医疗服务提供者对人乳头瘤病毒疫苗接种后风险补偿的看法和态度。
Healthcare providers' beliefs and attitudes regarding risk compensation following HPV vaccination.
作者信息
Kasting Monica L, Wilson Shannon, Dixon Brian E, Downs Stephen M, Kulkarni Amit, Zimet Gregory D
机构信息
Indiana University Fairbanks School of Public Health, Department of Epidemiology, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202, USA.
Indiana University School of Medicine, Department of Pediatrics, 410 W 10 Street Suite 1001, Indianapolis, IN 46202, USA.
出版信息
Papillomavirus Res. 2016 Dec;2:116-121. doi: 10.1016/j.pvr.2016.05.005.
BACKGROUND
Provider recommendation is a significant predictor of HPV vaccine uptake. Prior research suggests that concerns regarding risk compensation could cause some providers to hesitate recommending the HPV vaccine.
METHODS
During 15-30 minute semi-structured interviews in early 2015, 22 U.S. pediatric providers were asked about their beliefs regarding sexual risk compensation and cervical cancer screening following HPV vaccination. Providers were asked if these beliefs result in reservations recommending the vaccine. Interviews were audio-recorded, transcribed, and analyzed using inductive content analysis.
RESULTS
None of the providers believed the HPV vaccine would result in risky sexual behavior. Half indicated it was better to start vaccination early, before sexual activity was a worry. Others noted that patients' risky behavior decisions happen independently of vaccination. When providers were asked if they were concerned about decreased cervical cancer screening, half said they did not know and some stated they had never thought about it before. The main themes addressed were the significant time lapse between vaccination and screening and that women tend to get over-screened as opposed to under-screened.
CONCLUSION
Providers were generally in favor of HPV vaccination and do not perceive risk compensation as a barrier to HPV recommendation.
背景
医疗服务提供者的建议是HPV疫苗接种率的一个重要预测因素。先前的研究表明，对风险补偿的担忧可能会导致一些医疗服务提供者在推荐HPV疫苗时犹豫不决。
方法
在2015年初进行的15 - 30分钟半结构化访谈中，询问了22名美国儿科医疗服务提供者关于他们对HPV疫苗接种后性风险补偿和宫颈癌筛查的看法。询问医疗服务提供者这些看法是否导致他们在推荐疫苗时有所保留。访谈进行了录音、转录，并采用归纳性内容分析法进行分析。
结果
没有医疗服务提供者认为HPV疫苗会导致危险的性行为。一半的人表示最好在性行为成为担忧之前尽早开始接种疫苗。其他人指出，患者的危险行为决策与疫苗接种无关。当被问及是否担心宫颈癌筛查减少时，一半的人表示不知道，一些人表示他们以前从未想过这个问题。讨论的主要主题是接种疫苗和筛查之间存在显著的时间间隔，以及女性往往筛查过度而非筛查不足。
结论
医疗服务提供者普遍支持HPV疫苗接种，并且不认为风险补偿是推荐HPV疫苗的障碍。
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