SUS users’ knowledge of and attitude to HPV virus and vaccines available in Brazil

Osis, Maria José Duarte; Duarte, Graciana Alves; Sousa, Maria Helena de

doi:10.1590/S0034-8910.2014048005026

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Public Health Practice • Rev. Saúde Pública 48 (1) • Feb 2014 • https://doi.org/10.1590/S0034-8910.2014048005026 copy

SUS users’ knowledge of and attitude to HPV virus and vaccines available in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

: To investigate knowledge of HPV and HPV vaccines in men and women, users of the Brazilian Unified Health System, and the intention to get themselves and their teenage children vaccinated.

METHODS

: A descriptive, cross-sectional study with 286 women (18-49 years old) and 252 men (18-60 years old), users of five primary health units and two polyclinics in Campinas, SP, Southeastern Brazil, was carried out. Participants were interviewed in 2011 using a structured questionnaire. Bivariate and Poisson regression analysis were performed to identify variables associated with knowledge of HPV and HPV vaccines, and participants vaccination intentions.

RESULTS

: Almost 40.0% of the participants reported having heard of HPV and 28.9% mentioned adequate information. The main information source was the media (41.7%). Only 8.6% of the participants had heard of the HPV vaccines. Once the participants were informed of the existence of HPV vaccines about 94% of them said they would get vaccinated and/or vaccinate their teenage children, if the vaccines were available in the public health system. Schooling of over 8 years and being female were the variables independently associated with having heard of HPV, the vaccines and having adequate knowledge of the virus. Advanced age was associated with having heard of HPV vaccines. There were no variables associated with the vaccination intentions.

CONCLUSIONS

: These results reinforce the need for educational activities that provide the population with adequate information on HPV and preventive measures.

Human Papillomavirus 6; Human Papillomavirus 11; Human Papillomavirus 16; Human Papillomavirus 18; Human Papillomavirus 31; Papillomavirus Vaccines; Health Knowledge, Attitudes, Practice; Patient Acceptance of Health Care; Unified Health System

Variable		Had heard of HPV				p
		Yes		No

		n	%	n	%
Age (years)						0.058
	18 to 24	36	30.5	82	69.5
	25 to 34	76	44.2	96	55.8
	35 and over	92	37.1	156	62.9
Sex						< 0.001
	Male	74	29.4	178	70.6
	Female	130	45.5	156	54.5
Schooling (years)						< 0.001
	0 to 8	60	24.4	186	75.6
	9 and over	144	49.3	148	50.7
Marital status						0.512
	Living in union	141	36.9	241	63.1
	Not living in union	63	40.4	93	59.6
Skin color						0.272
	White	90	40.9	130	59.1
	Not white	114	35.8	204	64.2
Religion						0.480
	Yes	183	37.4	306	62.6
	No	21	43.8	27	56.2
Total living children						0.433
	None	52	41.9	72	58.1
	1 to 2	103	35.6	186	64.4
	≥ 3	49	39.8	74	60.2
Sex of children						0.685
	Male	47	34.1	91	65.9
	Female	46	39.0	72	61.0
	Both	59	37.8	97	62.2
In paid work						> 0.999
	Yes	142	37.8	234	62.2
	No	59	37.6	98	62.4
Socioeconomic strata						0.004
	A, B	93	46.0	109	54.0
	C, D	111	33.1	224	66.9

Variable		Knowledge of HPV				p
		Adequate		Not adequate

		n	%	n	%
Age (years)						0.188
	18 to 24	31	27.0	84	73.0
	25 to 34	54	34.4	103	65.6
	35 and over	58	26.1	164	73.9
Sex						< 0.001
	Male	47	19.9	189	80.1
	Female	96	37.2	162	62.8
Schooling (years)						< 0.001
	0 to 8	36	15.9	190	84.1
	9 and over	107	39.9	161	60.1
Marital status						0.673
	Living in union	98	28.2	249	71.8
	Not living in union	45	30.6	102	69.4
Skin color						0.078
	White	68	33.5	135	66.5
	Not white	75	25.8	216	74.2
Religion						0.341
	Yes	127	28.3	322	71.7
	No	16	36.4	127	63.6
Total living children						0.064
	None	44	36.1	78	63.9
	1 or more	99	26.8	271	73.2
Sex of children						0.507
	Male	29	23.2	96	76.8
	Female	29	27.4	77	72.6
	Both	41	29.5	98	70.5
In paid work						0.829
	Yes	97	28.2	247	71.8
	No	43	29.7	102	70.3
Socioeconomic strata						0.015
	A, B	66	35.7	119	64.3
	C, D	77	25.0	231	75.0

Variable		Had heard of the vaccine				p
		Yes		No

		n	%	n	%
Age (years)						0.310
	18 to 24	6	5.1	112	94.9
	25 to 34	16	9.3	156	90.7
	35 and over	24	9.7	224	90.3
Sex						0.062
	Male	15	6.0	237	94.0
	Female	31	10.8	255	89.2
Schooling (years)						< 0.001
	0 to 8	10	4.1	236	95.9
	9 to 11	36	12.3	256	87.7
Marital status						0.157
	Living in union	28	7.5	354	92.7
	Not living in union	18	11.5	138	88.5
Skin color						0.141
	White	24	10.9	196	89.1
	Not white	22	6.9	296	93.1
Religion						0.590
	Yes	41	8.4	448	91.6
	No	5	10.5	43	89.6
Total living children						0.296
	None	14	11.3	110	88.7
	1 or more	32	7.8	380	92.2
Sex of children						0.131
	Male	6	4.3	132	95.7
	Female	13	11.0	105	89.0
	Both	13	8.3	143	91.7
In paid work						0.549
	Yes	34	9.0	342	91.0
	No	11	7.0	146	93.0
Socioeconomic strata						0.049
	A, B	24	11.9	178	88.1
	C, D	22	6.6	313	93.4

Variable		Get vaccinated					Have daughter vaccinated					Have son vaccinated				p

		Yes		No		p	Yes		No		p	Yes		No
		n	%	n	%	p	n	%	n	%	p	n	%	n	%
Age (years)						^a					^a					^a
	18 to 24	32	91.4	3	8.6		33	94.3	2	5.7		33	91.7	3	8.3
	25 to 34	74	97.4	2	2.6		73	97.3	2	2.7		73	97.3	2	2.7
	35 and over	85	92.4	7	7.6		86	93.5	6	6.5		86	93.5	6	6.5
Sex						0.543^b					0.750^b					0.534^b
	Male	70	95.9	3	4.1		69	94.5	4	5.5		69	93.2	5	6.8
	Female	121	93.1	9	6.9		123	95.3	6	4.7		123	95.3	6	4.7
Schooling (years)						0.752					1.000					1.000
	0 to 8	56	93.3	4	6.7		57	95.0	3	5.0		57	95.0	3	5.0
	9 and over	135	94.4	8	5.6		135	95.1	7	4.9		135	94.4	8	5.6
Marital status						0.758^b					0.180^b					0.316^b
	Living in union	131	93.6	9	6.4		135	96.4	5	3.6		135	95.7	6	4.3
	Not living in union	60	95.2	3	4.8		57	91.9	5	8.1		57	91.9	5	8.1
Skin color						0.914					0.346					0.543^b
	White	84	93.3	6	6.7		84	93.3	6	6.7		84	93.3	6	6.7
	Not white	107	94.7	6	5.3		108	96.4	4	3.6		108	95.6	5	4.4
Religion						1.000					0.603					0.609
	Yes	171	94.0	11	6.0		171	94.5	10	5.5		171	94.0	11	6.0
	No	20	95.2	1	5.8		21	100.0	0	0		21	100.0	0	0
Total living children						^a					^a					^a
	None	50	98.0	1	2.0		47	94.0	3	6.0		48	94.1	3	5.9
	1 to 2	95	92.2	8	7.8		98	95.1	5	4.9		97	94.2	6	5.8
	≥ 3	46	93.9	3	6.1		47	95.9	2	4.1		47	95.9	2	4.1
Sex of children						0.637					0.531					0.530
	Male	45	95.7	2	4.3		45	95.7	2	4.3		44	93.6	3	6.4
	Female	42	91.3	4	8.7		45	97.8	1	2.2		45	97.8	1	2.2
	Both	54	91.5	5	8.5		55	93.2	4	6.8		55	93.2	4	6.8
In paid work						0.342^b					0.487^b					0.306^b
	Yes	134	95.0	7	5.0		134	95.7	6	4.3		135	95.7	6	4.3
	No	54	91.5	5	8.5		55	93.2	4	6.8		54	91.5	5	8.5
Socioeconomic strata						0.073					0.115^b					0.116^b
	A, B	91	97.8	2	2.2		90	97.8	2	2.2		90	97.8	2	2.2
	C, D	100	90.9	10	9.1		102	92.7	8	7.3		102	91.9	9	8.1
Score for HPV knowledge						^a					^a					^a
	Low	9	81.8	2	18.2		10	90.9	1	9.1		11	91.7	1	8.3
	Medium	103	97.2	3	2.8		101	96.2	4	3.8		101	96.2	4	3.8
	High	76	91.6	7	8.4		79	95.2	4	4.8		78	94.0	5	6.0
Score for STD knowledge						0.736^b					0.240^b					0.274^b
	Low/Medium	148	94.3	9	5.7		150	96.2	6	3.8		150	95.5	7	4.5
	High	43	93.5	3	6.5		42	91.3	4	8.7		42	91.3	4	8.7

Model/Variable		PR	95%CI	p
Model 1: Had heard of HPV (N = 538)
	Schooling (> 8 years)	2.04	1.51;2.75	< 0.001
	Female	1.57	1.18;2.08	0.002
Model 2: Adequate knowledge of HPV (STD and/or cancer and/or wart) (N = 494)
	Schooling (> 8 years)	2.52	1.73;3.67	< 0.001
	Female	1.88	1.33;2.67	< 0.001
Model 3: Knew or had heard about the HPV vaccines (N = 538)
	Schooling (> 8 years)	3.56	1.75;7.23	< 0.001
	Age (years)	1.04	1.01;1.07	0.011
	Female	2.16	1.14;4.08	0.017
Model 4: Intention to get vaccinated
	No associated variables
Model 5: Intention to have daughter vaccinated
	No associated variables
Model 6: Intention to have son vaccinated
	No associated variables

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E-mail: revsp@usp.br

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[1] Correspondence
: Maria José Duarte Osis. Rua Vital Brasil, 200 Cidade Universitária Zeferino Vaz. 13083-888 Campinas, SP, Brasil. E-mail: mjosis@cemicamp.org.br