HPV vaccine promotion: does referring to both cervical cancer and genital warts affect intended and actual vaccination behavior?

BACKGROUND: young women have poor awareness that human papillomavirus (HPV) can cause both cervical cancer and genital warts, a sexually transmitted infection (STI). A newly developed HPV vaccine can provide protection against both cervical cancer and genital warts. This vaccine could be promoted by health authorities/professionals as preventing cervical cancer plus genital warts, or cervical cancer alone. Because stigma around STIs may reduce acceptance of the vaccine, the effect of information framing ('cervical cancer' versus 'cervical cancer plus genital warts') on intention to receive the HPV vaccine and actual uptake behavior was examined using the health belief model (HBM).

METHODS: we randomized 159 young women under the age of 27 to receive one of two variations of a fact-sheet describing the HPV vaccine as 1) preventing cervical cancer or 2) preventing cervical cancer and genital warts.

RESULTS: the results revealed low HPV knowledge (22%) and high HPV vaccination intention (79%), which was not influenced by information framing. Receipt of the vaccine at the 2-month follow-up was 37%, and was also not influenced by information framing. The overall HBM predicted vaccination intention (p < .001) and behavior (p = .002). However, only barriers (p = .029) and benefits (p = .001) independently predicted HPV vaccination intention; susceptibility (p = .023) and benefits (p = .033) independently predicted HPV vaccination behavior.

CONCLUSION: highlighting the sexual transmissibility of HPV does not seem to lower vaccination intentions or behaviors among young women. Potential challenges for promotion of the HPV vaccination program in Australia and worldwide are discussed.