Maternal and Child Health Journal

Knowledge, Attitude, and Uptake of Human Papillomavirus (HPV) Vaccination among Chinese Female Adults: A National Cross-sectional Web-Based Survey Based on a Large E-commerce Platform

Human papillomavirus (HPV) vaccination is a promising step toward cervical cancer elimination. This study was conducted to investigate the knowledge, attitude, and HPV vaccine uptake among female adults in mainland China based on a large e-commerce platform. We conducted a cross-sectional online survey of female adults between March 4 to April 20, 2022. The survey consisted of sociodemographic information, related knowledge, vaccination uptake, and attitudes toward vaccination. We included women aged 18-45 years in the final analysis. Logistic regressions were conducted to explore influencing factors associated with related knowledge, HPV vaccination uptake, and willingness to be vaccinated. In total, 3,572 female adults (34 years, IQR 30-39) were included in the analysis. The majority of the participants were highly educated (78.7%) with a high monthly family income (79.0%). The median HPV knowledge score was 8.25 out of 11. More than 75% of respondents were unvaccinated, while 95.8% of unvaccinated female adults are willing to be vaccinated. Variables such as age, insurance, vaccination history, and whether one had heard of the HPV vaccine influence HPV vaccination practice (all p-values < 0.05). The main barriers to vaccination were vaccine inaccessibility and the high cost of the vaccine. The findings of our study highlight a moderate knowledge level, poor vaccination rate, and strong willingness to be vaccinated among Chinese female adults who were better educated and wealthier. Targeted health education and practical support should be provided in the future, to reduce gaps between vaccine uptake and vaccine acceptance.

Knowledge, Attitude, and Practice of Cervical Cancer Screening, and HPV Vaccination: A Cross-Sectional Study Among Obstetricians and Gynecologists in Egypt

Although cervical cancer is potentially preventable, lack of knowledge and poor attitude among healthcare professionals toward cervical cancer screening and Human Papilloma Virus (HPV) vaccination can result in underutilization of these preventive strategies. Then, the objective of this study was to assess the knowledge, attitude, and practice of cervical cancer and its prevention through Pap test screening and HPV vaccination among obstetricians and gynecologists (Ob-Gyns). A cross-sectional study was conducted on 250 Egyptian attendees of a national Ob-Gyns professional conference. Data collection was performed using a pre-designed self-administered questionnaire, which tested participants' knowledge, attitude, and practices related to cervical cancer, Pap test screening, and HPV vaccination. The study included 41.2% Ob-Gyns specialists and 37.6% of consultants from secondary and tertiary care hospitals or centers. About 45% of participants had poor-to-fair knowledge, 57% had negative-to-fair positive attitudes toward cervical cancer screening and HPV vaccination, and 44% had ever-performed Pap test, while 45% of participants had ever-prescribed the HPV vaccine to their patients. Physicians' knowledge and attitude were significantly associated with their age, professional level, work experience, and place of work. Although performing cervical cancer screening was significantly more common among older, more experienced, and highly professional participants, HPV vaccine prescription was associated with young, less experienced participants at lower educational and professional levels. Ob-Gyns had poor-to-fair knowledge, Attitude, and practices related to cervical cancer, Pap test screening, and HPV vaccination.

Association Between a Mother’s Cervical Cancer Screening and Child’s Human Papillomavirus (HPV) Vaccination Status

To investigate the association between maternal cervical cancer (CC) screening status and child human papillomavirus (HPV) vaccination uptake. To understand if child sex or social deprivation index (SDI) modify this association. We used a national cohort of children linked to at least one parent using electronic health record (EHR) data from a network of community health centers across the United States. We used SDI scores and child sex as moderating variables. We performed the analysis (1) for the whole sample (with SDI and child sex added as covariates), (2) stratified by SDI quartile (with child sex added as a covariate), and (3) stratified by SDI quartile and child sex, to examine whether associations vary by SDI quartile and by child sex. N = 52,919 linked mother-child pairs. Mother's receipt of CC screening was positively associated with the linked child's odds of receiving HPV vaccination [adjusted odds ratio (AOR) 1.39, 95% confidence interval (CI) 1.32, 1.47]. Neither sex or SDI modified this association. There were no significant differences in odds of HPV vaccination in children between SDI quartiles or between male and female children. An effective way to improve rates of HPV vaccination among children and adolescents may be to target attention towards increasing CC screening rates among mothers. Further, focusing resources and efforts on CC screenings and care of both mothers and their children may be more worthwhile than isolated efforts targeting HPV vaccination for children and adolescents.