kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2015.15.3.141 kjhp-15-141 Original Article Factors Associated with Human Papillomavirus Vaccination and Intention among Male and Female College Students LeeSeung Yeun 1 2 HanMi Ah 3 ParkJong 3 RyuSo Yeon 3 Department of Public Health, Chosun University Graduate School of Health Science, Gwangju, Korea Department of Laboratory Medicine, Singa Hospital, Gwangju, Korea Department of Preventive Medicine, Chosun University School of Medicine, Gwangju, Korea Corresponding author：Mi Ah Han, MD, PhD Department of Preventive Medicine, Chosun University School of Medicine, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Korea Tel: +82-62-230-6481, Fax: +82-62-225-8293 E-mail: mahan@chosun.ac.kr 122015 19122015 153 141149 03022015 15062015 Copyright © 2015 The Korean Society of Health Promotion and Disease Prevention 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

Human papillomavirus (HPV) is the most common viral infection of the reproductive tract and can cause cervical cancers. The purpose of this study was to investigate HPV vaccination status and related factors among male and female college students.

 Methods

The study subjects were 489 students conveniently sampled from Seoyeong University located in Gwangju. General characteristics, HPV vaccination status and knowledge of cervical cancer and HPV infection were collected by self- administered questionnaires between August 25 and September 19. The collected data were analyzed by chi-square tests, t-tests and multiple logistic regression analyses.

 Results

Of 328 female students, 22.9% were vaccinated. But none of the male students (n=161) were vaccinated. Vaccination intention of male and female students were 18.6% and 55.5%, respectively. In multiple logistic regression analysis, adjusted odds ratio (aOR) for HPV vaccination were significantly high in female subjects with high allowance (aOR=2.23, 95% confidence interval [CI]=1.13-4.42) or high knowledge score of cervical cancer (OR=1.10, 95% CI=1.02-1.16). Intention of HPV vaccination were associated with participation in school clubs, chronic disease and knowledge score of cervical cancer in male students. In female students, school record, family history, self-rated health and knowledge score of cervical cancer were associated with intention of vaccination.

 Conclusions

HPV vaccination rate was found to be low. Prevention efforts considering these results might be helpful in increasing HPV vaccination rate and reducing HPV-associated health risks.

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Awareness of HPV and vaccination status by sexa

Awareness and vaccination status Male (n=161) Female (n=328)
Awareness of HPV
Yes 27 (16.8) 218 (66.5)
No 134 (83.2) 110 (33.5)
Awareness of HPV vaccination
Yes 22 (13.7) 202 (61.6)
No 139 (86.3) 126 (38.4)
Status of HPV vaccination
Yes 0 (0.0) 75 (22.9)
No 161 (100) 253 (77.1)
Characteristics of vaccinated subjects Female (n=75)
Vaccination number
1st 3 (4.0)
2nd 8 (10.7)
3rd 64 (85.3)
Time interval between 1st and 2nd vaccination (mo)
<2 42 (56.0)
2-6 30 (40.0)
≥7 3 (4.0)
Time interval between 2nd and 3rd vaccination (mo)
<2 6 (8.0)
2-6 52 (69.3)
≥7 6 (8.0)
None 11 (14.7)
Reason for vaccination
Parental advice Self-decision 35 (46.7) 31 (41.4)
Medical team's advice 4 (5.3)
Friend′s advice 4 (5.3)
Others 1 (1.3)
Characteristics of unvaccinated subjects Male (n=161) Female (n=253)
Perceived reason for not having
HPV vaccination
Didn′t know about vaccine 150 (93.2) 155 (61.3)
High cost 1 (0.6) 42 (16.6)
Afraid of side-effect - 25 (9.8)
Unconvinced about efficacy of vaccine 1 (0.6) 12 (4.7)
No time 6 (3.7) 11 (4.4)
Afraid of injection Intention for HPV vaccination 3 (1.9) 8 (3.2)
Yes 30 (18.6) 141 (55.5)
No 131 (81.4) 112 (44.5)
Perceived facilitators to future HPV vaccination uptakeb
Reduction of vaccination cost 12 (40.0) 73 (51.8)
Useful information about vaccine 14 (46.7) 40 (28.4)
Health professional recommendation 2 (6.7) 15 (10.6)
Plenty of time 2 (6.7) 10 (7.1)
Other vaccination methods such as oral pills except injection - 3 (2.1)

Abbreviation: HPV, human papilloma virus.

Values are presented as N (%).

Including subjects who have intention for HPV vaccination.

HPV vaccination status by subjects characteristics in female college studentsa

Characteristics Vaccination P
Yes (n=75) No (n=253)
Age, y 20.7±2.0 20.1±2.3 0.083
Major 0.513
Health related 63 (22.3) 220 (77.7)
Non-health related 12 (26.7) 33 (73.7)
Allowance (10,000 won) 0.086
≤20 14 (15.0) 79 (85.0)
21-40 48 (27.0) 130 (73.0)
≥41 13 (22.8) 44 (77.2)
School record 0.052
High 21 (34.3) 40 (65.6)
Middle 45 (20.8) 171 (79.2)
Low 9 (17.7) 42 (82.3)
Participate in a club 0.271
Activity 13 (18.1) 59 (81.9)
Not 62 (24.2) 194 (75.8)
Friend of opposite sex 0.232
Yes 33 (26.4) 92 (73.6)
No 42 (20.7) 161 (79.3)
Father’s education level 0.913
≤Middle school 7 (18.9) 30 (81.1)
High school 33 (23.4) 108 (76.6)
≥College 34 (23.6) 110 (76.4)
Unknown 1 (16.7) 5 (83.3)
Mother’s education level 0.147
≤Middle school 11 (29.7) 26 (70.3)
High school 32 (18.0) 146 (82.0)
≥College 30 (28.6) 75 (71.4)
Unknown 2 (25.0) 6 (75.0)
Smoking status 0.249
Never smoker 70 (24.3) 218 (75.7)
Ex-smoker 2 (11.8) 15 (88.2)
Current smoker 3 (13.0) 20 (87.0)
Frequency of alcohol drinking 0.832
None 20 (25.0) 60 (75.0)
≤1/mo 22 (23.0) 74 (77.0)
2-3/mo 29 (22.8) 98 (77.2)
≥2/wk 4 (16.0) 21 (84.0)
Chronic disease 0.649
No 40 (23.7) 129 (76.3)
Yes 35 (22.0) 124 (78.0)
Family history of cervix/breast disease 0.950
Yes 12 (21.8) 43 (78.2)
No 38 (23.6) 123 (76.4)
Unknown 25 (22.3) 87 (77.7)
Self-rated health 0.184
Good 32 (24.4) 99 (75.6)
Fair 40 (24.1) 126 (75.9)
Poor 3 (9.7) 28 (90.3)
Intercourse experience 0.703
Yes 12 (25.0) 36 (75.0)
No 63 (22.5) 217 (77.5)
Menarche, y 0.298
≤13 35 (25.7) 101 (74.3)
≥14 40 (20.8) 152 (79.2)
Knowledge score of cervical cancer and HPV 10.3±8.2 8.2±5.4 0.004

Abbreviation: HPV, human papilloma virus.

Values are presented as N (%) or mean±SD.

OR (95% CI) for HPV vaccination in female college students

Female (n=328)
Age 1.10 (1.00-1.22)
Allowance (ref=≤20) (10,000 won)
21-40 2.23 (1.13-4.42)
≥41 1.44 (0.60-3.47)
School record (ref=low)
High 2.43 (0.98-6.16)
Middle 1.19 (0.53-2.67)
Knowledge score of cervical cancer and HPV 1.06 (1.01-1.12)

Abbreviations: CI, confidence interval; HPV, human papilloma vi rus; OR, odds ratios; ref, reference.

Intention for HPV vaccination according to subjects' characteristics by sexa

Characteristics Male (n=161) Female (n=253)
Yes No P Yes No P
Age, y 20.7±1.8 20.6±2.1 0.861 19.9±1.8 19.9±1.9 0.768
Major 0.029 0.545
Health related 18 (26.5) 50 (73.5) 121 (55.0) 99 (45.0)
Non-health related 12 (12.9) 81 (87.1) 20 (60.6) 13 (39.4)
Allowance (10,000 won) 0.812 0.597
≤20 6 (15.4) 33 (84.6) 43 (54.4) 36 (45.6)
21-40 17 (20.2) 67 (79.8) 76 (58.5) 54 (41.5)
≥41 7 (18.4) 31 (81.6) 22 (50.0) 22 (50.0)
School record 0.613 0.013
High 9 (23.7) 29 (76.3) 26 (65.0) 14 (35.0)
Middle 15 (16.3) 77 (83.7) 100 (58.5) 71 (41.5)
Low 6 (19.4) 25 (80.6) 15 (35.7) 27 (64.3)
Participate in a club 0.089 0.218
Activity 8 (32.0) 17 (68.0) 37 (62.7) 22 (37.3)
Not 22 (16.2) 114 (83.8) 104 (53.6) 90 (46.4)
Friend of opposite sex 0.390 0.132
Yes 14 (21.2) 50 (78.1) 57 (62.0) 35 (38.0)
No 16 (16.5) 81 (83.5) 84 (51.2) 77 (47.8)
Father’s education level 0.262 0.264
≤Middle school 3 (25.0) 9 (75.0) 14 (46.7) 16 (53.3)
High school 14 (17.7) 65 (82.3) 63 (58.0) 46 (42.6)
≥College 13 (22.8) 57 (77.2) 64 (58.2) 50 (41.8)
Mother’s education level 0.813 0.547
≤Middle school 1 (11.1) 8 (88.9) 13 (50.0) 13 (50.0)
High school 22 (23.4) 72 (76.6) 83 (56.3) 65 (44.5)
≥College 7 (15.2) 51 (84.8) 45 (60.0) 34 (40.0)
Smoking status 0.592 0.332
Never smoker 13 (16.7) 65 (83.3) 122 (56.0) 96 (44.0)
Ex-smoker 6 (26.1) 17 (73.9) 6 (40.0) 9 (60.0)
Current smoker 11 (18.3) 49 (81.7) 13 (65.0) 7 (35.0)
Frequency of alcohol drinkingb 0.068 0.979
None 3 (10.7) 25 (89.3) 33 (55.0) 27 (45.0)
<1/mo 4 (16.7) 20 (83.3) 40 (54.1) 34 (45.9)
2-3/mo 20 (26.0) 57 (74.0) 56 (57.1) 42 (42.9)
≥2/wk 2 (6.5) 29 (93.5) 12 (57.1) 9 (42.9)
Chronic disease 0.022 0.821
No 10 (11.9) 74 (88.1) 70 (56.5) 54 (43.6)
Yes 20 (26.0) 57 (74.0) 71 (55.0) 58 (45.0)
Family history of cervix/breast disease 0.065 0.036
Yes 5 (35.7) 9 (64.3) 31 (72.1) 12 (27.9)
No 16 (22.2) 56 (77.8) 68 (55.3) 55 (44.7)
Unknown 9 (12.0) 66 (88.0) 42 (48.3) 45 (51.7)
Self-rated health 0.906 0.091
Good 20 (18.2) 90 (81.8) 58 (58.6) 41 (41.4)
Fair 9 (20.5) 35 (79.5) 63 (50.0) 63 (50.0)
Poor 1 (14.3) 6 (85.7) 20 (71.4) 8 (28.6)
Intercourse experience 0.702 0.287
Yes 10 (20.4) 39 (79.6) 23 (63.9) 13 (36.1)
No 20 (17.9) 92 (82.1) 118 (54.4) 99 (45.6)
Menarche, y - 0.854
≤13 - - 84 (55.3) 68 (44.7)
≥14 - - 57 (56.4) 44 (43.6)
OBGY visiting experience - 0.018
No - - 102 (51.8) 95 (48.2)
Yes - - 39 (69.6) 17 (30.4)
Knowledge score of cervical cancer and HPV 6.3±5.4 3.8±5.2 0.018 9.3±5.0 6.7±5.5 <0.001

Abbreviations: HPV, human papillomavirus; OBGY, obstetrics and gynecology.

Values are presented as N (%) or mean±SD.

Excluded one case with missing value.

OR (95% CI) of intention HPV vaccination by sex

Male (n=161) Female (n=253)
Age 0.76 (0.57-1.03) 0.89 (0.75-1.04)
Major (ref=non-health related)
Health related 2.38 (0.83-6.80) -
School record (ref=low)
High - 2.80 (1.07-7.32)
Middle - 3.10 (1.43-6.73)
Participate in a club (ref=not)
Activity 4.37 (1.34-14.25) -
Alcohol drinking (ref=none)
<1/mo 1.48 (0.26-8.33) -
2-3/mo 1.89 (0.47-2.51) -
≥2/wk 0.32 (0.04-7.00) -
Chronic disease (ref=no)
Yes 2.69 (1.03-7.00) -
Family history (ref=unknown)
Yes 4.51 (0.98-20.82) 2.42 (1.04-5.66)
No 2.60 (0.90-7.52) 1.09 (0.60-2.00)
Self-rated health (ref=fair)
Good - 1.44 (0.81-2.56)
Poor - 3.21 (1.20-8.67)
OBGY visiting (ref=no)
Yes - 1.87 (0.93-3.78)
Knowledge score of cervical cancer and HPV 1.13 (1.02-1.26) 1.10 (1.02-1.16)

Abbreviations: CI, confidence interval; HPV, human papillomavirus; OBGY, obstetrics and gynecology; OR, odds ratios; ref, reference.