title: Knowledge and awareness of human papillomavirus (HPV), cervical cancer and HPV vaccine among women in two distinct Nepali communities.
abstract: BACKGROUND
  This study assessed human papillomavirus (HPV), cervical cancer, and HPV vaccine knowledge and awareness among women in two sub-populations in Nepal - Khokana, a traditional Newari village in the Lalitpur District about eight kilometers south of Kathmandu, and Sanphebagar, a village development committee within Achham District in rural Far-Western Nepal.
  
  
  METHODS
  Study participants were recruited during health camps conducted by Nepal Fertility Care Center, a Nepali non-governmental organization. Experienced staff administered a Nepali language survey instrument that included questions on socio-demographics, reproductive health and knowledge on HPV, cervical cancer, and the HPV vaccine.
  
  
  RESULTS
  Of the 749 participants, 387 (51.7%) were from Khokana and 362 (48.3%) were from Sanphebagar. Overall, 53.3% (n=372) of women were aware of cervical cancer with a significant difference between Khokana and Sanphebagar (63.3% vs 43.0%; p=0.001). Overall, 15.4% (n=107) of women had heard of HPV and 32% (n=34) of these women reported having heard of the HPV vaccine. If freely available, 77.5% of the women reported willingness to have their children vaccinated against HPV. Factors associated with cervical cancer awareness included knowledge of HPV (Khokana: Odds Ratio (OR)=24.5; (95% Confidence Interval (CI): 3.1-190.2, Sanphebagar: OR=14.8; 95% CI: 3.7-58.4)) and sexually transmitted infections (Khokana: OR=6.18; 95% CI: 3.1-12.4; Sanphebagar: OR=17.0; 95% CI: 7.3- 39.7) among other risk factors.
  
  
  CONCLUSIONS
  Knowledge and awareness of HPV, cervical cancer, and the HPV vaccine remains low among women in Khokana and Sanphebagar. Acceptance of a freely available HPV vaccine for children was high, indicating potentially high uptake rates in these communities.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA E-mail : sshrestha@uab.edu.
authors.forename: Derek Christopher
authors.initials: DC
authors.lastname: Johnson
authors.forename: Madhav Prasad
authors.initials: MP
authors.lastname: Bhatta
authors.forename: Santosh
authors.initials: S
authors.lastname: Gurung
authors.forename: Shilu
authors.initials: S
authors.lastname: Aryal
authors.forename: Pema
authors.initials: P
authors.lastname: Lhaki
authors.forename: Sadeep
authors.initials: S
authors.lastname: Shrestha
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009390:Nepal; D027383:Papillomaviridae / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000523:psychology / Q000821:virology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011379:Prognosis; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000523:psychology / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines