Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Padua, Italy.
Department of Public Health and Community Medicine, Hygiene and Environmental, Occupational and Preventive Medicine Division, University of Verona, Verona, Italy.
Health Soc Care Community. 2020 Sep;28(5):1514-1524. doi: 10.1111/hsc.12974. Epub 2020 Mar 17.
HPV vaccination is a milestone in primary prevention. However in Italy, vaccine coverage is still nowhere near the target of 95%. We investigated factors associated with inclination to get vaccinated in university students, as they are likely to have just assumed a central role in their healthcare decision-making. University students aged 18-25 were asked to fill in a questionnaire. The effect of socio-demographic and behavioural characteristics on HPV awareness was assessed with a logistic regression adjusting for age, gender, nationality, degree course, relationship, age at first intercourse, number of sexual partners, smoking, sexual orientation, past diagnosis of STDs and knowledge of people who had received HPV vaccine. A second regression adjusting also for information sources, awareness and knowledge investigated factors associated with inclination to receive vaccine. Nine thousand nine hundred and eighty-eight questionnaires were included (response rate 91.3%); awareness of HPV and vaccine was 83.3% and 69.9% respectively. Awareness (AOR: 3.3; 95% CI: 2.3-4.6) and a good knowledge positively affected acceptability, as well as a previous diagnosis of STDs and knowledge of vaccinated people. Healthcare workers (AOR: 1.6; 95% CI: 1.4-1.9) and family members (AOR: 1.7; 95% CI: 1.4-2.1) were the most influencing information sources, even if knowledge of vaccinated people was by far more persuasive (AOR: 2.7; 95% CI: 2.2-3.3). Only 12% of participants were acquainted with skin to skin HPV transmission, while 75% believed in a full effectiveness of condom; less than 22% associated HPV with cancer (other than cervical cancer). Efforts to increase awareness are likely to be worth considering that: awareness is the main determinant of vaccine acceptance; only 50% of individuals not interested in receiving vaccine were aware of it; males are much less aware (AOR: 0.09; 95% CI: 0.07-0.11). Moreover, this study spotlights some misconceptions around HPV and acknowledges a pivotal role of healthcare workers, family and peer influence.
HPV 疫苗接种是初级预防的一个里程碑。然而，在意大利，疫苗接种率仍远未达到 95%的目标。我们调查了与大学生接种疫苗意愿相关的因素，因为他们可能刚刚在医疗保健决策中扮演了重要角色。我们要求年龄在 18-25 岁的大学生填写一份问卷。我们使用逻辑回归来评估社会人口统计学和行为特征对 HPV 意识的影响，调整了年龄、性别、国籍、学位课程、关系、首次性行为年龄、性伴侣数量、吸烟、性取向、过去性病诊断和 HPV 疫苗接种者的知识。第二个回归还调整了信息来源、意识和知识，以调查与接种意愿相关的因素。共纳入 9988 份问卷（应答率为 91.3%）；HPV 和疫苗的知晓率分别为 83.3%和 69.9%。知晓率（优势比：3.3；95%置信区间：2.3-4.6）和良好的知识水平积极影响可接受性，以及以前的性病诊断和接种疫苗者的知识。医护人员（优势比：1.6；95%置信区间：1.4-1.9）和家庭成员（优势比：1.7；95%置信区间：1.4-2.1）是最有影响力的信息来源，尽管接种疫苗者的知识更有说服力（优势比：2.7；95%置信区间：2.2-3.3）。只有 12%的参与者了解皮肤到皮肤的 HPV 传播，而 75%的人相信避孕套的完全有效性；不到 22%的人将 HPV 与癌症（除宫颈癌外）联系起来。提高认识的努力可能是值得考虑的，因为：意识是疫苗接受的主要决定因素；只有 50%对接种疫苗不感兴趣的人了解疫苗；男性的意识要低得多（优势比：0.09；95%置信区间：0.07-0.11）。此外，这项研究还揭示了一些围绕 HPV 的误解，并承认了医护人员、家庭和同伴的影响的关键作用。
