title: Human papillomavirus knowledge, vaccine acceptance, and vaccine series completion among female entertainment and sex workers in Phnom Penh, Cambodia: the Young Women's Health Study.
abstract: Human papillomavirus is a common sexually transmitted infection and the causative agent for cervical cancer, a frequently occurring malignant disease among women in developing countries. We assessed human papillomavirus awareness prior to the delivery of a brief information and education intervention, and human papillomavirus vaccine provision to female entertainment and sex workers (N = 220). At baseline, only 23.6% of women had heard of human papillomavirus. Following the educational intervention, 90% answered all the human papillomavirus knowledge questions correctly. Of 192 participants attending the first quarterly cohort visit where vaccine was offered, 149 (78%) were eligible for vaccination; HIV-positive (n = 32) and pregnant (n = 11) women were excluded. Acceptance of vaccine among eligible women was universal, and 79.2% completed the three-dose vaccination series. Women who reported use of amphetamine-type stimulants had significantly and independently lower odds of vaccine completion (adjusted odds ratio [AOR] 0.24; 95% confidence interval [CI] 0.08, 0.69). New pregnancies also had an impact on vaccine completion: 5.4% (8/149 5.4%) who started the series had to stop due to new pregnancy. Results demonstrate the effectiveness of a simple education intervention designed to increase human papillomavirus knowledge and the feasibility of successful human papillomavirus vaccine in a population that is often difficult to engage in preventive health care.
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, and Global Health Sciences, San Francisco, CA, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Wadhera
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, and Global Health Sciences, San Francisco, CA, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Evans
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, and Global Health Sciences, San Francisco, CA, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Stein
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Gandhi
authors.affiliation: School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Couture
authors.affiliation: National Center for HIV/AIDS, Dermatology and STDs (NCHADS), Phnom Penh, Cambodia.
authors.forename: Neth
authors.initials: N
authors.lastname: Sansothy
authors.affiliation: Cambodian Women's Development Association (CWDA), Phnom Penh, Cambodia.
authors.forename: Keo
authors.initials: K
authors.lastname: Sichan
authors.affiliation: The Kirby Institute for Infection and Immunity (formerly the National Centre in HIV Epidemiology and Clinical Research); University of New South Wales, Sydney, NSW, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
authors.affiliation: The Kirby Institute for Infection and Immunity (formerly the National Centre in HIV Epidemiology and Clinical Research); University of New South Wales, Sydney, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Kaldor
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, and Global Health Sciences, San Francisco, CA, USA Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA PageK@salud.unm.edu.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
authors.affiliation: Cambodian Women's Development Association (CWDA), Phnom Penh, Cambodia.
authors.lastname: Kien
mesh_terms: D000293:Adolescent; D000328:Adult; D002160:Cambodia; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D060386:Sex Workers; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cambodia; HIV; HPV; Human papillomavirus; attitudes; brief intervention; cervical cancer; female sex workers; knowledge; prevention; sexually transmitted infection; vaccine; women