Main Article Content
adolescent health, papillomaviridae, severity, intention, sexually transmitted diseases, HPV
The human papillomavirus (HPV) infection is usually asymptomatic, may affect both sexes, and is easily transmitted. Providing male adolescents with information about HPV prevention before sexually active state is important. This study was designed to gain a better understanding of the perceptions on HPV severity, knowledge on ways to prevent HPV infection, and influencing factors toward preventive measures in male adolescents.
Materials and methods
A self-administered questionnaire was completed by students aged 13–17 years from six schools in Seoul and the surrounding metropolitan area, from October to December 2014. A total of 615 male adolescents participated in this cross-sectional survey.
Only 58 (9.5%) boys had heard of HPV. They perceived HPV infection as a disease more severe in girls. Perceptions of HPV as a sexually transmitted infection (STI) in boys (adjusted odds ratio [AOR] 1.79, 95% confidence interval [CI]: 1.00–3.19, p<0.05) and a cause of cancer in girls (AOR=2.69, 95% CI=1.26–5.84, p<0.05) were associated with the intention to maintain monogamous sexual relationships. Alcohol consumption was associated with the intention of postponing sexual intercourse (AOR=0.53, 95% CI=0.34–0.82, p<0.01) and having a sister was associated with the intention of being vaccinated against HPV (AOR=1.48, 95% CI=1.03–2.13, p<0.05).
Increasing awareness on the severity of HPV affected the intentions of male adolescents to prevent HPV infection. Efforts should be made to maximize awareness of HPV as a causative agent of cancer and a common STI in both boys and girls. Education materials on the influence of HPV infection and steps to be taken for proactive prevention should be included in school health subjects. Special consideration should be given for the preventive vaccination of male adolescents nationwide.
1. Lavelanet AF, Stampler KM, Dunton CJ. Human papillomavirus vaccine uptake: what works and what can we do better? J Low Genit Tract Dis. 2015;19(1):e17-e22. https://doi.org/10.1097/lgt.0000000000000036
2. Kim HW. Comparison of Factors Associated with Intention to Receive Human Papillomavirus Vaccine Between Male and Female Undergraduate Students. Korean Journal of Women Health Nursing. 2011;17(4):415-25. https://doi.org/10.4069/kjwhn.2011.17.4.415
3. Kim HW, Park S, Ahn HY, Park E-J. The effects of an HPV education program by gender among Korean university students. Nurse Educ Today. 2015;35(4):562-7. https://doi.org/10.1186/s12914-015-0042-2
4. Wong LP. Role of men in promoting the uptake of HPV vaccinations: focus groups’ finding from a developing country. Int J Public Health. 2010;55(1):35-42. https://doi.org/10.1007/s00038-009-0072-4
5. Blake KD, Ottenbacher AJ, Rutten LJF, et al. Predictors of human papillomavirus awareness and knowledge in 2013: gaps and opportunities for targeted communication strategies. Am J Prev Med. 2015;48(4):402-10. https://doi.org/10.1016/j.amepre.2014.10.024
6. Khurana S, Sipsma HL, Caskey RN. HPV vaccine acceptance among adolescent males and their parents in two suburban pediatric practices. Vaccine. 2015;33(13):1620-4. https://doi.org/10.1016/j.vaccine.2015.01.038
7. Bellia-Weiss T, Parsons M, Sebach AM, et al. Promoting HPV prevention in the school setting. NASN Sch Nurse. 2013;28(2):86-93. https://doi.org/10.1177/1942602x12463249
8. Park S, Choi JS. Comparison of human papillomavirus vaccination status, associated with health belief and knowledge between male and female highschool students. Journal of Korean biological nursing science. 2013;15(1):24-32. https://doi.org/10.7586/jkbns.2013.15.1.24
9. Hunter T, Weinstein M. Beliefs and knowledge about the human papillomavirus vaccine among undergraduate men. Health Educ J. 2016;75(2):249-56. https://doi.org/10.1177/0017896915572705
10. Sledge JA. The male factor: human papillomavirus (HPV) and HPV4 vaccine acceptance among African American young men. J Community Health. 2015;40(4):834-42. https://doi.org/10.1007/s10900-015-0007-3
11. Mosavel M, Ports KA. Upward communication about cancer screening: adolescent daughter to mother. J Health Commun. 2015;20(6):680-6. https://doi.org/10.1080/10810730.2015.1012245
12. Choi JS, Park S. A study on the predictors of Korean male students' intention to receive human papillomavirus vaccination. J Clin Nurs. 2016;25(21-22):3354-62. https://doi.org/10.1111/jocn.13461
13. Walker TY, Elam-Evans LD, Singleton JA, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2016. MMWR Morb Mortal Wkly Rep. 2017;66(33):874-82. https://doi.org/10.15585/mmwr.mm6633a2
14. Kim HW. Knowledge about human papillomavirus (HPV), and health beliefs and intention to recommend HPV vaccination for girls and boys among Korean health teachers. Vaccine. 2012;30(36):5327-34. https://doi.org/10.1016/j.vaccine.2012.06.040
15. D'Souza C, Zyngier S, Robinson P, et al. Health belief model: Evaluating marketing promotion in a public vaccination program. Journal of Nonprofit & Public Sector Marketing. 2011;23(2):134-57. https://doi.org/10.1080/10495142.2011.572668
16. Frank LB, Murphy ST, Chatterjee JS, et al. Telling stories, saving lives: creating narrative health messages. Health Commun. 2015;30(2):154-63. https://doi.org/10.1080/10410236.2014.974126
17. Kim HW. Awareness of human papillomavirus and factors associated with intention to obtain HPV vaccination among Korean youth: quasi experimental study. BMC Int Health Hum Rights. 2015;15(1):4. https://doi.org/10.1186/s12914-015-0042-2
18. Bonafide KE, Vanable PA. Male human papillomavirus vaccine acceptance is enhanced by a brief intervention that emphasizes both male-specific vaccine benefits and altruistic motives. Sex Transm Dis. 2015;42(2):76-80. https://doi.org/10.1097/olq.0000000000000226
19. Kim HW. Perception of the human papillomavirus and the willingness to prevent HPV infection of the boys. Poster session presented at: The 53rd Annual Meeting & 39th Post Graduate Course of the European Society of Paediatric Radiology (ESPR); 2017 May 20 – Jun 3; Davos, Swiss.
20. Select Statistical Services Ltd. Sample size calculator: Odds Ratio [Internet]. Exeter: Select Statistical Services Ltd; 2015 [cited 2015 Jan 27]. Available from: http://www.select-statistics.co.uk/sample-size-calculator-odds-ratio
21. Yang XR, Chang-Claude J, Goode EL, et al. Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies. J Natl Cancer Inst. 2010;103(3):250-63. https://doi.org/10.1093/jnci/djq526
22. Brewer NT, Calo WA. HPV transmission in adolescent men who have sex with men. Lancet Infect Dis. 2015;15(1):8-9. https://doi.org/10.1016/S1473-3099(14)71019-9
23. Reiter PL, McRee AL, Katz ML, et al. Human papillomavirus vaccination among young adult gay and bisexual men in the United States. Am J Public Health. 2015;105(1):96-102. https://doi.org/10.2105/AJPH.2014.302095
24. Hussain S, Nasare V, Kumari M, et al. Perception of human papillomavirus infection, cervical cancer and HPV vaccination in North Indian population. PLoS One. 2014;9(11):e112861. https://doi.org/10.1371/journal.pone.0112861
25. Bae JM. Human papillomavirus 16 infection as a potential risk factor for prostate cancer: an adaptive meta-analysis. Epidemiol Health. 2015;37:e2015005. https://doi.org/10.4178/epih/e2015005
26. Chaturvedi AK, Anderson WF, Lortet-Tieulent J, et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol. 2013;31(36):4550-9. http://doi.org/10.1200/JCO.2013.50.3870
27. Reiter PL, McRee AL, Pepper JK, et al. Longitudinal predictors of human papillomavirus vaccination among a national sample of adolescent males. Am J Public Health. 2013;103(8):1419-27. http://doi.org/10.2105/AJPH.2012.301189
28. Holman DM, Benard V, Roland KB, et al. Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature. JAMA Pediatr. 2014;168(1):76-82. http://doi.org/10.1001/jamapediatrics.2013.2752
29. Clark SJ, Cowan AE, Filipp SL, et al. Association of Older Sister's HPV Vaccination Status on HPV Vaccine Receipt by Adolescents. American Board of Family Medicine. 2015;28(6):816-8. https://doi.org/10.3122/jabfm.2015.06.150161
30. Korea Centers for Disease Control and Prevention. Notice: 12-year-old female teenager, one cancer can be prevented with two vaccination for the life [Internet]. Ilsan: Korea Centers for Disease Control and Prevention; 2017 [cited 2019 January 10]. Available from: http://cdc.go.kr/CDC/mobile/notice/CdcKrIntro0201.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0011&cid=72943
31. Gwon SH, Lee CY. Factors that influence sexual intercourse among middle school students: using data from the 8th (2012) Korea Youth Risk Behavior Web-based Survey. J Korean Acad Nurs. 2015;45(1):76-83. https://doi.org/10.4040/jkan.2015.45.1.76
32. Grandahl M, Oscarsson M, Stenhammar C, et al. Not the right time: why parents refuse to let their daughters have the human papillomavirus vaccination. Acta Paediatr. 2014;103(4):436-41. https://doi.org/10.1111/apa.12545
33. Voss DS, Wofford LG. Human papillomavirus vaccine uptake in adolescent boys: an evidence review. Worldviews Evid Based Nurs. 2016;13(5):390-5. https://doi.org/10.1111/wvn.12172