Toward an understanding of college women's decisionmaking regarding the human papillomavirus vaccine

Abstract

Background: In the U.S., according to the American Cancer Society, there will be an estimated 12,710 new cases of cervical cancer in 2011 and 4,290 women will die from it. It has been established that human papillomavirus (HPV) infection is a necessary cause of cervical cancer. In 2006, new HPV vaccines were approved by the U.S. Food and Drug Administration (FDA) for use with young women. To promote adoption of HPV vaccination among college women, there is a greater need for in-depth understanding of their HPV vaccine-uptake decision-making. Methods: This is a theory-based cross-sectional study employing a mixed-method research design. College women were recruited and anonymous online surveys were administered. The survey asked questions that included HPV vaccine adoption stages, HPV-related knowledge, cues to action, self-efficacy, perceived susceptibility and severity, perceived barriers and benefits, information pertinent to vaccine-uptake decision-making, attitudes toward HPV vaccines, and background information. Results: 357 college women participated in the HPV study. Of these, 192 participants (53.8%) reported receiving HPV vaccines. Age category, number of partners in the past year, cues to action, susceptibility without vaccine, perceived barriers, and attitude were identified using a multivariate logistic regression model to be significant predictors for HPV vaccine adoption. For college women the most pertinent factors affecting vaccine decisions were vaccine effectiveness against HPV infection and cervical cancer, side effects, whether their health care providers recommend the vaccine, and the cost of vaccine. From qualitative analysis, seven types of reasons for disinterest in HPV vaccines emerged: access issues, vaccine eligibility, fear of side effects, lack of information, lack of opportunity and time, lack of perceived value and trust, and lack of recommendation. Conclusion: The present study recommends stage-based outreach efforts in order to provide accurate and timely information related to HPV and HPV vaccines and to promote protective health behaviors in college women.