HPV Awareness and Knowledge Among Adults in Vietnam: Informing Intervention Strategies to Promote HPV Vaccination

Background: Human Papillomavirus (HPV) is a sexually transmitted virus responsible for cervical cancer, the second leading cause of cancer death among Vietnamese women. Three licensed HPV vaccines have been approved to effectively prevent the HPV-induced cervical changes since 2006 (Dönmez et al., 2018). However, HPV vaccine uptake rates among Vietnamese young people was very low (Tran et al., 2018). Previous studies show that HPV awareness and knowledge are positive factors for taking HPV vaccine (Jenny et al., 2013; Maness et al., 2016; Kamimura et al., 2018; Grigore et al., 2018). Therefore, the present study was designed to examine the level of HPV knowledge, factors related to HPV vaccine awareness, and factors related to HPV knowledge among Vietnamese adults.

Method: This study is part of a large survey on health and cancer screening literacy among Vietnamese in 2017. A cross-sectional design was conducted and a convenient sample of 226 Vietnamese aged 18 and over was recruited. The project site was Quang Tri Province of central Vietnam, which is one of rural provinces in Vietnam.  Data was collected through a self-administered questionnaire. Anderson’s behavioral model of health service use was utilized as the theoretical framework.

Results: Participants had a mean score of 2.32 (SD=1.96) from a 6-item scale. The correction rates ranged from 17.7% (“I can transmit HPV to my partner(s) even if I have no HPV symptoms”) to 50.9% (“Pap tests will almost always detect HPV”). In the model of awareness of HPV shots, gender (OR=2.974, p<.05), education level (OR=3.012, p<.01), and employed (OR=5.370, p<.05) were significant predictors. Among our participants, females were 1.19 times more likely to be aware of HPV shots than males. Compared to those whose education level was less than a bachelor’s degree, participants who had a bachelor’s degree or higher were 2.01 times more likely to be aware of the shots. Additionally, those who were employed were 4.27 times more likely to be aware than those who were unemployed. With regard to HPV knowledge, education (β=-.248, p<.001) was found to be a significant predictor; if participants increase their education level from less than bachelor to bachelor or higher, their HPV knowledge will increase by .24 score. Annual checkup (β=.137, p<.05) is another positive predictor for this model.

Conclusions and Implication: The results showed that Vietnamese adults had very limited HPV knowledge, an urgent need for immediate intervention, given that these adults will introduce HPV vaccine to their children. In order to increase HPV uptake rates among Vietnamese children and young adults, targeted interventions provided to enhance HPV knowledge and awareness of HPV vaccine are urgently needed, particularly for those who are male, have a lower education level, are not employed, and have limited health accessibility. Promoting education tailored to improve cervical cancer prevention that focuses on HPV vaccine awareness and knowledge will be an appropriate long-term strategy for decreasing cervical cancer disparity in Vietnam.