| Objective:To understand the knowledge and attitude of community members and medical staff toward Human Papillomavirus(HPV)and vaccination in Fujian Province,China.To find out the potential influencing factors.To explore the reasons why community members and medical staff accept or refuse the HPV vaccine.Whether medical staff want to recommend vaccine or not and what are the influencing factors.Besides,to investigate and analyze the potential obstacles to the promotion and application of HPV vaccine in China and put forward possible solutions,so as to provide a basis for the popularization of HPV vaccine and the formulation of cervical cancer prevention strategies in China.Methods:From December 2016 to July 2019,a multicenter cross-sectional survey was carried out in two stages to investigate the knowledge of HPV,the cognition and attitude of preventive vaccine,and the significance of recommendation among medical staff and community women aged 20-35 in Fujian Province.In the first stage,the basic information of community women aged 20-35,their cognition and attitude towards HPV and its vaccine were collected from 7 sampled cities in our province according to the planned sample size.In the second stage,a cross-sectional convenience sampling survey was conducted among medical staff in Fujian Province of China to understand the knowledge,willingness to vaccinate and attitude towards HPV and its vaccine.SPSS 19.0 software was used for statistical analysis.In addition to descriptive recommendation,Chi-square test and rank sum test were used for comparison between groups,and univariate and multivariate Logistic regression were used for analysis of influencing factors.The main statistical indicators included HPV awareness rate,cognitive score and vaccine acceptance rate(see the text for details).Results:A total of 1001 valid questionnaires were collected from the community female population.The awareness rate of HPV was 44.9%,and the acceptance rate of HPV vaccine was 83.7%.The number of people with HPV cognitive score ≥ 5(high cognitive level)was 214,accounting for 21.4%.The scores of cognition were related to education level,household registration,monthly per capita income,and awareness of the risk of HPV infection.The level of cognition was related to monthly per capita income.The community woman knew less about HPV but had a higher willingness to vaccinate.The willingness of HPV vaccination of rural women was lower than that of urban women.The willingness of vaccination of women with monthly income of less than 3000 yuan was the lowest.More than 70% of women are willing to pay the price of the HPV vaccine(less than 500 yuan)which is far lower than the price of the HPV vaccine in the existing market,and the price of rural women is lower than that of urban women.The most worrying reason for those who refused the HPV vaccine was that "HPV vaccine has not been popularized"(68.7%).The willingness of HPV vaccination was related to the level of cognition.The people with higher level of cognition were higher than those with lower level of cognition(OR =2.096,95% CI: 1.140-3.856).A total of 248 valid questionnaires were collected.The awareness rate of HPV was98%,and the acceptance rate of HPV vaccine was 91.1%.215(86.7%)had HPV cognitive score ≥ 5.The cognition level of HPV of medical staff is related to their specialties.The cognition level of Obstetricians and gynecologists is higher than that of other medical staff,and there is no significant difference between them and medical students of Obstetrics and gynecology.Among those who refused to receive the HPV vaccine,the most worrying reason was "the high price of vaccine"(54.5%).90.5% of the medical staff with daughters expressed their willingness to vaccinate their children with HPV vaccine.63.7% of the medical workers were willing to recommend the HPV vaccine.Conclusions:The community female population aged 20-35 in Fujian Province had a low awareness of HPV.But most of them hold a positive attitude towards HPV vaccination.The level of cognition is related to monthly per capita income,and people with higher levels of cognition are more willing to be vaccinated than those with lower levels of cognition.The willingness of HPV vaccination of rural women is lower than that of urban women.The price of vaccine that rural women are willing to pay is also lower than that of urban women."HPV vaccine has not yet been popularized" is the main reason affecting the vaccination willingness of the community female population.The cognition of HPV among medical workers is related to their specialties,and the cognition of Obstetricians and gynecologists is higher than that of other medical workers.91.1% of medical staff were willing to receive HPV vaccine,and "the high price of the vaccine" was the main reason for medical staff to refuse the vaccination.The acceptance of the HPV vaccine price by medical staff was only related to the hospital grade.The majority(37.3%)of medical staff working in provincial hospitals chose "501-1000 yuan " and the number of medical staff in municipal hospitals and below who chose "200-500 yuan" was the most(37.0%).The proportion of medical workers who have daughters willing to vaccinate their daughters is 90.5%,and "HPV vaccine has not been widely promoted" is the reason they are most worried about.63.7% of the medical workers were willing to recommend HPV vaccine,and the willingness of HPV vaccination was the main influencing factor.Therefore,our province government should focus on promoting the popularization of HPV related knowledge in rural areas and low-income areas(monthly per capita income is less than3000 yuan),can promote the localization process of vaccines at the source,can consider carrying out vaccine subsidies or bringing them into the overall payment of medical insurance in the suitable population.For the vaccination of teenagers,the Chinese government can consider bringing HPV vaccines into the national immunization plan to reduce people’s concerns about the popularity of HPV vaccines. |
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