Knowledge and beliefs of Greek parents towards HPV infection and vaccination – are they willing to vaccinate their sons?
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Aikaterini Toska
, Chrysoula Paraskeuopoulou
Abstract
Objectives
Human papillomavirus (HPV) stands as one of the prevalent sexually transmitted infections (STIs) and serves as the primary factor behind nearly all instances of cervical cancer, along with various other non-cancerous conditions like genital warts. Our objective was to explore the knowledge and beliefs of Greek parents regarding HPV infection and the vaccination of boys against HPV.
Methods
A cross-sectional study took place at a university hospital located in the Peloponnese region of Greece, from January to June 2021. The study employed convenience sampling as its methodology, and data gathering involved the distribution of self-administered questionnaires to parents who had at least one son between the ages of 9 and 18 years.
Results
The final sample consisted of 120 individuals. 65.8 % of parents have been informed about HPV vaccination, knew that the HPV vaccine provides immunity against genital warts (50 %), and that minimum of two doses is necessary (46.7 %). 30.8 % intended to vaccinate their boys against HPV if the vaccine were available for males. The most important reasons for vaccination were the perception that both genders share equal responsibility in the prevention of sexually transmitted infections (91.7 %) and the protection against cancer (87.6 %), whereas the fear of adverse reactions and the adequate knowledge about HPV-related diseases were most reported as reasons of the intentions to not vaccinate their sons with 31.7 % and 25.8 % respectively.
Conclusions
Although parents participating in the study know about HPV, however, there are significant lack of knowledge regarding HPV infection and the vaccine effects, which can significantly affect the acceptance of vaccination for boys.
Acknowledgments
We acknowledge all the parents who have participated in this study for their time and cooperation.
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Research ethics: A signed form was signed by the participants. The study was approved by the Scientific Council of the University hospital (protocol number 01/07.01.2021). The study was performed from January to June 2021.
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Informed consent: Verbal informed consent was obtained from all who consented to participate in the study. Confidentiality of respondents’ information and beliefs was maintained throughout the study. No names appeared on the data collection tool as one way of maintaining confidentiality.
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Author contributions: Aikaterini Toska, Dimitra Latsou: project management, methodology design, study design, supervision, project management, monitoring; Paraskeuopoulou Chrysoula, Evangelos Fradelos, Eleni Albani: data collection, methodology design, supervision, project management; Charalambos Millions, Mary Geitona, Dimitrios Papagiannis: monitoring, data collection, methodology design; Maria Saridi: study design, methodology design, supervision, monitoring. All authors read and approved the final manuscript.
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Competing interests: The authors state no competing interests.
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Research funding: This research received no external funding.
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Data availability: The raw data can be obtained on request from the corresponding author.
References
1. Chesson, HW, Dunne, EF, Hariri, S, Markowitz, LE. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis 2014;41:660–4. https://doi.org/10.1097/OLQ.0000000000000193.Search in Google Scholar PubMed PubMed Central
2. Trottier, H, Franco, EL. The epidemiology of genital human papillomavirus infection. Vaccine 2006;24:S1–15. https://doi.org/10.1016/j.vaccine.2005.09.054.Search in Google Scholar PubMed
3. Alemany, L, Saunier, M, Alvarado-Cabrero, I, Quiros, B, Salmeron, J, Shin, HR, et al.. Human papillomavirus DNA prevalence and type distribution in anal carcinomas worldwide. Int J Cancer 2015;136:98–107. https://doi.org/10.1002/ijc.28963.Search in Google Scholar PubMed PubMed Central
4. Parkin, DM, Bray, F. Chapter 2: the burden of HPV-related cancers. Vaccine 2006;24:S3/11–25. https://doi.org/10.1016/j.vaccine.2006.05.111.Search in Google Scholar PubMed
5. World Health Organization. WHO guidance note: comprehensive cervical cancer prevention and control: a healthier future for girls and women. Geneva: World Health Organization; 2013.Search in Google Scholar
6. Lowy, DR, Solomon, D, Hildesheim, A, Schiller, JT, Schiffman, M. Human papillomavirus infection and the primary and secondary prevention of cervical cancer. Cancer 2008;113:1980–93. https://doi.org/10.1002/cncr.23704.Search in Google Scholar PubMed PubMed Central
7. Brandt, HM, Pierce, JY, Crary, A. Increasing HPV vaccination through policy for public health benefit. Hum Vaccin Immunother 2016;12:1623–5. https://doi.org/10.1080/21645515.2015.1122145.Search in Google Scholar PubMed PubMed Central
8. Meites, E, Szilagyi, PG, Chesson, HW, Unger, ER, Romero, JR, Markowitz, LE. Human papillomavirus vaccination for adults: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep 2019;68:698–702. https://doi.org/10.15585/mmwr.mm6832a3.Search in Google Scholar PubMed PubMed Central
9. Hartwig, S, Baldauf, J, Dominiak-Felden, G, Simondon, F, Alemany, L, de Sanjosé, S, et al.. Estimation of the epidemiological burden of HPV-related anogenital cancers, precancerous lesions, and genital warts in women and men in Europe: potential additional benefit of a nine-valent second generation HPV vaccine compared to first generation HPV vaccines. Papillomavirus Res 2015;1:90–100. https://doi.org/10.1016/j.pvr.2015.06.003.Search in Google Scholar
10. Shapiro, GK, Tatar, O, Amsel, R, Prue, G, Zimet, GD, Knauper, B, et al.. Using an integrated conceptual framework to investigate parents’ HPV vaccine decision for their daughters and sons. Prev Med 2018;116:203–10. https://doi.org/10.1016/j.ypmed.2018.09.017.Search in Google Scholar PubMed
11. Qendri, V, Bogaards, JA, Berkhof, J. Health and economic impact of a tender-based, sex-neutral human papillomavirus 16/18 vaccination program in The Netherlands. J Infect Dis 2017;216:210–19. https://doi.org/10.1093/infdis/jix272.Search in Google Scholar PubMed
12. Bruni, L, Diaz, M, Barrionuevo-Rosas, L, Herrero, R, Bray, F, Bosch, FX, et al.. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Global Health 2016;4:e453–63. https://doi.org/10.1016/S2214-109X(16)30099-7.Search in Google Scholar PubMed
13. Stanley, M. HPV vaccination in boys and men. Hum Vaccin Immunother 2014;10:2109–11. https://doi.org/10.4161/hv.29137.Search in Google Scholar PubMed PubMed Central
14. Markowitz, LE, Tsu, V, Deeks, SL, Cubie, H, Wang, SA, Vicari, AS, et al.. Human papillomavirus vaccine introduction – the first five years. Vaccine 2012;30:139–48. https://doi.org/10.1016/j.vaccine.2012.05.039.Search in Google Scholar PubMed
15. Bruni, L, Saura-Lázaro, A, Montoliu, A, Brotons, M, Alemany, L, Diallo, MS, et al.. HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010-2019. Prev Med 2021;144:106399. https://doi.org/10.1016/j.ypmed.2020.106399.Search in Google Scholar PubMed
16. European Cancer Organisation. 2021. Available from: https://www.europeancancer.org/resources/199:hpv-vaccine-tracker.html.Search in Google Scholar
17. Crul, M, Aapro, M, Price, R, Couespel, N, Lawler, M. The impact of COVID-19 on cancer in Europe: the 7-point plan to address the urgency and build back better. Brussels: European Cancer Organisation; 2020. Available from: https://www.europeancancer.org/resources/174:covid-19-cancer-7-point-plan.Search in Google Scholar
18. Ministry of Health. Available from: https://www.moh.gov.gr/articles/health/dieythynsh-dhmosias-ygieinhs/emboliasmoi/ethniko-programma-emboliasmwn-epe-paidiwn-kai-efhbwn/10314-systash-ths-ethnikhs-epitrophs-emboliasmwn-gia-ton-emboliasmo-agoriwn-kai-koritsiwn-enanti-toy-ioy-twn-anthrwpinwn-thhlwmatwn?fdl=22621.Search in Google Scholar
19. Papagiannis, D, Rachiotis, G, Symvoulakis, EK, Daponte, A, Grivea, IN, Syrogiannopoulos, GA, et al.. Vaccination against human papillomavirus among 865 female students from the health professions in central Greece: a questionnaire-based cross-sectional study. J Multidiscip Healthc 2013;6:435–9. https://doi.org/10.2147/JMDH.S49558.Search in Google Scholar PubMed PubMed Central
20. Konstantinou, C, Xanthopoulos, A, Tsaras, K, Skoularigis, J, Triposkiadis, F, Papagiannis, D. Vaccination coverage against human papillomavirus in female students in Cyprus. Cureus 2022;14:e28936. https://doi.org/10.7759/cureus.28936.Search in Google Scholar PubMed PubMed Central
21. Grandahl, M, Tydén, T, Westerling, R, Nevéus, T, Rosenblad, A, Hedin, E, et al.. To consent or decline HPV vaccination: a pilot study at the start of the national school-based vaccination program in Sweden. Sch Health 2017;87:62–70. https://doi.org/10.1111/josh.12470.Search in Google Scholar PubMed PubMed Central
22. La Vincente, SF, Mielnik, D, Jenkins, K, Bingwor, F, Volavola, L, Marshall, H, et al.. Implementation of a national school-based Human Papillomavirus (HPV) vaccine campaign in Fiji: knowledge, vaccine acceptability and information needs of parents. BMC Publ Health 2015;15:1257. https://doi.org/10.1186/s12889-015-2579-3.Search in Google Scholar PubMed PubMed Central
23. D’Hauwers, KW, Gadet, PF, Donders, AR, Tjalma, WA. Impact of medical education on knowledge and attitudes regarding the human papilloma virus and vaccination: comparison before and 6 years after the introduction of the vaccines. Vaccine 2013;31:5843–7. https://doi.org/10.1016/j.vaccine.2013.09.068.Search in Google Scholar PubMed
24. Lacombe-Duncan, A, Newman, PA, Baiden, P. Human papillomavirus vaccine acceptability and decision-making among adolescent boys and parents: a meta-ethnography of qualitative studies. Vaccine 2018;36:2545–58. https://doi.org/10.1016/j.vaccine.2018.02.079.Search in Google Scholar PubMed
25. Patty, NJS, van Dijk, HM, Wallenburg, I, Bal, R, Helmerhorst, TJM, van Exel, J, et al.. To vaccinate or not to vaccinate? Perspectives on HPV vaccination among girls, boys, and parents in The Netherlands: a Q-methodological study. BMC Publ Health 2017;17:872. https://doi.org/10.1186/s12889-017-4879-2.Search in Google Scholar PubMed PubMed Central
26. Sherman, SM, Nailer. Attitudes towards and knowledge about Human Papillomavirus (HPV) and the HPV vaccination in parents of teenage boys in the UK. PLoS One 2018;13:e0195801. https://doi.org/10.1371/journal.pone.0195801.Search in Google Scholar PubMed PubMed Central
27. Schuler, CL, Coyne-Beasley, T. Has their son been vaccinated? Beliefs about other parents matter for human papillomavirus vaccine. Am J Men’s Health 2016;10:318–24. https://doi.org/10.1177/1557988314567324.Search in Google Scholar PubMed
28. Newman, PA, Logie, CH, Doukas, N, Asakura, K. HPV vaccine acceptability among men: a systematic review and meta-analysis. Sex Transm Infect 2013;89:568–74. https://doi.org/10.1136/sextrans-2012-050980.Search in Google Scholar PubMed PubMed Central
29. Liddon, N, Hood, J, Wynn, BA, Markowitz, LE. Acceptability of human papillomavirus vaccine for males: a review of the literature. J Adolesc Health 2010;46:113–23. https://doi.org/10.1016/j.jadohealth.2009.11.199.Search in Google Scholar PubMed
30. Cates, JR, Diehl, SJ, Fuemmeler, BF, North, SW, Chung, RJ, Hill, JF, et al.. Toward optimal communication about HPV vaccination for preteens and their parents: evaluation of an online training for pediatric and family medicine health care providers. J Public Health Manag Pract 2020;26:159–67. https://doi.org/10.1097/PHH.0000000000001022.Search in Google Scholar PubMed PubMed Central
31. Mari, A, Gianolio, L, Edefonti, V, Khaleghi Hashemian, D, Casini, F, Bergamaschi, F, et al.. HPV vaccination in young males: a glimpse of coverage, parental attitude and need of additional information from Lombardy region, Italy. Int J Environ Res Public Health 2022;19:7763. https://doi.org/10.3390/ijerph19137763.Search in Google Scholar PubMed PubMed Central
32. Zhu, P, Perez, S, Griffin-Mathieu, G, Tatar, O, Rosberger, Z. What influences parents to vaccinate (or not) their sons with the Human Papillomavirus (HPV) vaccine: an examination of HPV vaccine decision-making changes over time. J Psychosoc Oncol 2022;4:e068. https://doi.org/10.1097/OR9.0000000000000068.Search in Google Scholar
33. Lee Mortensen, G, Adam, M, Idtaleb, L. Parental attitudes towards male human papillomavirus vaccination: a pan-European cross-sectional survey. BMC Publ Health 2015;15:624. https://doi.org/10.1186/s12889-015-1863-6.Search in Google Scholar PubMed PubMed Central
34. Zhang, SK, Pan, XF, Wang, SM, Yang, CX, Gao, XH, Wang, ZZ, et al.. Knowledge of human papillomavirus vaccination and related factors among parents of young adolescents: a nationwide survey in China. Ann Epidemiol 2015;25:231–5. https://doi.org/10.1016/j.annepidem.2014.12.009.Search in Google Scholar PubMed
35. Reiter, PL, Stubbs, B, Panozzo, CA, Whitesell, D, Brewer, NT. HPV and HPV vaccine education intervention: effects on parents, healthcare staff, and school staff. Cancer Epidemiol Biomarkers Prev 2011;20:2354–61. https://doi.org/10.1158/1055-9965.EPI-11-0562.Search in Google Scholar PubMed PubMed Central
36. Muhwezi, WW, Banura, C, Turiho, AK, Mirembe, F. Parents’ knowledge, risk perception and willingness to allow young males to receive human papillomavirus (HPV) vaccines in Uganda. PLoS One 2014;9:1–11. https://doi.org/10.1371/journal.pone.0106686.Search in Google Scholar PubMed PubMed Central
37. Tisi, G, Salinaro, F, Apostoli, P, Bassani, R, Bellicini, A, Groppi, L, et al.. HPV vaccination acceptability in young boys. Ann Ist Super Sanita 2013;49:286–91. https://doi.org/10.4415/ANN_13_03_09.Search in Google Scholar PubMed
38. Venderbos, JR, Eilers, R, de Vries, H, van Zoonen, K. A qualitative study of parental associations and beliefs regarding the HPV vaccination for Dutch boys. BMC Publ Health 2022;22:1188. https://doi.org/10.1186/s12889-022-13605-y.Search in Google Scholar PubMed PubMed Central
39. Waller, J, Forster, A, Ryan, M, Richards, R, Bedford, H, Marlow, L. Decision-making about HPV vaccination in parents of boys and girls: a population-based survey in England and Wales. Vaccine 2020;38:1040–7. https://doi.org/10.1016/j.vaccine.2019.11.046.Search in Google Scholar PubMed PubMed Central
40. Moss, JL, Reiter, PL, Brewer, NT. HPV vaccine for teen boys: Dyadic analysis of parents’ and sons’ beliefs and willingness. Prev Med 2015;78:65–71. https://doi.org/10.1016/j.ypmed.2015.07.002.Search in Google Scholar PubMed PubMed Central
41. Bianco, A, Pileggi, C, Iozzo, F, Nobile, CG, Pavia, M. Vaccination against human papillomavirus infection in male adolescents: knowledge, attitudes, and acceptability among parents in Italy. Hum Vaccin Immunother 2014;10:2536–42. https://doi.org/10.4161/21645515.2014.969614.Search in Google Scholar PubMed PubMed Central
42. Donahue, KL, Hendrix, KS, Sturm, LA, Zimet, GD. Human papillomavirus vaccine initiation among 9-13-year-olds in the United States. Prev Med Rep 2015;2:892–8. https://doi.org/10.1016/j.pmedr.2015.10.003.Search in Google Scholar PubMed PubMed Central
© 2024 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Reviews
- Efficacy of behavioral interventions to increase engagement in sexual health services among LatinX youth in the United States: A meta-analysis for post-pandemic implications
- Electronic nicotine delivery system: a narrative review on growing threat to tobacco control and health of the young Indian population
- Original Articles
- Mindful awareness and resilience skills for adolescents (MARS-A): a mixed-methods study of a mindfulness-based intervention for a heterogeneous adolescent clinical population
- Adolescent health care and perceptions in a provincial hospital in Papua New Guinea
- Adolescents on an inpatient unit and their healthcare providers: what’s working and what’s not
- Adolescent and young adult long-acting reversible contraception post-insertion visit attendance before and after COVID-19
- Knowledge and beliefs of Greek parents towards HPV infection and vaccination – are they willing to vaccinate their sons?
- Prevalence and correlates of unintentional nonfatal injuries among school-going adolescents in Central America
- Prevention starts here: effectiveness of substance abuse prevention module among adolescent students in Bengaluru – a quasi experimental study
- Association of tobacco experimentation with anxiety and depression: findings from a representative sample of Tunisian adolescents
- Knowledge of smoking and influencing factors among school-going adolescents in Timor-Leste
- Tobacco use and oral health related quality of life among Indian adolescents