Background: The HPV vaccine is a primary prevention method available to reduce the burden of HPV-related cancers and genital warts. The vaccine is currently approved for catch-up vaccination among women 18 to 26 years of age. Despite this recommendation, the rate of vaccine uptake among this group is considerably low (~34% uptake). One demographic characteristic that is consistently reported as a risk factor for non-vaccination is relationship status, specifically married or monogamous relationships. While the epidemiological data confirm this association, there is a lack of understanding how this risk factor operates. By elucidating the mechanism for this risk factor, HPV vaccine uptake among this consistently unvaccinated group could be improved. Purpose: The purpose of this study was to understand how young adult women’s relationship status influence informational needs, motivations, and behavioral skills related to HPV vaccination. This objective was achieved through the following specific aims: (1) assess how relationship status affects primary reasons for non-vaccination among 18 to 26 year old women; and (2) understand how relationship status frames HPV vaccine decision-making among 18 to 26 year old women. Methods: To effectively achieve these specific aims, a concurrent mixed-methods study design was conducted. In Phase I, a secondary data analysis using the 2010 National Health Interview Survey was employed to determine if women in relationships are less likely to be interested in vaccination and identify the primary reasons (e.g., misinformation, motivations, behavioral skills) for non-vaccination among different relationship status categories. In Phase II, in-depth interviews were conducted with a sample (N=50) of 18 to 26 year old women at the University of South Florida, stratified by relationship status and vaccination status. A comparative thematic analysis was conducted to determine if there were differences in informational needs, motivations, behavioral skills, and HPV vaccine decision-making between the groups. Results: Using NHIS 2010 data, women who were living with a partner (PR 1.44 95%CI 1.07-1.87) and never married (PR 1.41 95%CI 1.12-1.73) were less likely to be interested in HPV vaccination compared women who were married. Moreover, primary reasons for non-vaccination differed significantly by relationship status group (p Conclusion: This study found that relationship status impacts HPV vaccine decision-making among young adult women. Specifically, it operates by modifying risk perceptions for HPV, which serve as barriers to vaccination. Young adult women have the knowledge and behavioral skills necessary to access and understand the importance of HPV vaccination; however, women were unable to accurately perceive their risk for HPV, resulting in impaired motivation for vaccination. A potential approach to address this issue is the use of health literacy. Future research should integrate health literacy techniques with healthcare providers serving this population to assist in the evaluation process for risk of HPV. This will facilitate shared decision-making and patient-provider communication surrounding the HPV vaccine. This can ultimately promote HPV vaccination among young adult women and reduce the morbidity and mortality of HPV-related diseases.

Hispanic Americans experience a disparate burden of human papillomavirus vaccination (HPV)-related cancers. Despite vaccine availability, HPV vaccine uptake amid Hispanic American adolescent males in the United States is under the national goal. Furthermore, childhood vaccination compliance is driven by the parents; yet, there is little research on parents' perceptions of HPV vaccination of male children. The purpose of this phenomenological study was to explore the attitudes, beliefs, concerns, and decision- making factors of Hispanic American parents of male children aged 11- to 13- years-old surrounding HPV vaccination. The health belief model provided the framework for the study. Face-to-face interviews were conducted with 12 participants in a rural county in Colorado in which Hispanic Americans had a higher rate of reportable sexually transmitted infections than non-Hispanics. Data analysis included descriptive coding to summarize and synthesize the interview results. The results showed Hispanic parents had a positive attitude toward HPV vaccination, and parents believed that the vaccination would protect their child. Most of the parents were aware of the HPV vaccine. The parents believed in healthcare providers and would accept the vaccine if it was recommended by them. Despite several parents having concerns about HPV vaccinations, they still claimed they would vaccinate their child. The findings from the study can be used to inform educational offerings regarding HPV vaccination for Hispanic American boys.

Knowledge and attitudes to HPV immunisation IV Author: Tereza Jelínková Thesis supervisor: PharmDr. Eva Zimčíková, Ph.D. Introduction HPV infection is one of the most common sexually transmitted diseases causing, apart from genital warts, other malignancies, most often cervical cancer. The most effective way of prevention is vaccination. So far, there have been 3 types of vaccines, most recent one being the nonavalent vaccine providing up to 90 % protection against cervical cancer- causing HPV, in contrast to the previously available 70 % protection from bivalent or quadrivalent vaccines. Aims The main aim of this thesis was to investigate the knowledge and attitudes towards vaccination against HPV, and knowledge about HPV in general, among secondary school students. Furthermore, to determine their vaccination status and compare the findings with data from previous theses, including a comparison of their knowledge about HPV and relevant prevention. Methodology The data was obtained by means of a questionnaire survey, which took place at three secondary schools. In December 2017 at Gymnázium in Mladá Boleslav, then during June 2018 at Gymnázium in Brandýs nad Labem, and finally in September 2018 at Gymnázium Chotěboř. The obtained data was recorded in a Microsoft Excel spreadsheet and then...

In the United States, parents' health beliefs affect HPV vaccination decisions for children. Our team acquired insights into mothers' health beliefs from their reactions and comments to posts on HPV vaccination in a social media adolescent health campaign in a randomized trial (n = 881 mothers; 63.1% reported daughters had 1+ doses of the HPV vaccine) evaluating communication intended to reduce daughters' indoor tanning. A total of 10 HPV vaccination messages in didactic (n = 7) and narrative (n = 3) formats were posted on vaccination need, uptake, and effectiveness and stories of young women who died from cervical cancer and a mother's decision to vaccinate her daughters. These posts received 28 reactions (like, love, and sad buttons; mean = 2.8 per post) and 80 comments (mean = 8.0 per post). More comments were favorable (n = 43) than unfavorable (n = 34). Data was not collected on views for posts. The most common favorable comment reported that daughters were vaccinated (n = 31). Unfavorable comments cited safety concerns, lack of physician support, distrust of pro-vaccine sources, and increased sexual activity of daughters. Mothers posting unfavorable (18.2%) as opposed to favorable (78.6%) comments or not commenting (64.0%) were less likely to have had their daughters vaccinated (chi-square = 22.27, p < 0.001). Favorable comments often did not state reasons for vaccinating. Concerns about lack of vaccine safety remain a barrier. Mothers may express distrust in pro-vaccine sources to reduce discomfort with not vaccinating daughters to reduce their risk for HPV infection. Many mothers who remained silent had vaccinated daughters, which suggests they did not resisit HPV vaccination.

Cervical cancer is the second most common cancer that women suffer from worldwide. Every year more than 270,000 women die from cervical cancer, and it is one of the top ten cancer that Taiwanese women suffer from. Differ from other kinds of cancer, cervical cancer can be effectively prevented by vaccination, since most cervical cancers are caused by HPV(Human Papillomavirus) infection. HPV infection is most common in people in their late teens and early 20s, and the HPV vaccine targets the HPV types that most commonly cause cervical cancer and can cause some other cancers. It also protects against the HPV types that cause most genital warts. The HPV vaccine is highly effective in preventing the targeted HPV types, as well as the most common health problems caused by them. Though HPV vaccination is included in the national immunization program in some countries, the vaccines are not provided to every female at no cost in Taiwan. While some cities and counties provides HPV vaccine for every female or a certain group of female gratuitously, female citizens of other cities and counties would have to pay approximately $300-360 USD for vaccination. This inconsistent policy among Taiwan has been questioned by local congressmen and citizens. To re-examine the HPV vaccine policy and implementation procedure among each local government in Taiwan, the Health Promotion Administration, Ministry of Health and Welfare (HPA) as well as ten local governments with different HPV vaccination policies were interviewed and evaluated. The research concludes that with no united HPV vaccination policy, the goals of the policy among the local governments is different, some even undefined, the implementation levels of each local government is uneven, and misleading communication between the central and the local governments exist. A united policy with specific goal, implementation guidelines, report system, two-way communication system should and would make the vaccination policy more ample, and equal.