Awareness of Human Papillomavirus and Acceptability of Human Papillomavirus Vaccine: A Survey of Turkish University Students

The Ministry of Health of Republic of Turkey is considering adding human papillomavirus (HPV) vaccination to the national vaccination programme. In a Muslim country such as Turkey, the implementation of HPV vaccine may be lower than expected because of some superstitions and religious reasons that may influence knowledge levels and attitudes about HPV and its vaccination. Therefore, this study was carried out to assess awareness, attitudes, and factors affecting HPV vaccination among Turkish university students.

A total of 287 students (158 from the department of communication (DoC) and 129 from the department of medicine, or DoM) received a survey including 33 questions in this cross-sectional study conducted in Ankara, Turkey, between January and April 2015.

Only 13.9% of students in the DoC had heard of the HPV vaccine (vs. 90.6% in the DoM). The study found that, overall, 44.7% of the male participants and 66.6% of the female participants were amenable to HPV vaccination. The following variables were found to be statistically significant among students who are willing versus unwilling to be vaccinated against HPV: likely adverse effects of HPV vaccine (p< 0.001), sexually transmission risk of HPV infection (p< 0.001), protective effect of HPV vaccine from cancer (p< 0.001), and protective effect of HPV vaccine from genital warts (p<0.001). Being aware of the protective effect of HPV vaccine from cancer was the most important factor and was found to be associated with higher willingness rate of having HPV vaccine; it increased the acceptability of HPV vaccine 7-fold among students.

The researchers are concerned that it may be more difficult to explain the benefits of a vaccine that prevents diseases mostly related to sexual relations in a country where most of the citizens are Muslim. Additionally, in some conservative cultures, virginity has a high moral standing, and a woman who had extramarital sex or polygamy may suffer from various social or familial problems. In Muslim countries and in conservative cultures, a negative campaign against vaccination may be arranged easily with speculations that the vaccination leads the people to extramarital sex or polygamy. In such a context, this study supports the suggestion that it is the protective effect of the HPV vaccine from cancer, specifically, that needs to be well communicated in order to increase HPV vaccination among Turkish university students.