PDF
ePub
Citation
Print
Abstract
Background
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract and can cause cervical cancers. The purpose of this study was to investigate HPV vaccination status and related factors among male and female college students.
Methods
The study subjects were 489 students conveniently sampled from Seoyeong University located in Gwangju. General characteristics, HPV vaccination status and knowledge of cervical cancer and HPV infection were collected by self- administered questionnaires between August 25 and September 19. The collected data were analyzed by chi-square tests, t-tests and multiple logistic regression analyses.
Results
Of 328 female students, 22.9% were vaccinated. But none of the male students (n=161) were vaccinated. Vaccination intention of male and female students were 18.6% and 55.5%, respectively. In multiple logistic regression analysis, adjusted odds ratio (aOR) for HPV vaccination were significantly high in female subjects with high allowance (aOR=2.23, 95% confidence interval [CI]=1.13-4.42) or high knowledge score of cervical cancer (OR=1.10, 95% CI=1.02-1.16). Intention of HPV vaccination were associated with participation in school clubs, chronic disease and knowledge score of cervical cancer in male students. In female students, school record, family history, self-rated health and knowledge score of cervical cancer were associated with intention of vaccination.
REFERENCES
1.Torre LA., Bray F., Siegel RL., Ferlay J., Lortet-Tieulent J., Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015. 65(2):87–108.
2.Jung KW., Won YJ., Kong HJ., Oh CM., Cho H., Lee DH, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat. 2015. 47(2):127–41.
3.Bosch FX., Lorincz A., Muñoz N., Meijer CJ., Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol. 2002. 55(4):244–65.
4.Centers for Disease Control and Prevention (CDC). Recommendations on the use of quadrivalent human papillomavirus vaccine in males--Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011. 60(50):1705–8.
5.Lee EH., Um TH., Chi HS., Hong YJ., Cha YJ. Prevalence and distribution of human papillomavirus infection in Korean women as determined by restriction fragment mass polymorphism assay. J Korean Med Sci. 2012. 27(9):1091–7.
6.Shin HR., Franceschi S., Vaccarella S., Roh JW., Ju YH., Oh JK, et al. Prevalence and determinants of genital infection with papillomavirus, in female and male university students in Busan, South Korea. J Infect Dis. 2004. 190(3):468–76.
7.Pitts M., Smith A., Croy S., Lyons A., Ryall R., Garland S, et al. Singaporean men's knowledge of cervical cancer and human papillomavirus (HPV) and their attitudes towards HPV vaccination. Vaccine. 2009. 27(22):2989–93.
8.Kim YT. Current status of cervical cancer and HPV infection in Korea. J Gynecol Oncol. 2009. 20(1):1–7.
9.Park SJ., Park HJ. Knowledge regarding cervical cancer, human papillomavirus and acceptance of vaccination in Korean adult men. J Korean Acad Fundam Nurs. 2012. 19(2):201–11.
10.Lee EJ., Park JS. Knowledge about cervical cancer, health beliefs and human papillomavirus vaccination rate in female university students. J Korean Oncol Nurs. 2011. 11(1):65–73.
11.Lee KE. Factors Associated with Intention to receive Human Papillomavirus Vaccine in Undergraduate Women: An Application of the Theory of Planned Behavior. J Korean Acad Fundam Nurs. 2014. 21(4):457–65.
12.Kim HW. Factors influencing mothers' acceptance of human papillomavirus vaccination to prevent cervical cancer in their daughters. Korean J Women Health Nurs. 2011. 17(2):137–47.
13.Bang KS., Sung S., Koo B., Kim M., Kim Y., Kim J, et al. Female university students' HPV-related knowledge and influencing factors on HPV vaccination. J Korean Oncol Nurs. 2011. 11(3):186–92.
14.Bang S., Yoo A., Cho S., Choi I., Kim S., Jeong Y, et al. Human papillomavirus vaccination status and related factors among some female college students. J Korean Soc Matern Child Health. 2012. 16(2):186–94.
15.Kim HW. Awareness of human papillomavirus and factors associated with intention to obtain HPV vaccination among Korean youth: quasi experimental study. BMC Int Health Hum Rights. 2015. 15:4.
16.Park SM., Choi JS. Comparison of human papillomavirus vacci-vation status, associated with health belief and knowledge between male and female highschool students. J Korean Biol Nurs Sci. 2013. 15(1):24–32.
17.Lee EY., Park JS., Cho EJ. The exact state of female high school students' knowledge about cervical cancer, human papillomavirus vaccination-related health belief and vaccination rate. J Korean Soc Matern Child Health. 2013. 17(1):27–37.
18.Rama CH., Villa LL., Pagliusi S., Andreoli MA., Costa MC., Aoki AL, et al. Awareness and knowledge of HPV, cervical cancer, and vaccines in young women after first delivery in São Paulo, Brazil--a cross-sectional study. BMC Womens Health. 2010. 10:35.
19.Hsu YY., Fetzer SJ., Hsu KF., Chang YY., Huang CP., Chou CY. Intention to obtain human papillomavirus vaccination among taiwanese undergraduate women. Sex Transm Dis. 2009. 36(11):686–92.
20.Song YH. Relationships among self-directed learning ability, collective efficacy, knowledge sharing, satisfaction in a university study circle. J Educ Studies. 2011. 42(3):179–209.
21.Lee HJ. Determinants of health among Korean adolescents. J Korea Inst Electron Commun Sci. 2013. 8(12):1819–24.
22.Han YJ., Lee SR., Kang EJ., Kim MK., Kim NH., Kim HJ, et al. Knowledge regarding cervical cancer, human papillomavirus and future acceptance of vaccination among girls in their late teens in Korea. Korean J Obstet Gynecol. 2007. 50(8):1090–9.
23.Kahn JA., Rosenthal SL., Hamann T., Bernstein DI. Attitudes about human papillomavirus vaccine in young women. Int J STD AIDS. 2003. 14(5):300–6.
24.Kang HY., Kim JS. Knowledge, attitudes of human papillomavirus vaccine, and intention to obtain vaccine among Korean female undergraduate students. Women Health. 2011. 51(8):759–76.
25.Santos-Sancho JM., López-de Andrés A., Jimenez-Trujillo I., Hernández-Barrera V., Carrasco-Garrido P., Astasio-Arbiza P, et al. Adherence and factors associated with influenza vaccination among subjects with asthma in Spain. Infection. 2013. 41(2):465–71.
Table 1.
Awareness of HPV and vaccination status by sexa
| Awareness and vaccination status | Male (n=161) | Female (n=328) |
|---|---|---|
| Awareness of HPV | ||
| Yes | 27 (16.8) | 218 (66.5) |
| No | 134 (83.2) | 110 (33.5) |
| Awareness of HPV vaccination | ||
| Yes | 22 (13.7) | 202 (61.6) |
| No | 139 (86.3) | 126 (38.4) |
| Status of HPV vaccination | ||
| Yes | 0 (0.0) | 75 (22.9) |
| No | 161 (100) | 253 (77.1) |
| Characteristics of vaccinated subjects | Female (n=75) | |
| Vaccination number | ||
| 1st | 3 (4.0) | |
| 2nd | 8 (10.7) | |
| 3rd | 64 (85.3) | |
| Time interval between 1st and 2nd vaccination (mo) | ||
| <2 | 42 (56.0) | |
| 2-6 | 30 (40.0) | |
| ≥7 | 3 (4.0) | |
| Time interval between 2nd and 3rd vaccination (mo) | ||
| <2 | 6 (8.0) | |
| 2-6 | 52 (69.3) | |
| ≥7 | 6 (8.0) | |
| None | 11 (14.7) | |
| Reason for vaccination | ||
| Parental advice Self-decision | 35 (46.7) 31 (41.4) | |
| Medical team's advice | 4 (5.3) | |
| Friend′s advice | 4 (5.3) | |
| Others | 1 (1.3) | |
| Characteristics of unvaccinated subjects | Male (n=161) | Female (n=253) |
| Perceived reason for not having | ||
| HPV vaccination | ||
| Didn′t know about vaccine | 150 (93.2) | 155 (61.3) |
| High cost | 1 (0.6) | 42 (16.6) |
| Afraid of side-effect | - | 25 (9.8) |
| Unconvinced about efficacy of vaccine | 1 (0.6) | 12 (4.7) |
| No time | 6 (3.7) | 11 (4.4) |
| Afraid of injection Intention for HPV vaccination | 3 (1.9) | 8 (3.2) |
| Yes | 30 (18.6) | 141 (55.5) |
| No | 131 (81.4) | 112 (44.5) |
| Perceived facilitators to future HPV vaccination uptakeb | ||
| Reduction of vaccination cost | 12 (40.0) | 73 (51.8) |
| Useful information about vaccine | 14 (46.7) | 40 (28.4) |
| Health professional recommendation | 2 (6.7) | 15 (10.6) |
| Plenty of time | 2 (6.7) | 10 (7.1) |
| Other vaccination methods such as oral pills except injection | - | 3 (2.1) |
Table 2.
HPV vaccination status by subjects characteristics in female college studentsa
Table 3.
OR (95% CI) for HPV vaccination in female college students
Table 4.
Intention for HPV vaccination according to subjects' characteristics by sexa
| Characteristics | Male (n=161) | Female (n=253) | ||||
|---|---|---|---|---|---|---|
| Yes | No | P | Yes | No | P | |
| Age, y | 20.7±1.8 | 20.6±2.1 | 0.861 | 19.9±1.8 | 19.9±1.9 | 0.768 |
| Major | 0.029 | 0.545 | ||||
| Health related | 18 (26.5) | 50 (73.5) | 121 (55.0) | 99 (45.0) | ||
| Non-health related | 12 (12.9) | 81 (87.1) | 20 (60.6) | 13 (39.4) | ||
| Allowance (10,000 won) | 0.812 | 0.597 | ||||
| ≤20 | 6 (15.4) | 33 (84.6) | 43 (54.4) | 36 (45.6) | ||
| 21-40 | 17 (20.2) | 67 (79.8) | 76 (58.5) | 54 (41.5) | ||
| ≥41 | 7 (18.4) | 31 (81.6) | 22 (50.0) | 22 (50.0) | ||
| School record | 0.613 | 0.013 | ||||
| High | 9 (23.7) | 29 (76.3) | 26 (65.0) | 14 (35.0) | ||
| Middle | 15 (16.3) | 77 (83.7) | 100 (58.5) | 71 (41.5) | ||
| Low | 6 (19.4) | 25 (80.6) | 15 (35.7) | 27 (64.3) | ||
| Participate in a club | 0.089 | 0.218 | ||||
| Activity | 8 (32.0) | 17 (68.0) | 37 (62.7) | 22 (37.3) | ||
| Not | 22 (16.2) | 114 (83.8) | 104 (53.6) | 90 (46.4) | ||
| Friend of opposite sex | 0.390 | 0.132 | ||||
| Yes | 14 (21.2) | 50 (78.1) | 57 (62.0) | 35 (38.0) | ||
| No | 16 (16.5) | 81 (83.5) | 84 (51.2) | 77 (47.8) | ||
| Father’s education level | 0.262 | 0.264 | ||||
| ≤Middle school | 3 (25.0) | 9 (75.0) | 14 (46.7) | 16 (53.3) | ||
| High school | 14 (17.7) | 65 (82.3) | 63 (58.0) | 46 (42.6) | ||
| ≥College | 13 (22.8) | 57 (77.2) | 64 (58.2) | 50 (41.8) | ||
| Mother’s education level | 0.813 | 0.547 | ||||
| ≤Middle school | 1 (11.1) | 8 (88.9) | 13 (50.0) | 13 (50.0) | ||
| High school | 22 (23.4) | 72 (76.6) | 83 (56.3) | 65 (44.5) | ||
| ≥College | 7 (15.2) | 51 (84.8) | 45 (60.0) | 34 (40.0) | ||
| Smoking status | 0.592 | 0.332 | ||||
| Never smoker | 13 (16.7) | 65 (83.3) | 122 (56.0) | 96 (44.0) | ||
| Ex-smoker | 6 (26.1) | 17 (73.9) | 6 (40.0) | 9 (60.0) | ||
| Current smoker | 11 (18.3) | 49 (81.7) | 13 (65.0) | 7 (35.0) | ||
| Frequency of alcohol drinkingb | 0.068 | 0.979 | ||||
| None | 3 (10.7) | 25 (89.3) | 33 (55.0) | 27 (45.0) | ||
| <1/mo | 4 (16.7) | 20 (83.3) | 40 (54.1) | 34 (45.9) | ||
| 2-3/mo | 20 (26.0) | 57 (74.0) | 56 (57.1) | 42 (42.9) | ||
| ≥2/wk | 2 (6.5) | 29 (93.5) | 12 (57.1) | 9 (42.9) | ||
| Chronic disease | 0.022 | 0.821 | ||||
| No | 10 (11.9) | 74 (88.1) | 70 (56.5) | 54 (43.6) | ||
| Yes | 20 (26.0) | 57 (74.0) | 71 (55.0) | 58 (45.0) | ||
| Family history of cervix/breast disease | 0.065 | 0.036 | ||||
| Yes | 5 (35.7) | 9 (64.3) | 31 (72.1) | 12 (27.9) | ||
| No | 16 (22.2) | 56 (77.8) | 68 (55.3) | 55 (44.7) | ||
| Unknown | 9 (12.0) | 66 (88.0) | 42 (48.3) | 45 (51.7) | ||
| Self-rated health | 0.906 | 0.091 | ||||
| Good | 20 (18.2) | 90 (81.8) | 58 (58.6) | 41 (41.4) | ||
| Fair | 9 (20.5) | 35 (79.5) | 63 (50.0) | 63 (50.0) | ||
| Poor | 1 (14.3) | 6 (85.7) | 20 (71.4) | 8 (28.6) | ||
| Intercourse experience | 0.702 | 0.287 | ||||
| Yes | 10 (20.4) | 39 (79.6) | 23 (63.9) | 13 (36.1) | ||
| No | 20 (17.9) | 92 (82.1) | 118 (54.4) | 99 (45.6) | ||
| Menarche, y | - | 0.854 | ||||
| ≤13 | - | - | 84 (55.3) | 68 (44.7) | ||
| ≥14 | - | - | 57 (56.4) | 44 (43.6) | ||
| OBGY visiting experience | - | 0.018 | ||||
| No | - | - | 102 (51.8) | 95 (48.2) | ||
| Yes | - | - | 39 (69.6) | 17 (30.4) | ||
| Knowledge score of cervical cancer and HPV | 6.3±5.4 | 3.8±5.2 | 0.018 | 9.3±5.0 | 6.7±5.5 | <0.001 |
Table 5.
OR (95% CI) of intention HPV vaccination by sex
XML Download