title: HPV vaccine promotion: does referring to both cervical cancer and genital warts affect intended and actual vaccination behavior?
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, NSW Australia. ilonaj@psych.usyd.edu.au
authors.forename: Ilona
authors.initials: I
authors.lastname: Juraskova
authors.forename: Royena Abdul
authors.initials: RA
authors.lastname: Bari
authors.forename: Michaeley Therese
authors.initials: MT
authors.lastname: O'Brien
authors.forename: Kirsten Jo
authors.initials: KJ
authors.lastname: McCaffery
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D003218:Condylomata Acuminata / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D036301:Qualitative Research; D013334:Students; D014495:Universities; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000523:psychology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines