Human Papillomavirus (HPV) Vaccination and Adolescent Girls' Knowledge and Sexuality in Western Uganda: A Comparative Cross-Sectional Study

Abstract

The purpose of the study was to investigate the influence of human papillomavirus (HPV) vaccination on adolescent girls’ knowledge of HPV and HPV vaccine, perception of sexual risk and intentions for sexual debut. This cross-sectional comparative study was conducted in Ibanda and Mbarara districts. Data was collected using a standardized self-administered questionnaire and analyzed using the Statistical Package for the Social Sciences computer software. Univariate, bivariate, and logistic regression analyses were conducted with significance level set at p < .05. Results showed that HPV vaccination was associated with being knowledgeable (Crude OR: 5.26, CI: 2.32–11.93; p = 0.000). Vaccination against HPV did not predict perception of sexual risk. Knowledge was low (only 87/385 or 22.6% of vaccinated girls were knowledgeable), but predicted perception of a high sexual risk (Adjusted OR: 3.12, CI: 1.37–3.63; p = 0.008). HPV vaccination, knowledge and perceived sexual risk did not predict sexual behaviour intentions. High parental communication was associated with adolescent attitudes that support postponement of sexual debut in both bivariate and multiple regression analyses. In conclusion, findings of this study suggest that HPV vaccination is not likely to encourage adolescent sexual activity. Influence of knowledge on sexual behaviour intentions was not definitively explained. Prospective cohort studies were proposed to address the emerging questions.

Impact of human papilloma virus vaccination on adolescent knowledge, perception of sexual risk and need for safer sexual behaviors in Bali, Indonesia

“…Vaccinated girls had significantly higher knowledge score than unvaccinated girls. A higher proportion of vaccinated girls in the present study (76.4%) had good knowledge about HPV and HPV vaccine compared with vaccinated girls in Uganda and in England, where only 23% and 45% of vaccinated girls had good knowledge about HPV and HPV vaccine, respectively. Concerning the specific aspects of HPV and HPV vaccine knowledge, 89.7% of vaccinated girls in the present study compared with 51% and 61% of vaccinated adolescents and young women in other studies, knew that HPV is mainly sexually transmitted; 89.5% compared with 22%, 53% and 51% answered correctly that HPV causes cervical cancer; 23.2% compared with 24% and 28% knew that men can get HPV; and 97.5% compared with 40% and 70% knew that HPV vaccine requires three doses.…”

“…The present study, however, did not find an association between adolescent perception of HPV and other STI risk and perception of need for continued safer sexual behaviors on both bivariate and multivariate modeling. In a previous study, less concern about HPV was independently associated with less need for safer sexual behaviors among the vaccinated adolescents, but there is growing evidence that altered risk perception after HPV vaccination does not lead to subsequent changes in sexual behaviors among adolescents . One explanation for the lack of a more consistent association between risk perceptions and need perception after HPV vaccination is that beliefs about reduced risk after HPV vaccination simply may not play a sufficiently important role in adolescent sexual behavior.…”

“…In this study, a high proportion of vaccinated girls had sufficient knowledge about HPV. Vaccinated girls had significantly higher knowledge score than unvaccinated 11 and 70% 12 knew that HPV vaccine requires three doses. On bivariate analysis, HPV vaccination was associated with better knowledge.…”

“…In a previous study, less concern about HPV was independently associated with less need for safer sexual behaviors among the vaccinated adolescents, 10 but there is growing evidence that altered risk perception after HPV vaccination does not lead to subsequent changes in sexual behaviors among adolescents. 11,15,16 One explanation for the lack of a more consistent association between risk perceptions and need perception after HPV vaccination is that beliefs about reduced risk after HPV vaccination simply may not play a sufficiently important role in adolescent sexual behavior. There are numerous contributing factors to adolescent beliefs and sexual behaviors that include individual factors such as adolescent psychosocial characteristics, attitudes and beliefs as well as contextual factors such as family structure, peer and romantic relationships, peer norms, and media exposure.…”

Knowledge and attitudes about human papillomavirus and vaccination

“…According to the speeches, controversial contexts have been observed, in which some are favorable to vaccination, even if they are clarified on the subject, 8,26,27 and others still show themselves concerned about the safety of vaccines. 28 What we find is that for unknowing the information, many parents don't vaccinate their children, not guaranteeing the protective effect from the immunobiological. 6 Protection can be achieved with the two-dose scheme of the substance, recommended before the begining of sexual practice, for offering better effectiveness in people who have never had contact with the virus, enabling a antibodies production ten times bigger than natural contact by HPV.…”