). The 13 studies were conducted across 3 continents: HPV prevalence for North America was 5% (95% CI: 3% to 7%, 9 studies, n=5781, age range =13 to 34); Europe, 14% (95% CI: 9% to 18%, 3 studies, n=2213, age range =13 to 29) and Australia 5% (95% CI: 3% to 8%, 1 study, n=5781, age range=13 to 34). Of the studies which reported the effect of vaccination on other non-vaccine HPV type prevalence (known as cross protective types) HPV (31, 33, 45, 51 & 58), the overall pooled cross protective HPV prevalence was 9% (95% CI: 6% to 12%, 4 studies, n=3081 age range=13 to 29), by continent North America had 14% (95% CI: 12 to 17%, 1 study, n=753 age range=14 to 24), Europe 7% (95% CI: 6 to 8%, 2 studies, n=1990, age range=13 to 29) and Australia with 8% (95% CI: 5% to 11%, 1 study, n=338 age range=18 to 26). Conclusion: This study showed an HPV prevalence of 7% in women vaccinated against HPV types 6,11,16 and 18, which represents a substantial difference to the 22% HPV prevalence in non-vaccinated women. There was no statistically significant difference between HPV prevalence across the continents. There is however, still a dearth of information on vaccinated women and HPV prevalence, highlighting the need for further studies in this area. Strengths and limitation of this review • The review comprehensively searched multiple databases and bibliographies. We had no language restrictions. • We were stringent in the selection of studies as far as vaccination status was concerned. Studies considering HPV prevalence in unvaccinated women were excluded. • A variety of methods was utilised in collecting data across the studies. However, some of the study participants were not representative of the general population. Caution therefore, needs to be considered when using these results to make inferences or conclusions about prevalence of certain populations.

Thesis advisor: James Lubben / In 2011, an estimated 12,710 women suffered from cervical cancer and 4,290 died from it in the U.S. HPV vaccination (HPV-V) and PAP screening (PAP-S) could reduce this burden. Using 2010 National Health Interview Survey data, current disparities in the use of PAP-S and HPV-V in U.S. women aged 18-30 years were investigated. An adapted Behavioral Model of Health Care Utilization guided the study. Main outcomes were PAP-S in prior year and ever-HPV-V, both initiation and completion. Adjusted predictor estimates were obtained through multivariate logistic regressions with appropriate statistical procedures and weights for complex survey design. A sub-analysis focused on unvaccinated women. The sample had 3,129 women aged 18-30 years, representing about 27 million women of similar age in the U.S. PAP-S, HPV-V initiation and completion rates were 53.5%, 17.9%, and 10.3%, respectively. Hispanics were 33% less likely than Non-Hispanic-Whites to initiate HPV-V. Non-Hispanic-Blacks were 55% more likely and 57% less likely than Non-Hispanic-Whites to receive PAP-S and complete HPV-V, respectively. Non-Hispanic Asians were 36% less likely than Non-Hispanic-Whites to receive PAP-S, but this result was borderline significant. Younger age and being unmarried were predictors of lower PAP-S but higher HPV-V. Ever gave birth was a predictor of higher PAP-S but lower HPV-V. Preventative behaviors (PAP-S and flu vaccination) were predictors of higher HPV-V. STI-history was a predictor of higher HPV-V and PAP-S. Not having health insurance for over one year or recent health provider visit were predictors of lower PAP-S and HPV-V. Living in the South was a predictor of lower HPV-V. Household income was not a predictor of any outcomes. Most common reported reason for no HPV-V was "no need." Study findings indicate interventions to mitigate disparities in cervical cancer prevention are needed. Tailored education interventions for both women and health care providers along with opportunities associated with the 2010 Affordable Care Act, such as broader access to health care, emphasis on health information technology, and initiatives with PAP screening and adult vaccination as potential quality indicators for performance/payment, can reduce these disparities. Future research should focus on the feasibility of alternative venues for receiving HPV-V and PAP-S. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Cervical cancer incidence in the United States has declined for the past 40 years, yet the odds of developing cervical cancer is much higher among marginalized women, particularly African American and Hispanic American women. Although preventable through vaccination against the human papillomavirus (HPV) prior to infection, uptake and completion rates of the vaccine among African American and Hispanic American women are low. The purpose of the study was to determine if a significant relationship existed between the health literacy levels of African American and Hispanic American women, ages 18-26, and the low HPV vaccination uptake. The integrated behavioral model, which identifies factors antecedent to behavioral intention, as well as the motivating variables, was the theoretical framework. Secondary data from the 2015 National Health Interview Survey were used to examine the relationships among the variables of interest. A logistic regression (n = 2093) showed that health literacy is a strong determinant of HPV vaccine behavior intention, and that there was a significant relationship between health literacy and HPV vaccine initiation. Health literacy mediated the relationships between the motivating variables and the vaccine uptake, and completely mediated the relationship between ethnicity and HPV vaccine uptake. Health literacy did not independently predict the vaccine initiation. The findings from this study might (a) provide public health practitioners with enough information to guide health promotion activities to increase the vaccination coverage to the level expected in Healthy People 2020, (b) save economic resources through cancer prevention, and (c) improve lives by curbing the excess deaths among racial minority women.

Human papillomavirus (HPV) is a preventable infection responsible for anogenital and oropharyngeal cancers, as well as genital warts. Two safe and effective vaccines are recommended for adolescents and young adults to protect against HPV infection. Both are severely underutilized. Sexual and ethnic minorities are disproportionately affected by HPV infection and its sequelae. The goals of this study were to (1) assess baseline differences in HPV-related awareness, knowledge, and attitudes between men and women, and (2) evaluate the differential efficacy of a brief, educational HPV intervention among ethnically and sexually diverse college students. Students attending undergraduate courses from 2015 to 2017 participated in a brief, tailored, classroom intervention designed to improve HPV-related awareness, knowledge, and attitudes. These outcomes were assessed immediately before and following an evidence-based educational presentation about HPV risks, outcomes, treatments, and prevention. At baseline, 84% of participants (N=386) had heard of HPV; 28% of men and 55% of women reported receiving ≥1 dose of HPV vaccine. Vaccinated women were seven times more likely to report favorable attitudes than unvaccinated women (RR=7.1, CI[3.3-15.5]). Hispanic participants had more positive attitudes toward HPV vaccination (62% vs. 44%; P=0.009) and were more willing to become vaccinated (66% vs. 46%; p=0.02) than non-Hispanic participants at baseline. Gay and bisexual men (92%) were more likely than heterosexual men (68%) to have heard of HPV, to receive any doses of HPV vaccine (37% vs 19%), to view HPV vaccination positively (58% vs 39%), and more willing to be vaccinated (86% vs 39%; P

This research project aims to examine the idea of stigma attached to cervical cancer in light of its association with HPV, a sexually transmitted infection (STI). The public recognition of this relationship appears to be increasing due to the current media attention surrounding HPV's causative role in the development of cervical cancer, and the newly-released HPV vaccine. Thus, this study explores the experiences and perceptions of cervical cancer patients and survivors living with this disease at a moment in time when it is becoming a very visible manifestation of a sexually transmitted infection, versus one identified historically as a life-threatening cancer. Disease-related stigma has vast individual, community, and societal repercussions: in the context of both cancer and sexually transmitted infections, it is broadly associated in the literature with decreased levels of screening, reluctance to seek treatment, decreased access to social support, economic discrimination, and major difficulties in implementing large-scale prevention efforts, such as contact tracing or name-based reporting. This study is premised on the belief that including the voices of patients and survivors themselves will provide a more holistic and complete understanding of the dimensions of cervical cancer-related stigma, which in turn will help to inform future educational and prevention messages tailored to reduce its impact. Additionally, it will illuminate the complexities and dynamics of how patients/survivors are able or unable to access social support-a first step in designing more effective and relevant support programs.

Background: Cervical cancer is second most common cancer in women. The 15% incidence of cervical cancer in women worldwide can potentially be reduced by the vaccine against human papillomavirus (HPV). It is therefore important for all healthcare professionals including registered nurses to understand what affects women’s intentions and willingness to receive HPV vaccination so that they can overcome any inappropriate barriers and promote public health. Aim: The aim of this article was to describe factors influencing women’s intentions to obtain the HPV vaccine. Method: The following databases Cinahl, Medline, PsycINFO, Summon @ HKR and Pubmed were searched for articles that studied factors influencing women’s intention to obtain the HPV vaccine. Ten studies met the inclusion criteria, five qualitative and five quantitative. Results:  Four main categories were identified that influenced women’s intention to obtain the HPV vaccine: knowledge, attitudes, the influence of other people and the safety of the vaccine. Discussion: Better access for women to accurate information is the key to increase women’s intention to obtain the HPV vaccine and improving public health. Conclusion: Correct information about HPV and HPV virus is needed to increase women’s intention to obtain the vaccine. / Bakgrund: Cervixcancer är den näst vanligaste cancern hos kvinnor med en global incidens på15 %. Cervixcancer leder till hög mortalitet. Genom Humant Papillomvirus (HPV)-vaccinering kan incidensen minskas kraftigt. Vaccintäckningen är suboptimal på många plaster i världen. Det är viktigt att vårdpersonal, inklusive sjuksköterskor, förstår vilka faktorer som påverkar viljan och beslutet att vaccinera sig. På så sätt kan sjukvårdspersonal påverka dessa beslut och faktorer och därigenom öka vaccinationstäckningen i befolkningen. Syfte: Syftet var att beskriva faktorer som påverkar kvinnors avsikt till att vaccinera sig mot HPV. Metod: I denna allmänna litteraturstudie användes databaserna Cinahl, Medline, PsycINFO, Summon @ HKR and Pubmed för att söka efter artiklar som studerade faktorer som påverkar kvinnor att vaccinera sig mot HPV. Totalt tio artiklar inkluderades, fem kvalitativa och fem kvantitativa studier. Resultat: Fyra huvudkategorier identifierades som påverkade kvinnor att vaccinera sig mot HPV: Kunskap, attityder, andras inflytande och vaccinets säkerhet. Diskussion: Bättre tillgång till korrekt information för kvinnor om HPV-vaccinet är nyckeln till att öka kvinnors avsikt att vaccinera sig och på så sätt förbättra folkhälsan. Slutsats: Det krävs korrekt information om HPV virus och vaccin för att öka kvinnors avsikt till att vaccinera sig.