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RESEARCH ARTICLE
Contents Vol 6(4)

Acceptance of human papillomavirus vaccination among first year female university students in Hong Kong

William C. W. Wong A D , Ben Fong B and Paul K. S. Chan C
+ Author Affiliations
- Author Affiliations

A Department of General Practice, School of Medicine, University of Melbourne, 200 Berkeley Street, Carlton, Vic 3053, Australia.

B Director of University Health Service, Central Campus, The Chinese University of Hong Kong, Hong Kong.

C Department of Microbiology, The Chinese University of Hong Kong, 1/F Clinical Science Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.

D Corresponding author. Email: w.wong@unimelb.edu.au

Sexual Health 6(4) 264-271 https://doi.org/10.1071/SH09017
Submitted: 17 February 2009  Accepted: 4 September 2009   Published: 13 November 2009

Abstract

The present study assessed sexual behaviour, knowledge and attitudes among first year university students in order to identify factors that may affect their acceptance of human papillomavirus (HPV) vaccination. A cross-sectional survey was conducted at the Chinese University of Hong Kong in August 2006. The survey was a self-administered questionnaire comprising questions regarding general health, sexual behaviour, knowledge about HPV and cervical cancer, and attitudes towards vaccination. χ2, anova and logistic regression tests were used to identify associations between categories. Of 992 students, 63 (6.5%) reported having had sexual intercourse, 22.4% of whom had had more than one sexual partner and 36.5% had had unprotected sexual intercourse. A total of 70.8% of participants were willing to accept the HPV vaccine, with ‘willingness’ independently associated with age, having had sexual intercourse and beliefs regarding the effectiveness of vaccination (P < 0.05). Understanding the role of these influences can aid in the design of successful HPV education, prevention and vaccination programs.

Additional keywords: China, health promotion, willingness.


Acknowledgements

The authors would like to express our sincere thanks to the staff of University Health Service and the students at the Chinese University of Hong Kong who participated in the survey. Thanks to Hanli in preparing the early draft of the manuscript and Ms Amie Bingham in revising the final manuscript.


References


[1] Kulasingam S,  Connelly L,  Conway E,  Hocking JS,  Myers E,  Regan DG, et al. A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program. Sex Health 2007; 4 165–75.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [verified June 2008].

[6] Australian Government. Department of Health and Ageing Fact Sheet: Australian Government funding of Gardasil. November 2006. Available online at: http://www.health.gov.au/internet/main/publishing.nsf/Content/4754B33584405E06CA2572220008CFA8/$File/Gardasilfunding-factsheet.pdf [verified June 2008].

[7] Lazcano-Ponce E,  Rivera L,  Arillo-Santillan E,  Salmeron J,  Hernandez-Avila M,  Munoz N. Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico. Arch Med Res 2001; 32 243–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[8] Mays RM,  Sturm LA,  Zimet GD. Parental perspectives on vaccinating children against sexually transmitted infections. Soc Sci Med 2004; 58 1405–13.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[9] Davis K,  Dickman ED,  Ferris D,  Dias JK. Human papillomavirus vaccine acceptability among parents of 10- to 15-year-old adolescents. J Low Genit Tract Dis 2004; 8 188–94.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[10] Zimet GD,  Mays RM,  Sturm LA,  Ravert AA,  Perkins SM,  Juliar BE. Parental attitudes about sexually transmitted infection vaccination for their adolescent children. Arch Pediatr Adolesc Med 2005; 159 132–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[11] Zimet GD,  Perkins SM,  Sturm LA,  Bair RM,  Juliar BE,  Mays RM. Predictors of STI vaccine acceptability among parents and their adolescent children. J Adolesc Health 2005; 37 179–86.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[12] Boehner CW,  Howe SR,  Bernstein DI,  Rosenthal SL. Viral sexually transmitted disease vaccine acceptability among college students. Sex Transm Dis 2003; 30 774–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[13] Kwan T,  Chan K,  Yip A,  Tam K,  Cheung A,  Lo S, et al. Acceptability of human papillomavirus vaccination among Chinese women: concerns and implications. BJOG 2009; 116 501–10.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[14] Ross JS,  Nuñes-Smith M,  Forsyth BA,  Rosenbaum JR. Racial and ethnic differences in personal cervical cancer screening amongst post-graduate physicians: Results from a cross-sectional survey. BMC Public Health 2008; 8 378.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[15] Sankaranarayanan R. Overview of cervical cancer in the developing world. FIGO 6th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2006; 95 S205–10.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[16] Steptoe A,  Wardle J. Locus of control and health behaviour revisited: A multivariate analysis of young adults from 18 countries. Br J Psychol 2001; 92 659–72.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[17] Lam CLK,  Fong DYT,  Lauder IJ,  Lam TPD. The effect of health-related quality of life (HRQOL) on health service ultilisation of a Chinese population. Soc Sci Med 2002; 55 1635–46.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[18] Leung KF , Tay M , Cheng S , Lin F . Hong Kong Chinese Version World Health Organization Quality of Life – Abbreviated version. Hong Kong: Hong Kong Hospital Authority; 1997.

[19] Shek DTL . The Chinese version of the Rosenberg Self-Esteem Scale. Hong Kong: Chinese University of Hong Kong; 1992.

[20] Pang SK , Ip WY , Chang A . The Chinese version of the Multidimensional Health Locus of Control Scale. Hong Kong: Chinese University of Hong Kong; 1999.

[21] Mays RM,  Zimet GD,  Winston Y. Human papillomavirus, genital warts, pap smears, and cervical cancer: knowledge and beliefs of adolescent and adult women. Health Care Women Int 2000; 21 361–74.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[22] Dell DL,  Chen H,  Ahmad F,  Stewart DE. Knowledge about human papillomavirus among adolescents. Obstet Gynecol 2000; 96 653–6.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[23] Holcomb B,  Bailey JM,  Crawford K,  Ruffin MT. Adults’ knowledge and behaviors related to human papillomavirus infection. J Am Board Fam Pract 2004; 17 26–31.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[24] Waller J,  McCaffery K,  Forrest S,  Szarewski A,  Cadman L,  Wardle J. Awareness of human papillomavirus among women attending a well woman clinic. Sex Transm Infect 2003; 79 320–2.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[25] Yacobi E,  Tennant C,  Ferrante J,  Naazneen P,  Richard R. University students’ knowledge and awareness of HPV. Prev Med 1999; 28 535–41.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[26] Pitts M,  Clarke T. Human papillomavirus infections and risks of cervical cancer: what do women know? Health Educ Res 2002; 17 706–14.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[27] Li J,  Li L,  Ma J,  Wei L,  Niyazi M,  Li C, et al. Knowledge and attitudes about human papillomavirus (HPV) and HPV vaccines among women living in metropolitan and rural regions of China. Vaccine 2009; 27 1210–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[28] Holroyd E,  Twinn S,  Adab P. Socio-cultural influences on Chinese women’s attendance for cervical screening. J Adv Nurs 2004; 46 42–52.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[29] Revzina NV. Prevalence and incidence of human papillomavirus infection in women in the USA: a systematic review. Int J STD AIDS 2005; 16 528–37.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[30] Kotloff KL,  Wasserman SS,  Russ K,  Shapiro S,  Daniel R,  Brown W, et al. Detection of genital human papillomavirus and associated cytological abnormalities among college women. Sex Transm Dis 1998; 25 243–50.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[31] Peyton CL,  Gravitt PE,  Hunt WC,  Hundley RS,  Zhao M,  Apple RJ, et al. Determinants of genital human papillomavirus detection in a US population. J Infect Dis 2001; 183 1554–64.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[32] Moscicki AB,  Burt VG,  Kanowitz S,  Darragh T,  Shiboski S. The significance of squamous metaplasia in the development of low grade squamous intraepithelial lesions in young women. Cancer 1999; 85 1139–44.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[33] Ley C,  Bauer HM,  Reingold A,  Schiffman MH,  Chambers JC,  Tashiro CJ, et al. Determinants of genital human papillomavirus infection in young women. J Natl Cancer Inst 1991; 83 997–1003.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[34] Warren CW,  Santelli JS,  Everett SA,  Kann L,  Collins JL,  Cassell C, et al. Sexual behavior among U.S. high school students, 1990–1995. Fam Plann Perspect 1998; 30 170–2, 200.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[35] Aten MJ,  Siegel DM,  Enaharo M,  Auinger P. Keeping middle school students abstinent: Outcomes of a primary prevention intervention. J Adolesc Health 2002; 31 70–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[36] Edgardh K. Sexual behavior and early coitarche in a national sample of 17-years-old Swedish girls. Sex Transm Infect 2000; 76 98–102.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[37] Davoli M,  Perucci CA,  Sangalli M,  Brancato G,  Dell’-Uomo G. Reliability of sexual behavior data among high school students in Rome. Epidemiology 1992; 3 531–5.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[38] Weisberg E,  North P,  Buxton M. Sexual activity and condom use in high school students. Med J Aust 1992; 156 612–3.
|  CAS | PubMed |

[39] Lam TH,  Stewart SM,  Ho LM. Prevalence and correlates of smoking and sexual activity among Hong Kong adolescents. J Adolesc Health 2001; 29 352–8.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[40] Zimet GD,  Mays RM,  Winston Y,  Kee R,  Dickes J,  Su L. Acceptability of HPV immunization. J Womens Health 2000; 9 47–50.
|  CAS |

[41] Hoover DR,  Carfioli B,  Moench EA. Attitudes of adolescent/young adult women toward human papillomavirus vaccination and clinical trials. Health Care Women Int 2000; 21 375–91.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[42] Kahn JA,  Rosenthal SL,  Hamann T,  Bernstein DI. Attitudes about human papillomavirus vaccine in young women. Int J STD AIDS 2003; 14 300–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[43] Zimet GD,  Mays RM,  Fortenberry JD. Vaccines against sexually transmitted infections: promise and problems of the magic bullets for prevention and control. Sex Transm Dis 2000; 27 49–52.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[44] Webb PM,  Zimet GD,  Mays R,  Fortenberry JD. HIV immunization: acceptability and anticipated effects on sexual behavior among adolescents. J Adolesc Health 1999; 25 320–2.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[45] Bourdieu P . The Logic of Practice (R Nice trans.) Stanford; Stanford University Press: 1990.

[46] Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 1966; 80 1–28.
|  CAS | PubMed |

[47] Wallston KA,  Wallston BS,  DeVellis RF. Development of the Multidimensional Health Locus of Control (MHLC) scales. Health Educ Monogr 1978; 6 160–70.
|  CAS | PubMed |

[48] Davis K,  Dickman ED,  Ferris D,  Dias JK. Human papillomavirus vaccine acceptability among parents of 10- to 15-year old adolescents. J Low Genit Tract Dis 2004; 8 188–94.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[49] Kirby D. The impact of schools and school programs upon adolescent sexual behavior. J Sex Res 2002; 39 27–33.
| PubMed |