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Obstetrics & Gynecology 2008;111:1103-1110
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Rates of Human Papillomavirus Vaccination, Attitudes About Vaccination, and Human Papillomavirus Prevalence in Young Women

Jessica A. Kahn, MD, MPH1, Susan L. Rosenthal, PhD2, Yan Jin, MS3, Bin Huang, PhD3, Azadeh Namakydoust, MS4 and Gregory D. Zimet, PhD5

From the 1Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; the 2Division of Adolescent and Behavioral Health, University of Texas Medical Branch at Galveston, Galveston, Texas; the 3Division of Epidemiology and Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; the 4University of Cincinnati College of Medicine, Cincinnati, Ohio; and the 5Division of Adolescent Medicine, Indiana University, Indianapolis, Indiana.

OBJECTIVE: To estimate rates of human papillomavirus (HPV) vaccination, factors associated with intention and belief in one’s ability (self-efficacy) to receive the vaccine, and prevalence of vaccine-type HPV during the first year after an HPV-6, HPV-11, HPV-16, HPV-18 vaccine was licensed.

METHODS: Sexually experienced females 13–26 years of age (N=409) were recruited from three primary care clinics, completed a questionnaire, and underwent cervicovaginal HPV DNA testing. Outcome measures were HPV vaccination, intention and belief in one’s ability to receive the HPV vaccine in the next year, and prevalence of vaccine-type HPV. Factors independently associated with intention and belief in one’s ability to receive the HPV vaccine were determined by logistic regression.

RESULTS: Five percent of participants had received at least one HPV vaccine dose, 66% intended to receive the vaccine, 65% were confident they could find the time to get vaccinated, 54% believed that they could receive all three shots, and 42% believed that they could afford vaccination. Sixty-eight percent of women were HPV-positive: 9% for HPV-6, 3% for HPV-11, 17% for HPV-16, and 12% for HPV-18. Factors independently associated with intention included believing that influential people would approve of vaccination, higher perceived severity of cervical cancer or genital warts, fewer safety barriers, and pregnancy history. Factors associated with a high belief in one’s ability to receive the vaccine included perceived severity of HPV, sexually transmitted disease history, insurance coverage, and fewer practical barriers to vaccination.

CONCLUSION: Interventions that aim to increase intention and belief in one’s ability to receive HPV vaccines, which may lead to higher vaccination rates, should address personal beliefs about vaccination as well as systemic barriers to vaccination.

LEVEL OF EVIDENCE: III






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