Factors Associated with Human Papillomavirus Vaccination and Intention among Male and Female College Students

Seung Yeun Lee; Mi Ah Han; Jong Park; So Yeon Ryu

doi:10.15384/kjhp.2015.15.3.141

Korean J Health Promot > Volume 15(3); 2015 > Article

Lee, Han, Park, and Ryu: Factors Associated with Human Papillomavirus Vaccination and Intention among Male and Female College Students

Original Article

Korean Journal of Health Promotion 2015;15(3):141-149.

Published online: December 19, 2015

DOI: https://doi.org/10.15384/kjhp.2015.15.3.141

Factors Associated with Human Papillomavirus Vaccination and Intention among Male and Female College Students

Seung Yeun Lee^1,², Mi Ah Han³, Jong Park³, So Yeon Ryu³

¹Department of Public Health, Chosun University Graduate School of Health Science, Gwangju, Korea

²Department of Laboratory Medicine, Singa Hospital, Gwangju, Korea

³Department 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

Received February 03, 2015 Accepted June 15, 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.

ABSTRACT

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.

Keywords: Awareness, Human papillomavirus, Uterine cervical neoplasms, Vaccination

Table 1.

Awareness of HPV and vaccination status by sex^a

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 uptake^b
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.

^aValues are presented as N (%).

^bIncluding subjects who have intention for HPV vaccination.

Table 2.

HPV vaccination status by subjects characteristics in female college students^a

Characteristics	Vaccination		P
Characteristics	Yes (n=75)	No (n=253)	P
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.

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

Table 3.

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.

Table 4.

Intention for HPV vaccination according to subjects' characteristics by sex^a

Characteristics	Male (n=161)			Female (n=253)
Characteristics	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 drinking^b			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.

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

^bExcluded one case with missing value.

Table 5.

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.

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