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).     

Broken Promises: Abstinence Pledging and Sexual and Reproductive Health

Approximately 12% of girls and young women in the United States pledge abstinence. Yet most break their pledges, engaging in first intercourse before marriage. The extant literature reports few differences between pledge breakers and nonpledgers in sexually transmitted infections and nonmarital pregnancies. The present research maintains that previous studies may have obscured important differences in exposure risk and hypothesizes that female pledge breakers who have higher exposure risk are more likely to experience human papillomavirus (HPV) and nonmarital pregnancies. To test this hypothesis, this study uses the National Longitudinal Study of Adolescent to Adult Health, logistic regression, and event history modeling. The results show that, after accounting for differences in exposure risk, pledge breakers have higher risk of HPV and nonmarital pregnancy. As a set, the results are consistent with the argument that pledgers use condoms and contraceptives less consistently and highlight unintended consequences of abstinence promotion.     

HPV vaccination campaign fear visuals: An eye-tracking study exploring effects of visual attention and type on message informative value,recall, and behavioral intentions

HPV is the most common sexually transmitted disease, and there are alarming global disparities in cervical cancer and HPV vaccination uptake (CDC, 2016a). To inform HPV vaccination public health campaigns, an experiment with a psychophysiological measure (eye-tracking) explores the effects of visual attention to vaccination messages on message recall, informative value, and behavioral intentions. Results indicate 1) visual type affects recall and informative value of vaccination messages as well as intentions to vaccinate; 2) visual attention is negatively related to message recall only when a non-fear visual is used; and 3) visual attention predicts intent to vaccinate only when a fear visual is utilized. These results suggest the use of fear appeals in health, crisis, and risk public relations campaigns may promote performance of recommended safeguarding behaviors.     

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.     

Comparison of the Sexual Well-Being of Individuals with and Without a Herpes and/or Human Papillomavirus Infection Diagnosis

ABSTRACT. This study compared individuals with and without herpes and/or human papillomavirus (HPV) on several aspects of sexual well-being. We also investigated whether gender and relationship status moderated these relationships. Participants were 183 individuals with herpes and HPV and 299 without a diagnosis who completed measures of sexual activity, sexual concerns, and sexual cognitive–affective factors. Individuals with herpes and HPV reported being less sexually satisfied and were more likely to experience a distressing sexual problem than were those with no sexually transmitted infections. However, they reported high-quality sexual well-being overall and, contrary to prediction, reported more positive sexual well-being compared with individuals without a diagnosis on some dimensions. Outcomes were largely the same regardless of gender and relationship status. The results are discussed in terms of the importance of examining a broad range of factors related to sexuality to understand the potential impact of herpes and HPV on sexual well-being.     

Effects of sexually transmitted infection status, relationship status, and disclosure status on sexual self-concept

Research has indicated that having a sexually transmitted infection (STI) such as genital herpes and genital human papilloma virus (HPV) can have a negative impact on an individual's sexuality. The current study was designed to evaluate the effect of STI status, relationship status, and disclosure status on various dimensions of sexual self-concept. A questionnaire that evaluated the above variables was completed by 117 individuals with genital herpes, 82 individuals with HPV, and 75 individuals with no STI. The results demonstrated that having herpes or HPV had a significant negative impact on aspects of sexual self-concept. It does not appear that an individual's relationship status is a factor associated with the impact of having an STI on the sexual self-concept. Respondents who had disclosed their STI to their partners, however, had significantly more positive feelings about aspects of their sexual self-concept than those who had not disclosed their STI to their partners. The implications of these research findings for health practitioners are discussed.     

From desire to disease: human papillomavirus (HPV) and the medicalization of nascent female sexuality

This article critically examines the proliferation of information on the human papillomavirus (HPV) vaccination as integral to contemporary processes of medicalization that take the young female body and her nascent sexuality as its primary object and target. We suggest that the recent introduction of voluntary HPV vaccination for girls, in North America and elsewhere, constitutes a form of neomedicalization (Batt & Lippman, 2010 ) that links risks for future disease (cervical cancer) with the transmission of a common, sexually transmitted infection (HPV). Informed by findings from a critical discourse analysis of Canadian English newspapers, magazines, and public information about HPV vaccination, our interest is on how the emergence of sexual relationships becomes constructed as a time fraught with risks to future health, and that must be managed through biotechnological intervention (vaccination). We suggest that this configuration of medicalization, rather than demarcate a new category of abnormality that can be treated with pharmaceutical or medical intervention, positions the emergence of sexuality itself as the basis of risk and pathologization. The article concludes by considering the implications of this form of medicalization for constructions of female sexuality and sexual health education.     

Effects of Sexually Transmitted Infection Status,Relationship Status,and Disclosure Status on Sexual Self-Concept

Research has indicated that having a sexually transmitted infection (STI) such as genital herpes and genital human papilloma virus (HPV) can have a negative impact on an individual's sexuality. The current study was designed to evaluate the effect of STI status, relationship status, and disclosure status on various dimensions of sexual self-concept. A questionnaire that evaluated the above variables was completed by 117 individuals with genital herpes, 82 individuals with HPV, and 75 individuals with no STI. The results demonstrated that having herpes or HPV had a significant negative impact on aspects of sexual self-concept. It does not appear that an individual's relationship status is a factor associated with the impact of having an STI on the sexual self-concept. Respondents who had disclosed their STI to their partners, however, had significantly more positive feelings about aspects of their sexual self-concept than those who had not disclosed their STI to their partners. The implications of these research findings for health practitioners are discussed.     

A Review of Human Papillomavirus (HPV) Infection and HPV Vaccine-Related Attitudes and Sexual Behaviors Among College-Aged Women in the United States

Abstract Objective: To identify human papillomavirus (HPV) infection and HPV vaccine-related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to present. Results: Of the 13 studies identified, most were cross-sectional. College-aged women saw HPV infection as serious and had positive attitudes toward the HPV vaccine. Barriers (ie, cost, lack of insurance coverage) existed that prevented women from obtaining the vaccine and many women did not see themselves at risk for HPV. The vaccine uptake rate, although increasing, has been slow. Conclusion: College-aged women in the United States may need unbiased information about HPV and HPV vaccine. Studies that focus on risk perception and the relationship between knowledge, attitudes, vaccine uptake, and sexual behaviors are needed to inform interventions and public health programs.     

The Quest for the Elusive Female Orgasm

Public health information and educational interventions regarding human papillomavirus (HPV) have focused on the link between vaginal sex and cervical cancer among women. Many people are unaware that HPV can be transmitted through oral sex or that HPV causes oral cancers. Given that HPV infections and unprotected oral sex are increasing, research on oral sex-related HPV risk is important. This study examined the effect of a brief informational intervention regarding HPV and oral sex on the sexual risk cognitions of young adults. College students (N = 238) read information on HPV, oral sex, and oral cancer or no information. Participants then completed measures of oral sex and HPV knowledge, oral sex willingness, HPV vaccination likelihood, and risk perceptions. Participants who read the information on HPV and oral sex and cancer (compared to those who did not) reported greater knowledge, perceived risk and concern, and lower willingness to engage in oral sex. These effects were only significant among women. However, men reported a higher likelihood of future HPV vaccination compared to women who had not yet received the vaccine. Focusing on oral sex and cancer, this study adds to research investigating ways to reduce HPV infections.     

Gender attitudes,sexual violence,and HIV/AIDS risks among men and women in Cape Town,South Africa

This study examined gender attitudes and sexual violence‐supportive beliefs (rape myths) in a sample of South African men and women at risk for HIV transmission. Over 40% of women and 16% of men had been sexually assaulted, and more than one in five men openly admitted to having perpetrated sexual assault. Traditional attitudes toward women's social and gender roles, as well as rape myths, were endorsed by a significant minority of both men and women. Multivariate analyses showed that for men, sexual assault history and rape myth acceptance, along with alcohol and other drug use history, were significantly related to cumulative risks for HIV infection. In contrast, although we found that women were at substantial risk for sexually transmitted infection (STI), including HIV, women's risks were only related to lower levels of education and alcohol use history. We speculate that women's risks for STI/HIV are the product of partner characteristics and male‐dominated relationships, suggesting the critical importance of intervening with men to reduce women's risks for sexual assault and STI/HIV.     

The Special Historical Section of the Journal of American College Health

Abstract

Objective: To identify human papillomavirus (HPV) infection and HPV vaccine–related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to present. Results: Of the 13 studies identified, most were cross-sectional. College-aged women saw HPV infection as serious and had positive attitudes toward the HPV vaccine. Barriers (ie, cost, lack of insurance coverage) existed that prevented women from obtaining the vaccine and many women did not see themselves at risk for HPV. The vaccine uptake rate, although increasing, has been slow. Conclusion: College-aged women in the United States may need unbiased information about HPV and HPV vaccine. Studies that focus on risk perception and the relationship between knowledge, attitudes, vaccine uptake, and sexual behaviors are needed to inform interventions and public health programs.     

Is “Sexual Competence” at First Heterosexual Intercourse Associated With Subsequent Sexual Health Status?

The timing of first sexual intercourse is often defined in terms of chronological age, with particular focus on “early” first sex. Arguments can be made for a more nuanced concept of readiness and appropriateness of timing of first intercourse. Using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), conducted in 2010–2012, this study examined whether a context-based measure of first intercourse—termed sexual competence—was associated with subsequent sexual health in a population-based sample of 17-to 24-year-olds residing in Britain (n = 2,784). Participants were classified as “sexually competent” at first intercourse if they reported the following four criteria: contraceptive protection, autonomy of decision (not due to external influences), that both partners were “equally willing,” and that it happened at the “right time.” A lack of sexual competence at first intercourse was independently associated with testing positive for human papillomavirus (HPV) at interview; low sexual function in the past year; and among women only, reported sexually transmitted infection (STI) diagnosis ever; unplanned pregnancy in the past year; and having ever experienced nonvolitional sex. These findings provide empirical support for defining the nature of first intercourse with reference to contextual aspects of the experience, as opposed to a sole focus on chronological age at occurrence.     

The Association of Sexual Experience with Attitudes,Beliefs, and Risk Behaviors of Inner‐City Adolescents

We compared knowledge, attitudes, and demographic characteristics of 630 sexually experienced and 422 inexperienced inner‐city adolescents aged 14–17 years. Sexual experience was associated with indicators of risk previously reported in the literature: male gender, older age, single‐family home, smoking, drinking, and poorer academic performance. We found lower HIV knowledge in sexually inexperienced youth, which suggested an area of vulnerability compared with sexually active teens. However, most inexperienced adolescents intended to remain virgins for the next 6 months, most had peer groups they also perceived to be virgins, and they were more positive and confident about remaining abstinent. Differences between the groups suggest there may be benefits to developing intervention programs targeted to their different strengths and weaknesses.     

HIV among people with mental illness: contributing factors, prevention needs, barriers, and strategies

1. Findings suggest that PWMI, including those with serious mental illness, are sexually active although some individuals, including mental health professionals, perceive them to be asexual or not sexually active. 2. PWMI may be particularly susceptible to HIV risk-related behaviors due to poor judgment, limited impulse control, deficits in problem-solving skills, and suicidal intent and self-destructive behavior. 3. Nurses, due to their close interaction with PWMI, are in key positions to document HIV risk-related behaviors and to advocate for integrating HIV risk reduction strategies into the therapeutic milieu.     

Adolescent sexuality and peer pressure

It appears that adolescents are becoming sexually active at younger ages than in past generations. How much are they influenced by their peers to become sexually active? A study of 89 adolescent girls in a parochial high school in Manhattan showed that adolescent girls are influenced by their peers when they decide to become sexually active; however, they do not see themselves influenced by their peers. Adolescents appear to have internalized their peers opinions. If adolescents are becoming sexually active at younger ages, they need to be given adequate information to allow them to make informed decisions about their behavior; thus balancing the influence of peer groups.     

HPV knowledge and behaviors of black college students at a historically black university

College students are at high risk for human papillomavirus (HPV) infection, yet their knowledge and self-protective behaviors appear inadequate. Researchers who have measured HPV-related knowledge and behaviors in evaluating college intervention efforts pay secondary attention to black college students because this group generally represents only a small subset of samples of the broader college population. OBJECTIVE AND PARTICIPANTS: The authors' purpose in this study was to examine HPV-related knowledge and behaviors in 351 black undergraduates attending a historically black southeastern university in the spring of 2003. METHODS: Voluntary and anonymous student participation was solicited in randomly selected undergraduate classes. RESULTS: Results indicated that most students lacked HPV awareness (64%), became aware of HPV largely after infection, and gained their HPV knowledge from a health-care provider or college class. The authors performed an analysis by gender and found that women were more knowledgeable about HPV than were men. Observed HPV-related knowledge and behaviors were similar to samples of the broader US college population. CONCLUSIONS: Findings suggest a greater need for HPV intervention efforts for all college students, including those at black colleges.     

Peep show establishments,police activity,public place,and time: A response to McCleary and meeker

I investigated the sexual experience of social nudists (including sexual guilt and sexual inhibitions) compared with that of a matched, non‐nudist sample. Much popular belief connects nudism with sexually permissive behaviors, but researchers have shown that social nudists have strict sexual conduct rules and that social nudists mentally separate nudity and sex, seeing nude bodies as “natural” and “pure” rather than sexually arousing. Therefore, I hypothesized that, when compared to non‐nudists, (a) fewer social nudists had experienced less socially acceptable sexual outlets, (b) more social nudists felt guilt about their sexual behaviors, and (c) more social nudists wished they had engaged in a sexual behavior they had not experienced. One hundred social nudists and 100 non‐nudists, matched according to sex, age, educational level, marital status, and area of the country, answered 25 questions on sexual experience, sexual guilt, and desire to experience sexual behaviors they had not, as well as on honesty of their responses. All three hypotheses were supported. These results illustrate that the sexual implications of nudity vary among people and that there is no direct relationship between nudity and sexually permissive behaviors.     

HPV Knowledge and Behaviors of Black College Students at a Historically Black University

College students are at high risk for human papillomavirus (HPV) infection, yet their knowledge and self-protective behaviors appear inadequate. Researchers who have measured HPV-related knowledge and behaviors in evaluating college intervention efforts pay secondary attention to black college students because this group generally represents only a small subset of samples of the broader college population. Objective and Participants The authors' purpose in this study was to examine HPV-related knowledge and behaviors in 351 black undergraduates attending a historically black southeastern university in the spring of 2003. Methods Voluntary and anonymous student participation was solicited in randomly selected undergraduate classes. Results Results indicated that most students lacked HPV awareness (64%), became aware of HPV largely after infection, and gained their HPV knowledge from a health-care provider or college class. The authors performed an analysis by gender and found that women were more knowledgeable about HPV than were men. Observed HPV-related knowledge and behaviors were similar to samples of the broader US college population. Conclusions Findings suggest a greater need for HPV intervention efforts for all college students, including those at black colleges.     

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.