title: Factors associated with HPV vaccination among adult women in Quebec.
abstract: OBJECTIVE
  Human papillomavirus (HPV) infections are the most common sexually transmitted infections in North America and are associated with cervical cancer. A publicly-funded HPV immunization program was launched in the province of Quebec, Canada, in the fall of 2008. The aim of this study was to explore factors associated with HPV immunization among young adult women not targeted by this program.
  
  
  METHODS
  A questionnaire was mailed to 2400 24-y-old women randomly selected from the Quebec provincial health insurance database and 56% responded. Factors associated with vaccination status were analyzed using a multivariate logistic regression model.
  
  
  RESULTS
  Few women had received at least one dose of HPV vaccine among the 1347 respondents. Age at first sexual intercourse ≥ 20 y, participating in cervical cancer screening, higher education level, being born in Quebec and some positive beliefs about HPV were associated with vaccination.
  
  
  CONCLUSIONS
  The rate of immunization in women who had to pay for the HPV vaccine was very low and was associated with characteristics that are generally associated with a lower risk for HPV infection and cervical cancer. Efforts are needed to reach at-risk adult women.
authors.affiliation: Laval University; Quebec City, QC Canada; Public Health Quebec Institute; Quebec, QC Canada; Research Center of CHU de Québec; Quebec, QC Canada.
authors.forename: Marilou
authors.initials: M
authors.lastname: Kiely
authors.forename: Chantal
authors.initials: C
authors.lastname: Sauvageau
authors.forename: Eve
authors.initials: E
authors.lastname: Dubé
authors.forename: Genevieve
authors.initials: G
authors.lastname: Deceuninck
authors.forename: Philippe
authors.initials: P
authors.lastname: De Wals
mesh_terms: D000328:Adult; D002170:Canada; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D055118:Medication Adherence; D030361:Papillomavirus Infections / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV infections; HPV vaccine; attitudes; beliefs; cervical cancer screening; knowledge; sexual activity