HPV vaccine acceptance among a sample of Southern men who have sex with men: A comparison of younger and older men

Objectives: Do short, online educational messages about the human papillomavirus (HPV) influence younger and older men who have sex with men (MSM) differently? Second, what are the HPV knowledge levels and risk perceptions of Southern MSM living outside of major metropolitan areas? Methods: This study draws on participants who completed an anonymous online survey asking about their knowledge, risk assessment, and vaccine acceptance regarding HPV. Results: Knowledge about HPV was low among the MSM in this study. After reading a one-page information intervention, vaccine acceptability increased by a statistically significant amount among both a Younger and Older cohort but risk perception only increased among the younger respondents. Single men regardless of age cohort reported sharper increases in perceived risk after the intervention, but relationship status did not produce significant differences in vaccine acceptability. Conclusion: Online, brief interventions may be effective means of increasing motivation to vaccinate among Southern MSM.     

Disparities in Human Papillomavirus Vaccine Literacy and Vaccine Completion Among Asian American Pacific Islander Undergraduates: Implications for Cancer Health Equity

Abstract

Purpose: Low rates of human papillomavirus (HPV) vaccination among young Asian American and Pacific Islander (AAPI) women need to be addressed, particularly given the high incidence of cervical cancer in this population. The current study aims to investigate predictors of HPV vaccination in young AAPI and non-Latina white (NLW) women. Methods: A secondary data analysis was conducted of a health survey administered to college-aged women (N = 2,270) at a large public university in the Midwest. Andersen's behavioral model of health services utilization guided the study theoretically, and hierarchical logistic regression analysis was conducted to investigate research aim. Results: NLW women had a significantly higher rate of vaccine completion than AAPI women (NLW = 60.7%; AAPI = 38.6%). NLW women also scored higher on all 5 measures of HPV vaccine literacy than AAPI women. Both groups of undergraduate women reported that increasing age, knowledge about HPV, greater use of gynecological services, and knowing someone who had cancer were significant factors related to HPV vaccination completion. In the NLW group, father's income was also found to be a predictor of HPV vaccination completion. Conclusions: Rate and predictors of HPV vaccination completion vary between NLW and AAPI women. Greater promotion of HPV literacy and gynecological service use should be made to young AAPI women to increase their HPV uptake. Further research should examine sociocultural factors that could hinder or promote HPV vaccination in young AAPI women.     

Intent to receive an HPV vaccine among university men and women and implications for vaccine administration

OBJECTIVE AND PARTICIPANTS: In 2006, the authors examined intention to receive an HPV vaccine among 340 college students. METHODS: A total of 138 men and 202 women completed questionnaires. The authors measured intention by asking participants how likely they would be to accept an HPV vaccine that prevented against (1) all HPV, (2) cervical cancer but not genital warts, (3) genital warts but not cervical cancer, and (4) both genital warts and cervical cancer. RESULTS: Men and women reported high intent to receive an HPV vaccine, although women did so at a significantly higher rate (77.5% vs 88.6%, respectively; p < .01). Men were less willing to receive a vaccine that prevents cervical cancer alone than they were to receive one that prevents cervical cancer and genital warts (34.1% vs 77.5%, p < .001). Intent to receive the vaccine was significantly greater among participants who reported more than 5 sex partners and correctly answered 2 or 3 HPV knowledge questions. CONCLUSIONS: Interest varied according to sexual history, according to knowledge about HPV, and (in men) according to vaccine target.     

Knowledge,Attitudes, and Informational Behaviors of College Students in Regard to the Human Papillomavirus

Abstract

Objective: To assess students’ human papillomavirus (HPV) knowledge, attitudes, and behaviors. Participants/ Methods: Students (N = 1,282) at a large, public university in the Northeast United States completed a questionnaire during February 2008 assessing HPV knowledge, prevalence, transmission, cervical cancer risk and stigma; sexual behavior, vaccination status, as well as past and preferred sources of information about HPV and sexual health. Results: A majority of respondents know of HPV. However, understanding was insufficient in several important areas. Overwhelmingly, respondents heard about HPV via television commercials yet preferred to obtain sexual health information from physicians. Hearing about HPV on a TV commercial was associated with increased knowledge. More knowledge of HPV was associated with less stigma. Men exhibit a higher level of stigma and less knowledge than women. Conclusions: Publicly funded health campaigns aimed at increasing knowledge about HPV are overdue and necessary. This is especially true for efforts targeting young adults about this extremely common sexually transmitted infection (STI).     

Human Papillomavirus Vaccine Intention Among College Men: What's Oral Sex Got to Do With It?

Abstract

Objective: To identify associations between engaging in oral sex and perceived risk of oral cancer among college men. Also, to identify associations, and their moderating factors, between oral sex and human papillomavirus (HPV) vaccine acceptance. Methods: Young men were recruited from 2 university campuses in the South (N = 150). Men completed an audio computer-assisted self-administered interview. Results: With the exception of receiving fellatio, each measure of oral sex behavior was significantly associated with greater perceived risk of oral cancer. Four oral sex behaviors evidenced significant associations with vaccine acceptance. Men engaging in recent oral sex or reporting oral sex behaviors with more than 2 partners were more likely to indicate vaccine intent. African American/black race, communication with parents about sex-related topics, and HPV-related stigma/shame were identified as moderating factors. Conclusion: Young college men giving or receiving oral sex with multiple partners may be predisposed to HPV vaccination.     

Transactional Sex and Preferences for Pre-Exposure Prophylaxis (PrEP) Administration Modalities Among Men Who Have Sex With Men (MSM)

Pre-exposure prophylaxis (PrEP) is an important biomedical human immunodeficiency virus (HIV) prevention tool gaining more popularity among Parisian men who have sex with men (MSM) who engage in transactional sex. This study examines the knowledge of, and willingness to use, different modalities of PrEP among this subgroup. Broadcast advertisements were placed on a geosocial-networking smartphone application with a link to a Web-based survey during three 24-hour periods in October 2016. Modified Poisson regression models were used to assess the association between engagement in transactional sex and preferences for each of these PrEP modalities. A total of 444 respondents were included. About 14% reported engagement in transactional sex. In all, 90% of MSM who engaged in transactional sex were knowledgeable of daily oral PrEP, while 13.3% were knowledgeable about long-acting injectable PrEP or penile or rectal microbicides. They were more likely to be aware of long-acting injectable PrEP (aRR = 2.52, 95% CI = 1.16 to 5.47) and willing to use daily oral PrEP (aRR = 1.48; 95% CI = 1.11 to 1.98) or long-acting injectable PrEP (aRR = 1.40; 95% CI = 1.09 to 1.81) than MSM who had not engaged in transactional sex. Long-acting injectable PrEP may be an important HIV-prevention option for MSM who engage in transactional sex if this modality is proven effective.     

Prevalence and Correlates of Sex Exchange Among a Nationally Representative Sample of Adolescents and Young Adults

The present study examines prevalence and correlates of exchanging sex for drugs, money, food shelter, or other favors (sex exchange) among a nationally representative sample of youth and young adults. Adolescents and young adults (n = 11,620, 53% female, 47% male) from the National Longitudinal Study of Adolescent Health were used for the current sample. Participants completed in-home interviews at both waves. Results revealed that sex exchange was reported by 4.9% (n = 569) of the population in wave 2 or wave 3, and 4.6% (n = 26) of those who exchanged sex did so at both waves. More males reported exchanging sex than females (n = 332 versus n = 237). Respondents who reported child sexual abuse were more likely to exchange sex (95% CI 2.51–4.28, p < .05) than respondents who reported any other form of child abuse. Both males and females who engaged in sex exchange were at greater risk for sexually transmitted infections; however, the odds of ever exchanging sex were highest among males who ever had gonorrhea (OR = 6.2; 95% CI 3.75–10.3). Although sex exchange has been studied extensively among homeless and runaway youth, the current study reveals sex exchange also occurs in the general population.     

The Effects of a Web-Based Intervention on College Students' Knowledge of Human Papillomavirus and Attitudes toward Vaccination

ABSTRACT

Research suggests that college students know relatively little about human papillomavirus (HPV), and that educational interventions increase knowledge of HPV. However, to date, there are no published studies testing the effects of computer-based education on attitudes toward being vaccinated in this population. The present study of 119 college students explored the effect of a web-based intervention on participants' knowledge of HPV and attitudes toward HPV vaccination. Participants were randomized to a web-based, self-administered HPV educational intervention or to a control group. Knowledge and attitudes were assessed at baseline, after the completion of the intervention, and at one-month follow-up. At baseline, women knew more than men about risks and symptoms of HPV. At immediate and long-term follow-up, the intervention group had better knowledge of HPV and more positive attitudes toward HPV vaccination than the control group. There were some gender differences in response to the intervention; increases in knowledge of HPV were greater in men, while changes in attitudes toward vaccination were larger in women.     

Examining Heterosexual Women’s Anal Sexual Health Knowledge and Product Use

Prevalence rates indicate that receptive anal sex is increasingly part of heterosexual women’s sexual repertoire. However, there is a body of literature linking this behavior to risk for adverse sexual health outcomes. Women’s anal sexual health knowledge and awareness of behaviors associated with elevated risk have received less attention in the research literature. The aim of the current study was to examine anal sexual health knowledge and product use among heterosexual women aged 18 to 30 years. A total of 33 self-identified heterosexual women recruited from the general population participated in one of six focus groups. The results suggest that knowledge was variable. Salient sexual health themes centered on risks of human immunodeficiency virus/sexually transmitted infections (HIV/STIs), other infections, and physical harm/damage. Product-use themes included cleanliness/hygiene, comfort, and product safety. Participants expressed the desire for anal sexual health education. The results have implications for sexual health research, education, and clinical practice.     

Predicting Human Papillomavirus Vaccine Intentions of College-Aged Males: An Examination of Parents' and Son's Perceptions

Abstract Objective: To examine male students' and their parents' human papillomavirus (HPV) vaccine communication in relation to males' willingness to discuss the vaccine with their health care provider and the likelihood of being vaccinated. Participants: Dyads (n = 111) of students and parents. Methods: Participants completed a HPV vaccine survey based on the risk perception attitude framework in 2009. Results: Male students' perceived susceptibility for HPV and self-efficacy to talk to their provider were directly related to their intention to discuss the HPV vaccine, and their intention was directly related to their likelihood of being vaccinated. Parents' perceived self-efficacy to talk to their son and response efficacy of the vaccine were directly related to their intention to talk to their son; however, parents' intention was not related to the likelihood of their son being vaccinated. Conclusions: College males may benefit from HPV vaccine educational programs that include communication skills training to discuss the HPV vaccine with their parents.     

Sexual Hookups and Adverse Health Outcomes: A Longitudinal Study of First-Year College Women

“Hookups” are sexual encounters between partners who are not in a romantic relationship and do not expect commitment. We examined the associations between sexual hookup behavior and depression, sexual victimization (SV), and sexually transmitted infections (STIs) among first-year college women. In this longitudinal study, 483 women completed 13 monthly surveys assessing oral and vaginal sex with hookup and romantic partners, depression, SV, and self-reported STIs. Participants also provided biological specimens that were tested for STIs. During the study, 50% of participants reported hookup sex and 62% reported romantic sex. Covariates included previous levels of the outcome, alcohol use, impulsivity, sensation seeking, and romantic sex. Autoregressive cross-lagged models showed that, controlling for covariates, hookup behavior during college was correlated with depression, Bs = .21, ps < .05, and SV, Bs = .19, ps < .05. In addition, precollege hookup behavior predicted SV early in college, B = .62, p < .05. Hookup sex, OR 1.32, p < .05, and romantic sex, OR 1.19, p < .05, were associated with STIs. Overall, sexual hookup behavior among college women was positively correlated with experiencing depression, SV, and STIs, but the nature of these associations remains unclear, and hooking up did not predict future depression.     

Family factors associated with emerging adults’ human papillomavirus vaccine behavior

Abstract

Objective: The current study examined the role of family influences on the vaccine behavior of emerging adults. Participants: In Spring 2017, we conducted anonymous online surveys of undergraduate students (n?=?608) at a large, public university in the mid-Atlantic. Methods: Logistic regression was used to examine associations between family factors and students’ awareness of the HPV vaccine, vaccine receipt, and vaccine intentions. Family factors included sex communication, religiosity, parental monitoring, family structure, and parents’ birthplace. Results: More comprehensive family sex communication is associated with less uncertainty regarding HPV vaccine receipt and greater likelihood of being already vaccinated. More frequent family religiosity and more parental monitoring are associated with greater likelihood of having decided against vaccination rather than already being vaccinated. Significant gender and racial disparities exist. Conclusion: Further research, policy, and programmatic intervention are needed to reduce disparities and to improve emerging adults’ compliance with HPV vaccine recommendations.     

Risk level, knowledge, and preventive behavior for human papillomaviruses among sexually active college women.

During the past decade, there has been mounting scientific evidence linking human papillomavirus (HPV) with cervical cancer and, at the same time, a great increase in physician consultations for HPV infections. HPV infection risk factors include multiple sex partners, early age at first intercourse, history of sexually transmitted diseases (STDs), and smoking. This study surveyed 263 sexually active college women and concluded that (1) they are at considerable risk for contracting HPV, (2) they lack awareness of HPV, and (3) they are not practicing preventive behaviors that could reduce their risk of HPV and its serious consequences.     

Knowledge,Beliefs, and Behaviors: Examining Human Papillomavirus–Related Gender Differences Among African American College Students

Abstract

Objective: Given recent approval for administration of a human papillomavirus (HPV) vaccine to men, it is important to assess the HPV-related perspectives of men and women. The purpose of this study was to examine gender differences in HPV knowledge, beliefs, and vaccine acceptance among college students attending 3 historically black colleges/universities in the Southeast. Participants and Methods: A nonprobability sample of 575 students completed a self-report questionnaire. Results: Males were significantly less likely to have heard of HPV, scored lower in HPV knowledge, were less likely to perceive HPV health outcomes as severe and that there was a benefit to vaccinate, reported fewer cues for vaccine acceptance, and perceived more barriers to vaccination compared to females (all p < .05). Conclusions: The gender disparities demonstrated in this study highlight the need to increase HPV-related communication/education to include men and to extend HPV research to a broader segment of the college population.     

Women's Unprotected Sex Intentions: Roles of Sexual Victimization,Intoxication, and Partner Perception

Sexually victimized women may make sexual decisions differently than nonvictimized women. This study used an eroticized scenario and laboratory alcohol administration to investigate the roles of victimization history, intoxication, and relationship context in women's perceptions of a male partner and their subsequent intentions for unprotected sex. A community sample of 436 women completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. After random assignment to an alcohol or control condition, participants read and projected themselves into a sexual scenario that depicted the male partner as having high or low potential for a lasting relationship. Participants rated their perceptions of his intoxication, sexually transmitted infection (STI) risk level, and anticipated reactions to insistence on condom use. They then indicated their likelihood of allowing the partner to decide how far to go sexually (abdication) and of engaging in unprotected sex. Structural equation modeling (SEM) analyses revealed that intoxication predicted greater unprotected sex likelihood indirectly via abdication. CSA and ASA predicted partner perceptions, which in turn predicted unprotected sex likelihood. These findings indicate that, compared to their nonvictimized counterparts, sexually victimized women may respond differently in sexual encounters partly as a function of their perceptions of partners' STI risk and anticipated reactions to condom insistence.     

Men's perceptions and knowledge of human papillomavirus (HPV) infection and cervical cancer

The authors assessed young men's knowledge and perceptions of genital human papillomavirus (HPV) infection to identify factors that predict intention to make positive behavioral changes. Male university students aged 18 to 25 years completed a self-report instrument to assess knowledge and perceptions of genital HPV infection. If diagnosed with HPV, most men (95%) reported that they would use condoms with new partners. The intention to reduce number of sex partners was associated with an understanding that HPV may have severe consequences for women, whereas intention to encourage female sex partners to undergo Pap smear screening was associated with increased general knowledge of HPV infection. The authors concluded that it is important to include men in HPV education and prevention efforts, especially within the context that HPV may lead to cervical cancer in female partners.     

Still a “female problem”: a framing analysis of the Human Papillomavirus (HPV) vaccine in Chinese online news

Approximately 562 million women in China are at risk for cervical cancer, which is mainly triggered by persistent infections with human papillomavirus (HPV). HPV is also responsible for the majority of penile, anal, and oropharynx cancers in men. In this study, online Chinese news content was examined 12?months before and after the approval of the HPV vaccine in China. The coding instrument captured issue-specific and generic frames of the HPV vaccine. The sample of 224 online news articles revealed that headlines about the vaccine tended to be neutral in tone (48.7%); however, 32.1% of the sample did not mention the vaccine. Although information about vaccine efficacy, costs, and the populations recommended for vaccination increased after the approval, other information, such as safety concerns, increased significantly. Although 76.3% of the sample labeled the vaccine as a tool for cervical cancer prevention, they failed to recognize it as a method for preventing sexually transmitted diseases. In the sample, gender bias was present in both the headlines and content of the articles. For example, in the news stories, the consideration of the eligibility of males for vaccination, the effectiveness of the vaccine in preventing diseases in men and the use of male exemplars were far from satisfactory. Moreover, the gender bias remained consistent over time. The implications of the findings and the contributions of the study are discussed.     

Knowledge and perception of female nursing students about human papillomavirus (HPV), cervical cancer,and attitudes toward HPV vaccination

Objective: The researchers aimed to evaluate the knowledge and perceptions of first-year female nursing students about human papillomavirus (HPV), cervical cancer (CC), and HPV vaccination. Participants: The sample included 690 female nursing students from sampled universities between April and June 2015. Methods: Students were surveyed by using a pretested HPV and CC awareness questionnaire. Results: More than half of the students (65.1%) answered questions incorrectly with a mean HPV knowledge score of 6.085?±?3.38. The majority of students (82.6%) did not hear HPV vaccine. Only, 2.8% of the students had been vaccinated. A statistically significant relationship was found between HPV knowledge score and hearing about HPV vaccine (U?=?28280.500, p?=?.015), and believing HPV vaccine protectiveness (χ²?=?14.153, p?=?.001). Conclusions: This study highlights the lack of knowledge and low level of awareness about HPV, CC, and HPV vaccination among first-year nursing college students.     

Sexual Risk Behavior Among Women with Injected Drug Use Histories

This study documents the sexual risk, behavior for HIV infection and transmission in inner-city women with a history of injected drug use (IDU). The sample consists of N = 38 HIV+ and N = 37 HIV- women who were demographically comparable. A surprisingly high number of women in both. groups reported both male and female sex partners during their lifetime, and significantly more HIV+ women currently identified as bisexual and lesbian. Overall, HIV+ women had had more lifetime male and female sex partners, although the two groups did not differ in their current sexual behavior regarding numbers of partners and sex occasions. Both groups of women had little information about risk characteristics of their male sex partners, except for a history of IDU that was common among partners of both HIV+ and HIV- women. Sex for money was practiced by a subgroup of women in both groups and sex in exchange for drugs by very few women. A disturbingly high number of HIV+ and HIV- women reported occasions of unprotected sex during the past six months (86% vs. 97%), a finding that suggests that educational efforts for behavior change in IDU women need to be intensified.