title: Female students receiving post-secondary education in Greece: the results of a collaborative human papillomavirus knowledge survey.
abstract: OBJECTIVE
  Contrary to the optimistic forecasts, existing until 2008 and despite the incorporation of the vaccine into the Greek National Immunization Program, six years later, the percentage of HPV vaccination coverage in Greece remains disappointingly low. The aim of this extended study was to investigate the knowledge, behaviour and attitude of a representative sample of the initial target group; young female students of Greek higher education institutions to Pap cervical screening, biology of HPV infection and principles of HPV vaccination.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  One thousand two hundred ten (1210) questionnaires were completed by young female students aged 17-24 years. The survey questionnaire sought data relating to sociodemographic characteristics, health behaviour and knowledge about HPV, as well as vaccination status.
  
  
  RESULTS
  79.6% of the sample reported at least one annual gynaecologic examination and 92.6% were familiar with the rationale of cervical screening; however only 52.9% had undergone a Pap smear. 69.7% reported adequate knowledge about HPV and 89.3% were aware of the possible course of HPV infection. Despite most (95.9%) were aware of vaccine availability, vaccinated students represented only 33.1%. According to the multivariate analysis, vaccination status was associated with university studies (OR 1.96; 95% CI: 1.19-3.20), parental area of expertise (OR 2.77; 95% CI: 1.18-6.53, OR 2.03; 95% CI: 1.05-3.94), and adequate knowledge of the reasons for which women should undergo regular cervical screening (OR 4.23; 85% CI: 1.55-11.55). Fear of side-effects and equivocal information were the main reasons of non-vaccination (52.2% and 33.1% respectively). Finally, the majority of unvaccinated individuals showed a positive attitude towards prospective HPV vaccination, providing they received well-documented advising.
  
  
  CONCLUSIONS
  Young women attending Greek higher education exhibit a good level of knowledge about HPV and its correlation with cervical cancer. These data highlight the need for further sensitization of the general population.
authors.affiliation: Department of Obstetrics & Gynaecology, Patras University Medical School, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Michail
authors.affiliation: Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Smaili
authors.affiliation: Department of Economics, University of Piraeus, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Vozikis
authors.affiliation: Department of Public Health, School of Medicine, University of Patras, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Jelastopulu
authors.affiliation: Department of Obstetrics & Gynaecology, Patras University Medical School, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Adonakis
authors.affiliation: Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, Greece. Electronic address: kpoulas@upatras.gr.
authors.forename: K
authors.initials: K
authors.lastname: Poulas
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D004500:Education, Graduate; D005260:Female; D006115:Greece; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D065006:Papanicolaou Test / Q000706:statistics & numerical data; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Greece; Human papillomavirus (HPV) vaccination; Post-secondary education; Young women