Advertisement

Journal of Cancer Education

, Volume 33, Issue 2, pp 404–416 | Cite as

Characteristics Associated with HPV Diagnosis and Perceived Risk for Cervical Cancer Among Unmarried, Sexually Active College Women

  • Kelly L. Wilson
  • Clayton J. Cowart
  • Brittany L. Rosen
  • Jairus C. Pulczinski
  • Kayce D. Solari
  • Marcia G. Ory
  • Matthew Lee Smith
Article

Abstract

Human papillomavirus (HPV) has been identified as the leading cause of cervical cancer. While HPV risk factors have been well studied, less is known about those with HPV and their perceptions about health ramifications. The purposes of this study were to examine unmarried college student women’s (1) HPV diagnosis status and (2) perceived risk of getting cervical cancer in the next 5 years. Data were analyzed from 1106 unmarried, sexually active college women aged 18 to 26. Binary logistic regression compared HPV-related knowledge, vaccination-related perceptions, mandate support, healthcare utilization, sexual behaviors, and personal characteristics. Multinomial logistic regression was performed to assess the degree to which these factors were associated with perceived risk of cervical cancer diagnosis. Relative to those not diagnosed with HPV, participants who had more lifetime sex partners (P < 0.001), unprotected sex during last intercourse (P = 0.003), Pap test in the past year (P < 0.001), and perceived themselves to be at higher risk for cervical cancer (P < 0.001) were significantly more likely to be diagnosed with HPV. Those with HPV were more likely to support HPV vaccination mandates (P = 0.036) and have fewer friends vaccinated (P = 0.002). Participants who were uninsured (P = 0.011), diagnosed with HPV (P < 0.001), and had a family member (P < 0.001) or friend (P < 0.001) with cervical cancer were more likely to perceive themselves at risk for developing cervical cancer in the next 5 years. Findings indicate women with HPV, despite engaging in risky sexual behaviors, acknowledge their cervical cancer risk and may be strong advocates for HPV vaccination mandates to protect youth against this preventable virus.

Keywords

HPV Cervical cancer HPV vaccination mandates 

References

  1. 1.
    Accelerating HPV vaccine uptake: Urgency for action to prevent cancer (2014) A report to the President of the United States from the President’s Cancer Panel. Bethesda, MD: National Cancer Institute. Retrieved from http://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/index.htm#sthash.QtuhL1hc.dpbs
  2. 2.
    Allen JD, Mohllajee AP, Shelton RC, Othus MK, Fontenot HB, Hanna R (2009) Stage of adoption of the human papillomavirus vaccine among college women. Preventive Medicine 48(5):420–425CrossRefPubMedGoogle Scholar
  3. 3.
    Anhang R, Goodman A, Goldie SJ (2004) HPV communication: review of existing research and recommendations for patient education. CA: A Cancer Journal for Clinicians 54(5):248–259Google Scholar
  4. 4.
    Baer H, Allen S, Braun L (2000) Knowledge of human papillomavirus infection among young adult men and women: Implications for health education and research. Journal of Community Health 25(1):67–78CrossRefPubMedGoogle Scholar
  5. 5.
    Budd AC, Brotherton JML, Gergtig DM, Chau T, Drennan KT, Saville M (2014) Cervical screening rates for women vaccinated against human papillomavirus. Medical Journal of Australia 201(5):279–282CrossRefPubMedGoogle Scholar
  6. 6.
    Centers for Disease Control and Prevention (2010) Behavioral risk factor surveillance system questionnaire-2010. Retrieved from http://www.cdc.gov/brfss/annual_data/pdf-ques/2010brfss.pdf
  7. 7.
    Centers for Disease Control and Prevention (2014) What are the risk factors for cervical cancer? Retrieved from http://www.cdc.gov/cancer/cervical/basic_info/risk_factors.htm
  8. 8.
    Centers for Disease Control and Prevention (2015a) Genital HPV infection—fact sheet. Retrieved from http://www.cdc.gov/std/HPV/STDFact-HPV.htm
  9. 9.
    Centers for Disease Control and Prevention (2015b) HPV and cancer. Retrieved from http://www.cdc.gov/hpv/cancer.html
  10. 10.
    Chesson HW, Ekwueme DU, Saraiya M, Watson M, Lowy DR, Markowitz LE (2012) Estimates of the annual direct medical costs of the prevention and treatment of disease associated with human papillomavirus in the United States. Vaccine 30(42):6016–6019CrossRefPubMedGoogle Scholar
  11. 11.
    Cohen TF, Legg JS (2014) Factors associated with HPV vaccine use among Hispanic college students. Journal of Allied Health 43(4):241–246(6)PubMedGoogle Scholar
  12. 12.
    Conroy K, Rosenthal SL, Zimet GD, Jin Y, Bernstein DI, Glynn S, Kahn JA (2009) Human papillomavirus vaccine uptake, predictors of vaccination, and self-reported barriers to vaccination. Journal of Women’s Health 18(10):1679–1686CrossRefPubMedGoogle Scholar
  13. 13.
    Daley EM, Perrin K, Vamos C, Webb C, Mueller T, Packing-Ebuen J et al (2008) HPV knowledge among HPV-positive women. American Journal of Health Behavior 32:477–487CrossRefPubMedGoogle Scholar
  14. 14.
    Dell DL, Chen H, Ahmad F, Stewart DE (2000) Knowledge about human papillomavirus among adolescents. Obstetrics and Gynecology 96(5):653–656PubMedGoogle Scholar
  15. 15.
    Dunne EF, Unger ER, Sternberg M, McQuillan G, Swan DC, Patel SS, Markowitz LE (2007) Prevalence of HPV infection among women in the United States. Journal of American Medical Association 297(8):813–819CrossRefGoogle Scholar
  16. 16.
    Edberg M (2015) Essentials of health behavior social and behavioral theory in public health, 2nd edn. Jones & Bartlett, BurlingtonGoogle Scholar
  17. 17.
    Ekwueme DU, Uzunangelov VJ, Hoerger TJ, Miller JW, Saraiya M, Benard VB et al (2014) Impact of the national breast and cervical cancer early detection program on cervical cancer mortality among uninsured low-income women in the US, 1991–2007. American Journal of Preventive Medicine 47(3):300–308CrossRefPubMedGoogle Scholar
  18. 18.
    Gilbert LK, Alexander L, Grosshans JF, Jolley L (2003) Answering frequently asked questions about HPV. Sexually Transmitted Diseases 30(3):193–194CrossRefPubMedGoogle Scholar
  19. 19.
    Glanz K, Rimer BK, Su SM (eds) (2005) Theory at a glance: A guide for health promotion practice, 2nd edn. U.S. National Cancer Institute, Washington DCGoogle Scholar
  20. 20.
    Hariri S, Unger ER, Sternberg M, Dunne EF, Swan D, Patel S, Markowitz LE (2011) Prevalence of genital human papillomavirus among women in the United States, the national health and nutrition examination survey, 2003–2006. Journal of Infectious Diseases 204(4):566–573CrossRefPubMedGoogle Scholar
  21. 21.
    US Department of Health and Human Services (2014) Healthy People 2020: immunization and infectious disease. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId = 23
  22. 22.
    Kahn JA, Rosenthal SL, Hamann T, Bernstein DI (2003) Attitudes about human papillomavirus vaccine in young women. International Journal of STD & AIDS 14:300–306CrossRefGoogle Scholar
  23. 23.
    Kahn JA, Rosenthal SL, Jin Y, Huang B, Namakydoust A, Zimet GD (2008) Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women. Obstetrics & Gynecology 111(5):1103–1110CrossRefGoogle Scholar
  24. 24.
    Karnieli-Miller O, Salyers MP (2011) Clinical communications with persons who have severe mental illnesses. In: Rudnick A, Roe D (eds) Serious mental illnesses (SMI): Person-centered approaches. Radcliffe Publishing, Abington, UKGoogle Scholar
  25. 25.
    Kosenko KA, Hurley RJ, Harvey JA (2012) Sources of the uncertainty experienced by women with HPV. Qualitative Health Research 22:534–545CrossRefPubMedGoogle Scholar
  26. 26.
    Kosenko KA, Harvey-Knowles J, Hurley RJ (2014) The information management processes of women living with HPV. Journal of Health Communication: International Perspectives 19(7):813–824CrossRefGoogle Scholar
  27. 27.
    Lambert EC (2001) College students’ knowledge of human papillomavirus and the effectiveness of a brief intervention. Journal of the American Board of Family Practice 14:178–183PubMedGoogle Scholar
  28. 28.
    Langlie J (1977) Social networks, health beliefs, and preventive behavior. Journal of Health and Social Behavior 18:244–260CrossRefPubMedGoogle Scholar
  29. 29.
    Legare F, Ratte S, Stacey D, Kryworuchko J, Gravel K, Graham ID, Turcotte S (2010) Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database of Systematic Reviews 5. doi: 10.1002/14651858.CD006732.pub2
  30. 30.
    Levano W, Miller JW, Leonard B, Bellick L, Crane BE, Kennedy SK et al (2014) Public education and targeted outreach to underserved women through the national breast and cervical cancer early detection program. Cancer 120(16):2591–2596CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Licht AS, Murphy JM, Hyland AJ, Fix BV, Hawk LW, Mahoney MC (2010) Is use of the human papillomavirus vaccine among female college students related to human papillomavirus knowledge and risk perception? Sexually Transmitted Infections 86(1):74–78CrossRefPubMedGoogle Scholar
  32. 32.
    Linnehan MJ, Groce NE (2009) Counseling and educational interventions for women with genital HPV infection. AIDS Patient Care and STDs 14:439–445CrossRefGoogle Scholar
  33. 33.
    Maggino T, Casadei D, Panontin E, Fadda E, Zampieri MC, Donà MA et al (2007) Impact of an HPV diagnosis on the quality of life in young women. Gynecologic Oncology 107:S175–S179CrossRefPubMedGoogle Scholar
  34. 34.
    Magidson JF, Blashill AJ, Wall MM, Balan IC, Wang S, Lejuez CW, Blanco C (2014) Relationship between psychiatric disorders and sexually transmitted diseases in a nationally representative sample. Journal of Psychosomatic Research 76(4):322–328CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Maissi E, Marteau TM, Hankins M, Moss S, Legwood R, Gray A (2004) Psychological impact of HPV testing in women with borderline or mildly dyskaryotic cervical cancer smear test results: cross-sectional questionnaire study. British Medical Journal 328:1293–1298CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Markowitz LE, Liu G, Hariri S, Steinau M, Dunne EF, Unger ER (2016) Prevalence of HPV after introduction of the vaccination program in the United States. Pediatrics, peds-2015Google Scholar
  37. 37.
    Markowitz LE, Dunne EF, Saraiya M, Lawson HW, Chesson H, Unger ER (2007) Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 56(RR-2):1–24PubMedGoogle Scholar
  38. 38.
    McCaffery K, Irwig L (2005) Australian women’s needs and preferences for information about HPV in cervical screening. Journal of Medical Screening 13:134–141CrossRefGoogle Scholar
  39. 39.
    McCaffery K, Waller J, Nazroo J, Wardle J (2006) Social and psychological impact of HPV testing in cervical screening: a qualitative study. Sexually Transmitted Infections 82:169–174CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    McLeroy KR, Bibeau D, Steckler A, Glanz K (1988) An ecological perspective on health promotion programs. Health Education Quarterly 15(4):351–377CrossRefPubMedGoogle Scholar
  41. 41.
    McRee DH, Daley EM, Gorbach P, Hamm RM, Sharpe PA, Brandt HM et al (2010) Awareness of diagnosis and knowledge of HPV in women patients: data from a multi-site study. American Journal of Health Education 41(4):197–205CrossRefGoogle Scholar
  42. 42.
    Montori VM, Gafni A, Charles CA (2006) A shared treatment decision-making approach between patients with chronic conditions and their clinicians: the case of diabetes. Health Expectations 9:25–36CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Nadarzynski T, Waller J, Robb KA, Marlow LA (2012) Perceived risk of cervical cancer among pre-screening age women (18–24 years): The impact of information about cervical cancer risk factors and the causal role of HPV. Sexually Transmitted Infections 88(6):400–406CrossRefPubMedGoogle Scholar
  44. 44.
    National Foundation for Infectious Diseases (2014) Call to action: HPV vaccination as a public health priority. Retrieved from http://www.nfid.org/homepage/additional-offerings/hpv-call-to-action.pdf
  45. 45.
    Perrin KM, Daley EM, Naoom SF, Packing-Ebuen JL, Rayko HL, McFarlane M, McDermitt RJ (2006) Women’s reactions to HPV diagnosis: insights from in-depth interviews. Women & Health 43(2):93–110CrossRefGoogle Scholar
  46. 46.
    Ramirez JE, Ramos DM, Clayton L, Kanowitz S, Moscicki AB (1997) Genital human papillomavirus infections: knowledge, perception of risk, and actual risk in a nonclinic population of young women. Journal of Women’s Health 6(1):113–121CrossRefPubMedGoogle Scholar
  47. 47.
    Sandfort JR, Pleasant A (2009) Knowledge, attitudes, and informational behaviors of college students in regards to the human papillomavirus. Journal of American College Health 58(2):141–149CrossRefPubMedGoogle Scholar
  48. 48.
    Satterwhite CL, Torrone E, Meites E, Dunne EF, Mahajan R, Ocfemia MC et al (2013) Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sexually Transmitted Diseases 40(3):187–193CrossRefPubMedGoogle Scholar
  49. 49.
    Smith ML, Wilson KL, Pulczinski JC, Ory MG (2014b) Support for HPV vaccination mandates for both women and males. American Journal of Health Behavior 38(6):831–838CrossRefPubMedGoogle Scholar
  50. 50.
    Smith RA, Hernandez R, Catona D (2014a) Investigating initial disclosures and reactions to unexpected, positive HPV diagnosis. Western Journal of Communication 78(4):426–440CrossRefPubMedGoogle Scholar
  51. 51.
    World Health Orgainzation (2014) Plan for HPV vaccine introduction. Retrieved from http://www.who.int/immunization/hpv/plan/en/
  52. 52.
    Yacobi E, Tennant C, Ferrante J, Pal N, Roetzheim R (1999) University students’ knowledge and awareness of HPV. Preventive Medicine 28(6):535–541CrossRefPubMedGoogle Scholar

Copyright information

© American Association for Cancer Education 2016

Authors and Affiliations

  • Kelly L. Wilson
    • 1
  • Clayton J. Cowart
    • 2
  • Brittany L. Rosen
    • 3
  • Jairus C. Pulczinski
    • 4
  • Kayce D. Solari
    • 5
  • Marcia G. Ory
    • 6
  • Matthew Lee Smith
    • 2
  1. 1.Department of Health and KinesiologyTexas A&M UniversityCollege StationUSA
  2. 2.Department of Health Promotion and Behavior, College of Public HealthUniversity of GeorgiaAthensUSA
  3. 3.School of Human ServicesUniversity of CincinnatiCincinnatiUSA
  4. 4.Department of Occupational and Environmental Health, School of Public HealthTexas A&M Health Science CenterCollege StationUSA
  5. 5.Department of Psychological Health and Learning SciencesUniversity of HoustonHoustonUSA
  6. 6.Department of Health Promotion and Community Health SciencesTexas A&M School of Public HealthCollege StationUSA

Personalised recommendations