I am grateful to all the faculty members of the Faculty of Medicine at Nazarbayev University, especially Dr. Byron Crap for his great support throughout the study period and assistance in advising the study. The purpose of the research was to investigate students' awareness, knowledge, and attitudes toward HPV and HPV vaccination by determining the level of knowledge about HPV infection among students, students' attitudes and beliefs toward HPV infection and the vaccine, and students' willingness to accept the HPV vaccine.
Univariate, bivariate and multivariate logistic regression was performed to obtain the results of the study. Variables such as age, family income, whether the student had heard of the HPV vaccine and HPV and alcohol consumption were found to be significant predictors of the knowledge score. The score of intention to receive the HPV vaccination was statistically related to the student's academic performance, whether the student had heard of HPV and HPV vaccination before the study, or whether the student used contraception.
This study can contribute to the improvement of the existing vaccination policy in Kazakhstan and also educational policy.
INTRODUCTION
BACKGROUND/ LITERATURE REVIEW
Apart from that, cervical cancer is the second most common cancer among women and is the first most common cancer among women between the ages of 15 and 44 with the age-specific incidence of 36 (Bruni et al., 2017). Epidemiological study in Kazakhstan revealed that between 1999 and 2008, the average age of cervical cancer patients was 53.5±0.7 years (Igissinov et al., 2012). These vaccines are recommended before the first sexual activity and are offered as 3 doses over a period of 6 months (Bosch et al., 2012).
The price for both vaccines for the three required vaccines equals more than US$300 (Lancet, 2011). Therefore, due to the relatively high price, these vaccination offers may not be affordable for every country in the world. In addition, Kazakh media have reported an unsuccessful case of vaccination of a woman in Pavlodar, which caused resonance in the acceptance of the vaccine (Tengrinews.kz, 2018).
Although the media claims that the vaccination still exists, there is no information about its details.
LACK OF PUBLIC HEALTH RESEARCH IN FIELD OF HPVSTUDY
Given the fact that HPV is a public burden in Kazakhstan and that public health research is lacking, this study investigated students' awareness, knowledge, and attitudes toward HPV and HPV vaccination. In addition, the results of the study can also help the Kazakh government to adopt changes in the existing policy to improve the vaccination program.
OBJECTIVES OF THE STUDY
RESEARCH METHODOLOGY
- STUDY DESIGN…
- STUDY POPULATION
- SAMPLING METHODOLOGY
- SAMPLE SIZE
- STUDY INSTRUMENT
- PILOT STUDY
- DATA COLLECTION
But the aim of the study is still not to establish cause and effect, but only to determine the relationship between socio-demographic variables and knowledge of HPV and the HPV vaccine, attitude towards HPV vaccination and the intention score to get HPV receive vaccination. Students were chosen from the following faculties of the universities: Astana Medical University (Deanery of the Faculty of Public Health, Pharmacy, Stomatology, Deanery of General Medicine); Nazarbayev University (School of Science and Technology, School of Humanities and Social Sciences, School of Medicine), Eurasian National University (Faculty of Natural Sciences, Faculty of Mechanics and Mathematics, Faculty of Journalism and Political Science, Faculty of Transport and Energy); Kazakh Agricultural University (Faculty of Veterinary Medicine and Animal Husbandry, Department of Energy, Humanitarian Faculty, Technical Faculty). When universities were chosen, university authorities were approached to obtain permission for the study.
Therefore, the outcome variable is awareness about the availability of the HPV vaccine, and the exposed group consists of female students. Third, the existing questionnaire already conceptualizes and measures the variables (Hyman, Lamb, and Bulmer, 2006). Because some questions were not exhaustive, they were removed or modified to suit this study.
To meet the aims of the study, questions on sex life and lifestyle characteristics were added.
ETHICAL CONSIDERATIONS
The last part contained the most sensitive questions and asked the students about their behavioral characteristics, such as the presence of a sexual life, the presence of a sexual partner, the method of contraception, the presence of a sexually transmitted infection, an STI test, maintaining a healthy diet, smoking status and alcohol consumption. The questionnaire was conducted in Russian, Kazakh and English, depending on the request and language of study of the participants. All three language versions of the questionnaire were tested by 23 students of Eurasian National University and Nazarbayev University between October and November 2017.
One of the main reasons for conducting a pilot study is that it can provide an early warning of where the main research study might fail, where research protocols may not be followed, or whether the proposed methods or instruments are inadequate or too difficult (van Teijlingen and Hundley). , 2001). None of the participants refused to answer or stopped responding at any point in the survey. This study design and questionnaire content were approved by the Research Ethics Committee of the Nazarbayev Faculty of Medicine (NUSOM REC).
To ensure that all ethical considerations were taken into account, verbal consent was obtained from participants.
DATA ANALYSIS
DATA ENTRY AND CLEANING
STATISTICAL ANALYSIS
RESULTS
The majority of participants rated their household income as average (79%) and their health status as good (60%). Regarding the statements about the HPV vaccine, the majority of participants did not know the correct answers to the statements. The rest of the variables were found to be associated with the knowledge score about HPV and HPV vaccination (Table 6).
The majority of participants did not believe they were at increased risk of HPV infection (61.7%). Conversely, the majority of participants in the study believe that getting HPV is serious (63.8%) and can be life-threatening (56.6%). Only 4.9% of participants were willing to receive the vaccine with the highest intention score.
When assessing the attitude, a statistically significant predictor is the student's smoking status, whether he has heard of HPV and the HPV vaccine (Table 12).
DISCUSSION
As a result, given the crude odds ratios, almost all independent variables are statistically significant predictors of the knowledge score, with the exception of year of survey (Table 11). And for the last dependent variable, all independent variables, except year of study and income level, were found to be statistically significant predictive variables for the intention score to receive vaccination (Table 13). From Table 14, variables such as age, family income, whether the student heard about HPV and the HPV vaccine, and alcohol consumption were found to be significant predictors of the knowledge score.
In the last table, Table 16, the score of intention to receive the HPV vaccination is only statistically related to the student's academic performance, whether the student has heard of HPV and HPV vaccination before the study, or whether the student uses contraception. To discuss HPV awareness, about half of the students had heard of HPV infection and only a third of them had heard of HPV vaccination before participating in this study. The results of this study revealed that more than half of the respondents had a low level of knowledge about HPV.
Despite the low knowledge scores, half of the students had a positive attitude towards the HPV vaccination and the readiness for the HPV vaccination was also high. In addition, a study conducted in England showed that despite being aware of HPV, only 27% of respondents know that HPV causes cervical cancer. Therefore, the findings of this study and previous studies reveal that there is a lack of adequate knowledge about HPV regardless of country.
These findings point to the fact that HPV-related topics were covered in a later study period. About half of the study participants had positive attitudes toward HPV vaccination and high scores to receive HPV vaccination. The reason why only half of the participants have a good perception of the vaccine and are willing to receive it can be explained by the fact that HPV is a sexually transmitted infection and therefore represents a potential barrier to vaccine acceptance since the vaccine must be administered in advance. at first sexual contact (Cavazos-Rehg et al., 2009).
The findings of the study can be applied to this study as the average age of the participants was 19.9 and 24.5% of the respondents already had a sexual life. Therefore, by default, one quarter of the participants were not suitable for vaccination, since they had already had their first sexual contact.
STUDY LIMITATIONS
As mentioned earlier, one of the sampling techniques was non-random sampling within universities during student selection. In conclusion, this cross-sectional study focused on the topic of knowledge of HPV infection and perception of HPV vaccination, including attitudes toward and intention to receive the vaccine among Astana students. In contrast, there were more students with a high attitude score towards the vaccine and a high intention score to receive the vaccine.
On the one hand, this study can contribute to the improvement of the existing vaccination policy in Kazakhstan. Second, to track changes in HPV knowledge and perception of HPV prevention, the study design should be changed from cross-sectional to longitudinal panel study. I believe that the side effects of the vaccine will not prevent me from receiving the vaccine.
Study title: Knowledge and perception about human papillomavirus infection and vaccination among students of a university in Astana. This study will look at the topic of knowledge and awareness about HPV infection and attitudes towards HPV vaccination. Furthermore, the aim is to investigate the knowledge and awareness of HPV infection, attitudes towards HPV vaccination among university students and their intention to receive the HPV vaccine.
CONCLUSION AND RECOMMENDATION
TABLES
HPV can be transmitted through vaginal, anal and oral sex as well as genital to genital contact. HPV can only be transmitted from a carrier to his/her partner if the carrier shows symptoms. I believe that the current HPV vaccine is able to prevent the occurrence of cervical cancer.
On a scale of 1 to 10: 1 is the least likely and 10 is the most likely, how much are you now willing to get vaccinated with the HPV vaccine?
QUESTIONNAIRE (ENGLISH, KAZAKH, RUSSIAN)
CONSENT FORM (ENGLISH, KAZAKH, RUSSIAN)
