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Genital Human Papil omavirus Infection: A Comparison of Risk Behaviors, Attitudes, and Knowledge in a Cohort of Female University Students

Romanson, Brittney (2011)
Master's Thesis (103 pages)
Committee Chair / Thesis Adviser: Sales, Jessica
Committee Members: Elifson, Kirk
Research Fields: Health Sciences, Public Health
Partnering Agencies: Does not apply (no collaborating organization)
Keywords: Human Papillomavirus; HPV; Cervical Cancer; Undergraduate; Female; Sexual Risk Behaviors; Sexual Attitudes and Beliefs; HPV Knowledge; Pap Smear; Vaccination; Vaccine; Condom Use
Program: Rollins School of Public Health, Behavioral Sciences and Health Education
Permanent url: http://pid.emory.edu/ark:/25593/9419x

Abstract

Human Papillomavirus (HPV) is estimated to be one of the most common sexually transmitted infections (STIs) in the United States with over 50% of all sexually active adults acquiring HPV at least once in their lifetime. This study seeks to determine if a relationship exists between HPV knowledge and HPV risk factors, preventative measures, sexual attitudes and beliefs, and sexual risk behaviors. The purpose of exploring theses relationships is to identify whether the HPV knowledge level, the main dependent variable, one has attained is associated with the independent variables listed such as age of first sexual intercourse, frequency of condom use, or HPV vaccination status. A 50 item, self-administered, paper and pencil questionnaire completed by 207 undergraduate females ages 17 to 27 assessed the students' responses to sexual history, sexual attitudes and behaviors, and current HPV knowledge items. Overall HPV awareness was relatively high, with 91.6% of study participants indicating that they had heard of HPV. However, a lack of understanding in the prevalence and effects of the virus on fertility were evident. Moreover, although half reported hearing about HPV from a healthcare professional, the most significant correlate to increased HPV knowledge is when data are received from social media. Multivariate linear regression models showed that sexual attitudes and beliefs were marginal y significant in predicting HPV knowledge levels. More specifical y, believing that one should tel her sexual partner about a current STI prior to engaging in sexual intercourse and believing that one should inquire about her partner's and a significant other's sexual health history prior to engaging in sexual intercourse all significantly predicted HPV knowledge. Based on the current study findings, it is vital that researchers and practitioners develop education curricula and messages appropriate for the undergraduate student population. Although many college institutions incorporate STI prevention into their health education curriculum, the content needs to be revised in order to include the implications of an HPV diagnosis. Public health professionals are encouraged to continue research on predictive factors effecting HPV knowledge and developing materials aimed to decrease the stigmatization of HPV and increase preventative measures.

Table of Contents

Table of Contents

Problem Definition ................................................................................1
Theoretical Framework ..........................................................................6
Specific Aims and Significance ................................................................8
Literature Review ................................................................................10
Human Papillomavirus (HPV) ...............................................................10
Health Consequences .......................................................................11
Prevalence and Incidence Among Females ............................................13
Risk Factors ....................................................................................15
Prevention ......................................................................................18
Vaccine .....................................................................................18
Gynecological Testing ...................................................................22
Condom Use ...............................................................................26
Stigma ............................................................................................27
HPV knowledge .................................................................................29
Sample and Recruitment ........................................................................34
Procedure ...........................................................................................35
Measures ............................................................................................37
Demographic Information ....................................................................37
Sexual Health and History ..................................................................38
Sexual Risk Behaviors ........................................................................41
Sexual Attitudes and Beliefs ...............................................................42
HPV Knowledge ................................................................................42
Hypotheses .........................................................................................43
Data Analysis .......................................................................................45
Results ................................................................................................45
Participants .......................................................................................45
Sexual Health and History .....................................................................47
HPV Awareness and Knowledge .............................................................50
Sexual Attitudes and Beliefs .................................................................52
Sexual Risk Behaviors Scale ..................................................................54
Bivariate Associations ..........................................................................56
Multivariate Linear Regression Models ......................................................57
Discussion .............................................................................................59
Limitations .............................................................................................63
Implications and Recommendations .............................................................65
Conclusion .............................................................................................67
References ............................................................................................68
Appendices ............................................................................................77
Appendix A- Informed Consent Form ........................................................77
Appendix B- Glossary of Terms ...............................................................80
Appendix C- Women's Health Survey .......................................................81
Appendix D- Demographic Data ..............................................................89
Appendix E- Sexual Health and History Scale Descriptives ...........................90
Appendix F- Individual HPV Knowledge Item Scores ....................................92
Appendix G- Sexual Attitudes and Beliefs Scale Items .................................93
Appendix H- Sexual Risk Behavior Scale Descriptives ..................................94
Appendix I- Total Scale Score Descriptives ..............................................95

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