­­Human papillomavirus and Chinese international students in the United States: attitudes, knowledge, vaccination trends, healthcare behaviors, and sexual activity

Abstract

Human papillomavirus (HPV) is the most common sexually transmitted infection in the world, with the ability to cause external genital warts and cancers. The HPV vaccine, first released in the United States of America (USA) in 2006, has been shown to protect against the highest risk HPV strains responsible for the majority of HPV-related cancers. In mainland China, the HPV vaccine was only recently approved in 2016 and is therefore not readily available. As a result, Chinese international students (CIS) studying in the USA continue to have low HPV vaccination rates. This study completed in person and online surveying of 396 CIS at a large Southern California university, with the goal of better understanding CIS knowledge and awareness of HPV disease, vaccination and healthcare behaviors, and sexual activity. Among participants, the reported HPV vaccination rate was 61% (females: 85%; males: 32%). HPV vaccination was significantly correlated with a past visit to the on-campus student health center, having university-sponsored student health insurance, higher self-perceived HPV knowledge, and increased willingness to pay for vaccination. A large portion of participants portrayed low levels of sexual activity, which suggests that CIS can take advantage of catch-up HPV vaccination recommendations through 26 years of age. The results of this study can be used to inform policy initiatives, particularly at the campus level, that attempt to improve HPV vaccination rates amongst CIS.

The Place of Human Papillomavirus Test in the Screening of Intraepithelial Lesions of Cervix in South-Kivu Province, DR Congo

“…Human Papillomavirus is the most common cause of cervical cancer; it can also lead to cancers of the oropharynx, vagina, vulva, penis and anus. It is estimated that 14 million Americans were newly infected with HPV in 2019 [3].…”

HPV vaccination, information sources, and acculturation among Chinese college students aged 18–26 in the United States

“…However, one study conducted among 396 Chinese international students studying at a California university found that 61% had received an HPV vaccine (Esagoff et al, 2021). All of these rates remain far below the Healthy People 2030 target of 80% vaccination (US Department of Health and Human Services [USDHHS], n.d.a).…”

“…HPV vaccination behaviors among CCS in the United States are part of a complex and multifactorial process that includes social determinants of health (SDH) such as individual, psychological, provider, system (Esagoff et al, 2021;Tung et al, 2019Tung et al, , 2020, and cultural factors (Gao et al, 2016).…”

“…Regarding individual factors, CCS who were younger, female, and had been sexually active in the last 12 months had more knowledge and positive attitudes about HPV vaccination; and those who had had a past visit to an on-campus student health center were more likely to be vaccinated (Esagoff et al, 2021;Tung et al, 2019). Psychological factors, including perceived higher risk of HPV infection, willingness to pay for a vaccination, and concerns about side effects and effectiveness, have also been found to be important predictors of HPV vaccination behaviors (Esagoff et al, 2021;Tung et al, 2020). Provider and system factors, such as recommendations from health care providers and universitysponsored student health insurance, are significantly related to HPV vaccination practices among CCS studying in the United States (Esagoff et al, 2021;Tung et al, 2020).…”

“…Psychological factors, including perceived higher risk of HPV infection, willingness to pay for a vaccination, and concerns about side effects and effectiveness, have also been found to be important predictors of HPV vaccination behaviors (Esagoff et al, 2021;Tung et al, 2020). Provider and system factors, such as recommendations from health care providers and universitysponsored student health insurance, are significantly related to HPV vaccination practices among CCS studying in the United States (Esagoff et al, 2021;Tung et al, 2020). Cultural factors certainly play a role: CCS studying in the United States believe that they start having sex later than American students, and thus do not need to be vaccinated at a young age.…”