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HPV and HPV Vaccination Knowledge and Attitudes Among Medical Students in Alabama

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Abstract

In addition to being the most common sexually transmitted infection, the human papillomavirus (HPV) is associated with six types of cancer in men and women. The HPV vaccine provides long-lasting, effective protection from high-risk HPV infection, thus serving as a means of cancer prevention. An effective healthcare provider recommendation is well-established as the most significant influence on HPV vaccine uptake, and, as emerging providers, it is critical that medical students receive comprehensive training in this area. However, the type and extent of such training for current medical students in the USA is unclear. An online survey assessing HPV and HPV vaccine knowledge, attitudes, and vaccine status was distributed to all medical students at an Alabama university. Scales were developed to assess composite HPV and HPV knowledge scores and HPV vaccination intentions. Of those age-eligible, 32.1% reported completion of the HPV vaccine series while 15.2% reported partial completion. Knowledge of both HPV and HPV vaccination significantly increased with program year (p < 0.0001 and p = 0.0069, respectively); however, there were knowledge gaps across all years regarding HPV-associated cancers. Attitudes and intentions showed a similar association, with more advanced students demonstrating more positive attitudes toward HPV vaccination (p = 0.0003). There is a need within the current curriculum to include more education and training on HPV, HPV vaccination, and counseling—particularly for students in the first 2 years of their program. Implementation of a classroom module or interactive workshop would likely improve knowledge and attitudes, better preparing students for their future role as potential immunizers.

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References

  1. Cogliano V, Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F (2005) Carcinogenicity of human papillomaviruses. Lancet Oncol 6(4):204

    Article  Google Scholar 

  2. HPV and cancer: statistics. https://www.cdc.gov/cancer/hpv/statistics/index.htm. Accessed 8 July 2019

  3. Meites E, Kempe A, Markowitz LE (2016) Use of a 2-dose schedule for human papillomavirus vaccination - updated recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep 65(49):1405–1408

    Article  Google Scholar 

  4. Huh WK, Joura EA, Giuliano AR, Iversen OE, de Andrade RP, Ault KA, Bartholomew D, Cestero RM, Fedrizzi EN, Hirschberg AL, Mayrand MH, Ruiz-Sternberg AM, Stapleton JT, Wiley DJ, Ferenczy A, Kurman R, Ronnett BM, Stoler MH, Cuzick J, Garland SM, Kjaer SK, Bautista OM, Haupt R, Moeller E, Ritter M, Roberts CC, Shields C, Luxembourg A (2017) Final efficacy, immunogenicity, and safety analyses of a nine-valent human papillomavirus vaccine in women aged 16-26 years: a randomised, double-blind trial. Lancet 390(10108):2143–2159

    Article  CAS  Google Scholar 

  5. Van Damme P, Meijer C, Kieninger D, Schuyleman A, Thomas S, Luxembourg A, Baudin M (2016) A phase III clinical study to compare the immunogenicity and safety of the 9-valent and quadrivalent HPV vaccines in men. Vaccine 34(35):4205–4212

    Article  Google Scholar 

  6. Walker TY, Elam-Evans LD, Yankey D, Markowitz LE, Williams CL, Mbaeyi SA, Fredua B, Stokley S (2018) National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years - United States, 2017. MMWR Morb Mortal Wkly Rep 67(33):909–917

    Article  Google Scholar 

  7. Swiecki-Sikora AL, Henry KA, Kepka D (2019) HPV vaccination coverage among US teens across the rural-urban continuum. J Rural Health

  8. Warner EL, Ding Q, Pappas LM, Henry K, Kepka D (2017) White, affluent, educated parents are least likely to choose HPV vaccination for their children: a cross-sectional study of the National Immunization Study - teen. BMC Pediatr 17(1):200

    Article  Google Scholar 

  9. Cartmell KB, Young-Pierce J, McGue S, Alberg AJ, Luque JS, Zubizarreta M, Brandt HM (2018) Barriers, facilitators, and potential strategies for increasing HPV vaccination: a statewide assessment to inform action. Papillomavirus Res 5:21–31

    Article  Google Scholar 

  10. Dilley SE, Peral S, Straughn JM Jr, Scarinci IC (2018) The challenge of HPV vaccination uptake and opportunities for solutions: lessons learned from Alabama. Prev Med 113:124–131

    Article  Google Scholar 

  11. Gilkey MB, McRee AL (2016) Provider communication about HPV vaccination: a systematic review. Hum Vaccin Immunother 12(6):1454–1468

    Article  Google Scholar 

  12. Gerend MA, Shepherd MA, Lustria ML, Shepherd JE (2016) Predictors of provider recommendation for HPV vaccine among young adult men and women: findings from a cross-sectional survey. Sex Transm Infect 92(2):104–107

    Article  Google Scholar 

  13. Smith PJ, Stokley S, Bednarczyk RA, Orenstein WA, Omer SB (2016) HPV vaccination coverage of teen girls: the influence of health care providers. Vaccine 34(13):1604–1610

    Article  Google Scholar 

  14. McCusker SM, Macqueen I, Lough G, Macdonald AI, Campbell C, Graham SV (2013) Gaps in detailed knowledge of human papillomavirus (HPV) and the HPV vaccine among medical students in Scotland. BMC Public Health 13:264

    Article  Google Scholar 

  15. Voidazan S, Morariu SH, Tarcea M, Moldovan H, Curticapian I, Dobreanu M (2016) Human papillomavirus (HPV) infection and HPV vaccination: assessing the level of knowledge among students of the University of Medicine and Pharmacy of Tirgu Mures, Romania. Acta dermatovenerol Croatica : ADC 24(3):193–202

    Google Scholar 

  16. Wen Y, Pan XF, Zhao ZM, Chen F, Fu CJ, Li SQ, Zhao Y, Chang H, Xue QP, Yang CX (2014) Knowledge of human papillomavirus (HPV) infection, cervical cancer, and HPV vaccine and its correlates among medical students in Southwest China: a multi-center cross-sectional survey. Asian Pac J Cancer Prev : APJCP 15(14):5773–5779

    Article  Google Scholar 

  17. Shetty S, Prabhu S, Shetty V, Shetty AK (2019) Knowledge, attitudes and factors associated with acceptability of human papillomavirus vaccination among undergraduate medical, dental and nursing students in South India. Hum Vaccines Immunother:1–10

  18. Afonso NM, Kavanagh MJ, Swanberg SM, Schulte JM, Wunderlich T, Lucia VC (2017) Will they lead by example? Assessment of vaccination rates and attitudes to human papilloma virus in millennial medical students. BMC Public Health 17(1):35

    Article  Google Scholar 

  19. Berenson AB, Hirth JM, Fuchs EL (2017) US medical students’ willingness to offer the HPV vaccine by vaccination status. Vaccine 35(9):1212–1215

    Article  Google Scholar 

  20. Evans L, Matley E, Oberbillig M, Margetts E, Darrow L (2019) HPV knowledge and attitudes among medical and professional students at a Nevada University: a focus on oropharyngeal cancer and mandating the vaccine. Journal of cancer education : the official journal of the American Association for Cancer Education

  21. Wiley R, Shelal Z, Urbauer D, Bernard C, Ramondetta L (2019) Relationship between intent to vaccinate and the education and knowledge of human papillomavirus among medical school faculty and students in Texas. Tex Med 115(1):e1

    PubMed  Google Scholar 

  22. Vadaparampil ST, Kahn JA, Salmon D, Lee JH, Quinn GP, Roetzheim R, Bruder K, Malo TL, Proveaux T, Zhao X, Halsey N, Giuliano AR (2011) Missed clinical opportunities: provider recommendations for HPV vaccination for 11-12 year old girls are limited. Vaccine 29(47):8634–8641

    Article  Google Scholar 

  23. Gilkey MB, Moss JL, Coyne-Beasley T, Hall ME, Shah PD, Brewer NT (2015) Physician communication about adolescent vaccination: how is human papillomavirus vaccine different? Prev Med 77:181–185

    Article  Google Scholar 

  24. Hswen Y, Gilkey MB, Rimer BK, Brewer NT (2017) Improving physician recommendations for human papillomavirus vaccination: the role of professional organizations. Sex Transm Dis 44(1):42–47

    Article  CAS  Google Scholar 

  25. Lake PW, Kasting ML, Christy SM, Vadaparampil ST (2019) Provider perspectives on multilevel barriers to HPV vaccination. Human vaccines & immunotherapeutics:1–10

  26. State Fact Sheets: Alabama [https://data.ers.usda.gov/reports.aspx?StateFIPS=01&StateName=Alabama&ID=17854]. Accessed 8 July 2019

  27. Schnaith AM, Evans EM, Vogt C, Tinsay AM, Schmidt TE, Tessier KM, Erickson BK (2018) An innovative medical school curriculum to address human papillomavirus vaccine hesitancy. Vaccine 36(26):3830–3835

    Article  Google Scholar 

  28. HPV vaccines [https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-vaccines.html]. Accessed 10 July 2019

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Acknowledgments

Research support was provided by the Abraham A. Mitchell Clinical Cancer Research Award.

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Correspondence to Casey L. Daniel.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Approval for this study was gained through the Institutional Review Board at the University of South Alabama and informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Daniel, C.L., McLendon, L., Green, C.L. et al. HPV and HPV Vaccination Knowledge and Attitudes Among Medical Students in Alabama. J Canc Educ 36, 168–177 (2021). https://doi.org/10.1007/s13187-019-01613-3

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