Awareness of human papillomavirus, cervical cancer and its prevention among primigravid antenatal clinic attendees in a tertiary care hospital in Sri Lanka: a cross-sectional study
Aruni H. W. de Silva A I , Nirma Samarawickrema B , Anuradhani Kasturiratne C , S. Rachel Skinner D , Ananda Rajitha Wickremasinghe C and Suzanne M. Garland E F G HA Department of Family Medicine, Faculty of Medicine, University of Kelaniya, P.O. Box 6, Thalagolla Road, Ragama, Sri Lanka.
B Department of Biochemistry and Molecular Biology, Monash University, Vic. 3800, Australia.
C Department of Public Health, Faculty of Medicine, University of Kelaniya, Sri Lanka.
D Discipline of Child and Adolescent Health, Sydney University and Children’s Hospital Westmead, NSW 2145, Australia.
E Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Parkville, Vic. 3052, Australia.
F Murdoch Children’s Research Institute, Parkville, Vic. 3052, Australia.
G Department of Obstetrics and Gynaecology, University of Melbourne, Vic. 3010, Australia.
H Department of Microbiology, Royal Children’s Hospital, Parkville, Vic. 3052, Australia.
I Corresponding author. Email: aruni.weerakoon@yahoo.com
Sexual Health 16(3) 212-217 https://doi.org/10.1071/SH18080
Submitted: 26 April 2018 Accepted: 18 December 2018 Published: 15 May 2019
Abstract
Background: Cervical cancer is the second commonest cancer amongst Sri Lankan women. With introduction of the human papillomavirus (HPV) vaccine to the national immunisation schedule, awareness and prevention of disease underpins vaccine uptake. Knowledge of HPV, HPV-related diseases and attitudes towards prevention and screening among urban women was assessed. Methods: Primigravids attending Colombo North Teaching Hospital antenatal clinics were recruited over 8 months as surrogates for women who have recently become sexually active. Data through a self-administered questionnaire on three domains were collected (cervical cancer, Pap testing, HPV and vaccine). Results: Of 667 participants (mean age 23.9 (s.d. = 4.4) years, 68.0% (n = 454) had >11 years of schooling), only 1.5% (n = 10) were aware of all three domains: 55.0% (370/667) had heard of cervical cancer, 19.0% of whom (70/370) knew it was sexually acquired, 9.0% (60/667) were aware of Pap screening, while 5.4% (36/665) had heard about HPV and <1.0% (5/667) knew it caused cancer. The total knowledge score ranged from zero (379/665) to nine (2/665), with a mean of 0.9 (s.d. – 1.4), with awareness increasing with level of education (χ2 = 18.6; P <0.001). Of those aware of Pap testing, 8.0% (5/60) were reluctant to undergo testing, while 46.6% (28/60) had no apprehension. Conclusions: Knowledge of cervical cancer, Pap testing, HPV and vaccine was low, especially in terms of HPV. Among those aware of Pap screening, generally there were favourable attitudes to having a test. These data have implications for acceptance of the vaccine and any future expansion of cervical screening with newer, more cost-effective technologies.
Additional keywords: Pap test, screening, South Asia, vaccine, women.
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