Genital Human Papillomavirus Infections: Knowledge, Perception of Risk, and Actual Risk in a Nonclinic Population of Young Women

Abstract

The purpose of this study was to assess knowledge, beliefs, and attitudes about genital human papillomavirus (HPV) infections in a group of young women in a nonclinic setting and to examine the association between perception of risk and actual risk. One hundred ten women attending a state university participated in the study and were asked to complete a self-administered questionnaire about knowledge and perceptions of risk. They were then offered testing for the virus using a self-administered vaginal method. The mean age was 20 +/- 1.2 years. Ninety (82%) were sexually experienced (SE), with a mean number of lifetime partners of 5.1 +/- 4.3. The mean knowledge score was less than the 68th percentile, reflecting low levels of knowledge about genital HPV infections. The SE group had a higher knowledge score than the sexually inexperienced (p < .02), but there were no differences in knowledge between those who chose to be tested and those who refused testing. The majority of women attributed negative emotion to being hypothetically tested positive for HPV. Emotions selected by > 50% of the group included feeling scared, angry, guilty, anxious, confused, dirty, regretful, and panicky. A greater negative emotion score was associated with refusing HPV testing (p < .002). Of the SE women, 58% (51) perceived themselves at risk, and, of this group, 71% (36) agreed to be tested. Of the women who agreed to HPV testing, 36% who perceived themselves at risk and 35% who did not perceive themselves at risk were, in fact, positive for HPV (p = ns). The majority of women have little knowledge of HPV infections and have attributed many negative emotions associated with infectivity. These negative attributes appear to influence women's decision making concerning HPV testing. The risk of HPV infection in this nonclinic group was substantial, suggesting that even in a nonclinic group, the prevalence of HPV is quite high. Perception of risk was unrelated to actual risk (HPV positive test), reflecting the lack of self-identified risk.

Attitudes towards HPV testing: a qualitative study of beliefs among Indian, Pakistani, African-Caribbean and white British women in the UK

“…However, the study is advantaged by its ethnically heterogeneous sample and the inclusion of older married women, who have been poorly represented in previous research, but for whom the impact of HPV may be greater, since they are more likely to be in long-term monogamous relationships. Previous work on the psychosocial impact of HPV testing has been quantitative and sampled young, white, affluent populations, often American college students (Ramirez et al, 1997;Reed et al, 1999), and has failed to distinguish psychological outcomes between those with visible, symptomatic genital warts (low-risk types) and those with high-risk HPV (Maw et al, 1998). The current study overcame both these limitations.…”

Knowledge and Attitudes About HPV Infection, HPV Vaccination, and Cervical Cancer Among Rural Southeast Asian Women

“…Challenges associated with the introduction of the new vaccine in these countries include the administration cost, dissemination and access to vaccines, and social cultural aspects of immunization of a sexually transmitted infection (STI) vaccine [6,7]. Numerous studies have demonstrated that public awareness of HPV, perceived risks of HPV infection, and knowledge of potential health consequences of HPV infection are low [8][9][10]. Factors associated with the acceptability of the HPV vaccine are knowledge about the disease, beliefs about vaccines, physician recommendation, previous experience with HPV infections, perceived risk for HPV infection, perceived vaccine safety and efficacy, and perceived vaccination would promote adolescent sexual behavior [11][12][13].…”

What Do Women in the U.S. Know about Human Papillomavirus and Cervical Cancer?

“…Current clinical guidelines recommend using the HPV DNA test in women ages 30 and older for primary screening (2,3) and in all ages for follow-up to abnormal cytology (4). More recent recommendations include administering the HPV vaccine in adolescent and young adult females (ages [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] to prevent the transmission of certain carcinogenic HPV types (5).…”

“…Most research in the U.S. on knowledge of HPV and its link to cervical cancer have been conducted in special populations such as adolescent and young adults (9)(10)(11)(12)(13)(14)(15)(16)(17) or individuals attending sexually transmitted infection (STI) and primary care clinics (18)(19)(20)(21)(22)(23). These studies suggest that HPV awareness is low.…”