Impact of university students' awareness and attitudes on vaccination practices for human papillomavirus, and perception on self-sampling for cervical cancer screening

J Pharm Policy Pract. 2022 Oct 29;15(1):73. doi: 10.1186/s40545-022-00471-7.

Abstract

Background: The burden of Human Papilloma Virus (HPV)-associated cancer remains high in developing nations.

Aims: To assess the impact of self-reported awareness and attitudes on vaccination practices, and the perception on self-sampling for cervical cancer screening.

Methods: A 12-month survey using purposive sampling of females attending an urban public university was conducted. SPSS version 25 was used to compare the responses for students enrolled in health vs non-health related programmes.

Results: Of the 290 questionnaires distributed, 240 were returned (response rate = 83%) in approximately equal proportion from the faculties of Health Science and Pharmacy (n = 127), and from the Hotel and Tourism, Business Management, and Art and Design (n = 113) faculties. About one-third (28.8%) had completed 3 shots, 19.6% received the first shot, 11.4% had scheduled appointments for first shots while 40.2% were both unvaccinated and had not scheduled any appointment. Most (71%) were aware of the HPV vaccines while 50.5% were unaware that HPV vaccines were also available for men. Students enrolled in health-related programmes were 3.2 times more perceptive to the benefits of vaccination particularly in preventing spread to their partners (OR 3.2, 95% CI 1.3-3.41, p = 0.006) than their counterparts. A weak-positive correlation was observed between knowledge and vaccination practices (r = 0.2, p = 0.001). The level of knowledge on HPV and its vaccine was greater for health-related (Mdn = 6.5) than for students of non-health related (Mdn = 1.5) programmes (U = 2790.5, p-value = 0.00). Attitudes towards immunisation were influenced by perceived benefits versus risks for side effects, cost barriers, and influences of primarily their doctors and parents. The study was limited in that relationship statuses were used to estimate sexual history as direct questions were unanswered in the pilot survey.

Conclusion: HPV vaccine uptake for an immunisation-targeted young female population is low despite moderate knowledge levels. It is plausible that the low rates among females enrolled in particularly the non-health programmes were impacted by misperceived vaccine-associated risks, and misconception that testing and vaccination for HPV and cervical cancer were for those married or sexually active. Self-sampling could offer a potential alternative to sampling via pelvic examination, particularly for societies where premarital sex is seen as a taboo.

Keywords: Diagnostic self-sampling; Early detection of cancer; Papillomaviridae; Predictive value of tests; Primary prevention; Uterine cervical neoplasms; Vaccination.