Division of Gastroenterology, Department of Medicine, University of Puerto Rico School of Medicine, PO Box 365067, San Juan, PR, 00936-5067, Puerto Rico.
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
J Racial Ethn Health Disparities. 2016 Mar;3(1):55-62. doi: 10.1007/s40615-015-0112-0. Epub 2015 Apr 22.
Women with inflammatory bowel disease (IBD) may be at increased risk of human papilloma virus (HPV) infection and HPV-related malignancies, as many are immunocompromised secondary to the use of immunosuppressant agents. Several studies have addressed the knowledge about cervical cancer risk factors in different populations, particularly HPV infection and its association with cervical malignancies; most of these studies show poor patient knowledge. The purpose of this study is to describe the knowledge of females with IBD about HPV infection and the HPV vaccine. We performed a cross-sectional study in 147 consecutive patients attending the clinics of the University of Puerto Rico Center for IBD from 2009 to 2010. An interviewer-administered questionnaire was used to collect information on demographics, lifestyles, and HPV-related knowledge of participants. Bivariate analysis using the chi-square statistics and Fisher's exact test was used to examine factors associated with HPV awareness. The mean age of participants was 36.6 years (SD = 13.91 years). Three fourth (77 %) of women had awareness of the existence of HPV, and 58 % did know about the existence of HPV vaccines. Among those who had heard about HPV, 79.6 % knew that HPV can cause cervical cancer, and 57.5 % knew that the virus is sexually transmitted. Among those who knew of the vaccine, 75.3 % learned about its existence through the media, while only 15.3 %, through their health-care provider. Only three women within recommended ages (2 %) had been vaccinated against HPV, although 50 % of participants indicated that they would definitely/probably vaccinate against HPV in the future. A significant trend was observed, where more educated women were more likely to have heard of HPV (p for trend = 0.0017). Women who were high school graduates/some college (OR = 6.63, 95 % CI = 1.71-25.66) and those with at least an associate degree (OR = 11.69, 95 % CI = 3.05-45.89) were more likely to be aware of the HPV vaccine than women without a high school degree. Our study documents poor knowledge of HPV and HPV vaccine in this population of IBD patients in Puerto Rico. Although vaccination coverage is low in this population, women are receptive to the possibility of vaccination in the future. Given that this population may be at an increased risk of HPV infection and related morbidities, education and vaccination programs should be promoted among them.
患有炎症性肠病(IBD)的女性可能面临人乳头瘤病毒(HPV)感染和 HPV 相关恶性肿瘤的风险增加,因为许多人由于使用免疫抑制剂而免疫功能低下。一些研究已经探讨了不同人群对宫颈癌危险因素的认识,特别是 HPV 感染及其与宫颈癌的关系;这些研究中的大多数都显示患者的知识水平较低。本研究旨在描述患有 IBD 的女性对 HPV 感染和 HPV 疫苗的认识。我们于 2009 年至 2010 年在波多黎各大学 IBD 中心的诊所对 147 例连续患者进行了横断面研究。采用访谈者管理的问卷收集参与者的人口统计学、生活方式和 HPV 相关知识信息。采用卡方检验和 Fisher 确切检验进行单变量分析,以检查与 HPV 意识相关的因素。参与者的平均年龄为 36.6 岁(标准差=13.91 岁)。四分之三(77%)的女性意识到 HPV 的存在,58%的人知道 HPV 疫苗的存在。在听说过 HPV 的人中,79.6%的人知道 HPV 可导致宫颈癌,57.5%的人知道该病毒是通过性传播的。在了解疫苗的人中,75.3%是通过媒体了解到其存在的,而只有 15.3%是通过他们的医疗保健提供者了解到的。尽管 50%的参与者表示将来肯定/可能会接种 HPV 疫苗,但只有 3 名符合推荐年龄(2%)的女性接种了 HPV 疫苗。我们观察到一个显著的趋势,即受教育程度较高的女性更有可能听说过 HPV(趋势检验 p=0.0017)。高中及以上学历(OR=6.63,95%CI=1.71-25.66)和至少大专学历(OR=11.69,95%CI=3.05-45.89)的女性比没有高中学历的女性更有可能了解 HPV 疫苗。我们的研究记录了波多黎各 IBD 患者群体中 HPV 和 HPV 疫苗知识的不足。尽管该人群的疫苗接种率较低,但女性对未来接种疫苗的可能性持接受态度。鉴于该人群可能面临 HPV 感染和相关疾病的风险增加,应在他们中间推广教育和疫苗接种计划。