Ethnic Variations in Perception of Human Papillomavirus and its Vaccination among Young Women in Nepal

Abstract

Background: The Human Papillomavirus (HPV) is strongly associated with cervical and other cancers. In women, cervical cancer is the third most common cancer. HPV infection can be largely prevented through vaccination of (adolescent) girls. At the same time, Nepal is a low-income country experiencing a cultural change in attitudes towards sex and sexual behaviour. However, in the adolescent population knowledge about HPV, factors associated with an increased risk of HPV and the existence of the vaccination is often low. Materials and Methods: This was a cross-sectional study with female students enrolled in health and non-health science courses in Pokhara, Nepal. The questionnaire included demographic details, knowledge and attitude questions related to HPV, associated risk behaviour and its vaccination. Descriptive statistics, including Chi-Square test, were used to identify statistically significant relationships. Ethical approval was granted by the relevant authority in Nepal. Results: Hindu religion (75.0 %; 95% CI: 70.9, 78.6) and Newari caste (75.5%; CI: 61.1, 86.7) were more aware about HPV, HPV vaccination. Hindus religion (55.6%; 95% CI: 51.2, 60.0) and Dalit caste (61.6%, 95% CI: 53.3, 69.4) more willing to be vaccinated than other religions and other castes, respectively. Not unsurprisingly, students on health-related courses had a greater awareness of HPV, HPV vaccination and were more willing to be vaccinated than students on other courses. Similar patterns of association arose for knowledge related to those sexually active at an early age; HPV risk and multiple sex partners; and fact that condoms cannot fully prevent the transmission of HPV. Conclusion: Knowledge about the link between HPV and (a) early sexual initiation, (b) having multiple sexual partners, and (c) the limited protection of condoms and other birth control measures was poor in our study compared to similar research conducted in other parts of the world. One key implication is the need for education campaigns in Nepal to educate young women and their parents about HPV, its risk factors and the benefits of vaccination. .

Multidimensional social and cultural norms influencing HPV vaccine hesitancy in Asia

“…[75][76][77] In some cultures, women also need approval from their husband to vaccinate their child against HPV. 75,76,78 In the event that the 9-valent HPV vaccine comes to be recommended for women who have initiated sexual behavior, it is important to gain male opinion about their partner being vaccinated against the sexually transmitted HPV infection and to determine whether or not men would support their partner seeking HPV vaccination. Married women in most Asian sociocultural contexts will seek their husband's permission regarding their own healthcare before making a decision.…”

Virus papiloma humano y factores asociados en pacientes con citología desconocida atendidas en el norte de Perú

“…En otros trabajos sí se ha hallado asociación entre el VPH y estos factores (23)(24)(25)(26)(27)(28)(29) . Sathian y col. y Bosch y col. mencionan que la promiscuidad y el número de parejas sexuales son factores de infección por el VPH (30,31) y el estudio de Francheschi y col. menciona que existe relación entre la infección por VPH y la edad de primera relación sexual (32) .…”

Human papillomavirus (HPV) knowledge, beliefs, and vaccine uptake among United States and international college students

“…All the studies were conducted in university settings among college students except one which was conducted in the community setting with undergraduate college students. They conducted a face-to-face interview for the data collection process (Sathian et al, 2017). Five studies used a paper-based self-administered questionnaire to collect the data (Koc, 2015;Rashid et al, 2016;Kasymova et al, 2018;Farazi et al, 2018;Kamimura et al, 2018).…”

“…In a study conducted in Cyprus, the majority (91%) of the students reported that they had heard about HPV (Farazi et al, 2018). The findings from the study conducted among the female college students in Nepal revealed that 71.7% of the participants had the knowledge about HPV however, only 51.8% of the students knew about the HPV vaccine (Sathian et al, 2017). Studies conducted in the US have found moderate to higher HPV and HPV vaccine awareness level whereas studies conducted outside the US showed low HPV and HPV vaccine awareness level (Barnard et al, 2017;Kasymova et al, 2018;Cooper et al, 2018;Koc, 2015;Sathian et al, 2017).…”