Getting Vaccinated against HPV: Attitudes, Intentions and Perceived Barriers of Female Undergraduates.

This study examines college women's intention to receive the Human Papilloma Virus (HPV) vaccine and their perceived barriers to being vaccinated. The study reports findings from an online questionnaire completed by 856 undergraduate women enrolled in a required personal health course at a large (27,000 plus) southeastern university. The majority of the respondents (78.6%) indicated that they would get the vaccine; however, only 60.7% of the respondents who self-identified as not yet sexually active reported that they plan to be vaccinated. Side effects, costs and lack of knowledge about the vaccine were most often indicated as barriers to receiving the vaccine. Education about HPV and the vaccine is needed to address the perceived barriers to vaccination. ********** There are more than 100 types of human papillomavirus (HPV) and over 40 types can infect the genital area (Koutsky & Kiviat, 1999). With an incidence rate of 6.2 million, genital HPV is the most common sexually transmitted infection in the U.S. (Weinstock, Berman & Cates, 2004). While the majority of HPV infections resolve spontaneously, persistent HPV infection is a predictor of high-grade cervical cancer and most cases of cervical cancer are caused by the sexually transmitted human papilloma virus (American Cancer Society, 2008; Molano et al., 2003). Genital HPV types are categorized according to their epidemiologic association with cervical cancer (Munoz, 2003). High-risk types are detected in 99% of cervical cancers with types 16 and 18 causing 70% of all cases (Bosch & de Sanjose, 2003). An estimated 11,070 new cases of cervical cancer will be diagnosed in 2008 in the United States, and 3,870 women will die from their cancers (American Cancer Society, 2008). Approximately 50% of college women are infected with the HPV virus (ACS, 2008). In June 2006, the Food and Drug Administration (FDA) approved the first HPV vaccination which is intended for females aged 9-26 (Markowitz et al., 2007). The vaccine protects against the two most common types of HPV associated with high-risk cervical cancer (16 and 18) and the two most common types of HPV associated with genital warts (6 and 11). The vaccine, manufactured by Merck and known as Gardasil, has shown to have almost 100% efficacy in studies with women who were previously uninfected with the four types of HPV (Gardasil[R], 2006). The Advisory Committee on Immunization Practices (ACIP) recommends routine HPV vaccination for females 11 and 12, with catch-up vaccination for females 13 through 26 (Markowitz et al., 2007). Ideally, the vaccine should be administered before potential exposure to HPV through sexual contact. Although it is not possible to assess the benefits of HPV vaccination for females who might have already been exposed to HPV, the Centers for Disease Control (CDC) recommends that they should also be vaccinated (Markowitz et al., 2007). The vaccine is administered in a 3-dose series with the second and third doses administered two and six months after the first dose. The cost of the series is approximately $350. While experts predict that the HPV vaccine will lead to significant public health benefits, historically vaccine availability has not necessarily lead to widespread use (Gonik, 2006; Zimet, et al., 2000). For example, the CDC (2008) reported that just 25% of young women aged 13 to 17 years old, roughly 2.5 million young women, have received the immunization. The Health Belief Model (HBM) has been utilized extensively in vaccination studies, including vaccinations for flu (Chen, 2007), Hepatitis A and B (Rhodes & Arceo, 2004; de Wit, Vet, Schutten & van Steenbergen, 2005), and varicella (chickenpox) (Sparks & Russel, 1998). In addition, Ingledue, Cottrell, and Bertrand (2004) examined HPV/cervical cancer knowledge, perceptions and sexual behaviors among 428 college women (ages 18-30) with constructs of the HBM. Results indicated that low perceived susceptibility was coupled with high-risk sexual behavior among the woman in their study. …