title: Uptake of the HPV vaccination programme in England: a cross-sectional survey of young women attending sexual health services.
abstract: OBJECTIVE
  The U.K. human papilloma virus (HPV) vaccination programme requires 80% uptake to have a significant impact on cervical cancer rates. Uptake in the first three years of the programme was 66%. We report the results of a cross-sectional survey of young women attending sexual health services (SHS) in England, reviewing HPV vaccination uptake and prevalence of HPV-related risk factors.
  
  
  METHODS
  An anonymous questionnaire surveyed women aged 13-19 attending 19 hospital-based and 13 community-based SHS across England, March-August 2011. Data were analysed using multiple logistic regression.
  
  
  RESULTS
  2247 questionnaires were completed. Compared with national data, respondents had higher smoking rates (48% vs. 14% of 15 year olds), coitarche under-16 (52% vs. 38%), previous sexually transmitted infections (STIs) (25% vs. 4%) and a higher proportion not in education, employment or training (NEETs) (8% vs. 2% of 16 year olds). Seventy-four per cent had been offered the vaccination, with significantly lower offer rates in London, non-white ethnicities, 17-19 year olds, NEETs, smokers and those with previous STIs (all p<0.05 in multivariate analysis). Sixty-five per cent of those offered, completed, with significantly lower completion rates in London, non-white ethnicities, 17-19 year olds, NEETs, smokers and those with previous STIs (all p<0.05 in multivariate analysis). Overall completion rate was 47%.
  
  
  CONCLUSIONS
  We observed lower vaccination offer and completion rates and higher prevalence of HPV-related risk factors compared with national data. The highest risk individuals were the least likely to have been offered or to have completed the course. This survey highlights an opportunity for primary prevention by routinely offering the HPV vaccine to eligible women attending SHS.
authors.affiliation: Jefferiss Wing, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Sacks
authors.affiliation: Research Department of Infection & Population Health, University College London, London, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Copas
authors.affiliation: Jefferiss Wing, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Wilkinson
authors.affiliation: Camden Provider Services, Central and North West London NHS Foundation Trust, London, UK.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Robinson
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D004522:Educational Status; D004739:England / Q000453:epidemiology; D005260:Female; D006296:Health Services; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D016015:Logistic Models; D008131:London / Q000453:epidemiology; D032541:Mass Vaccination; D015999:Multivariate Analysis; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D060728:Reproductive Health; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV; PREVENTION; VACCINATION; WOMEN