Equity in human papilloma virus vaccination uptake?: sexual behaviour, knowledge and demographics in a cross-sectional study in (un)vaccinated girls in the Netherlands

BMC Public Health

Adriana Tami⁶  Hester E de Melker³  Hans W Nijman⁵  Marianne AB van der Sande¹  Tjalke A Westra²  Toos Daemen²  Willibrord CM Weijmar-Schultz⁵  Symen K Spoelstra⁵  Karin Lubbers⁵  Madelief Mollers⁴ 

[1] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;Department of Medical Microbiology, Molecular Virology Section, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands;Pathology, VU University Medical Center (VUmc), Amsterdam, The Netherlands;Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;Department of Medical Microbiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands

关键词: Knowledge;    Sexual behaviour;    Vaccination uptake;    Human papilloma virus;    Monitoring;   

Others  :  1131778
DOI  :  10.1186/1471-2458-14-288

 received in 2013-09-04, accepted in 2014-03-18,  发布年份 2014

【 摘 要 】

Background

In the Netherlands, human papillomavirus (HPV) vaccination is part of a national program equally accessible for all girls invited for vaccination. To assess possible inequalities in vaccine uptake, we investigated differences between vaccinated and unvaccinated girls with regard to various characteristics, including education and ethnicity, (both associated with non-attendance to the national cervical screening program), sexual behaviour and knowledge of HPV.

Methods

In 2010, 19,939 nationwide randomly-selected 16–17 year-old girls (2009 vaccination campaign) were invited to fill out an online questionnaire. A knowledge scale score and multivariable analyses identified variables associated with vaccination status.

Results

2989 (15%) of the selected girls participated (65% vaccinated, 35% unvaccinated). The participants were comparable with regard to education, ethnicity, most sexual risk behaviour and had similar knowledge scores on HPV transmission and vaccination. However, unvaccinated girls lived in more urbanised areas and were more likely to have a religious background. Irrespective of vaccination status, 81% of the girls were aware of the causal relationship between HPV and cervical cancer, but the awareness of the necessity of cervical screening despite being vaccinated was limited.

Conclusions

HPV vaccine uptake was not associated with knowledge of HPV and with factors that are known to be associated with non-attendance to the cervical cancer screening program in the Netherlands. Furthermore, most sexual behaviour was not related to vaccination status meaning that teenage unvaccinated girls were not at a disproportionally higher risk of being exposed to HPV. Routine HPV vaccination may reduce the social inequity of prevention of cervical cancer.

【 授权许可】

   
2014 Mollers et al.; licensee BioMed Central Ltd.

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