title: HPV awareness in higher-risk young women: the need for a targeted HPV catch-up vaccination program.
abstract: OBJECTIVE
  To determine levels of HPV awareness and knowledge in higher-risk young women and their attitudes toward HPV vaccination and catch-up programs.
  
  
  METHODS
  An anonymous, cross-sectional, Internet-based, self-reported questionnaire was completed by women ages 13 to 25 attending two outreach clinics. Primary outcomes were HPV infection/vaccine awareness, vaccination rates, and catch-up program acceptability. Chi-square, Fisher exact test, and logistic regression analyses were performed.
  
  
  RESULTS
  Of 105 respondents (mean age 19.32), 66.7% received social assistance and 54.3% relied on walk-in clinics. Overall HPV awareness was 81.0% and vaccine awareness was 76.2%. HPV awareness was significantly higher in women < 20 years old (P = 0.032) and with past sexually transmitted infection (STI) history (P = 0.039) but didn't differ by education level. Vaccine awareness differed significantly with STI history (P = 0.031) but not by age or education level. Awareness of HPV's association with genital warts and cervical cancer was low (30.0%, 41.9%) and didn't differ by education level or sexually transmitted infection history. Thirty percent had been vaccinated (of those, 42% had received 3 doses), mainly in school-based programs (71%). Odds of vaccination were significantly higher in those with a family doctor (OR 8.08). Reasons for not being vaccinated included: "Did not know about it"(28.5%) and "Don't know" (28.5%). Catch-up program acceptability was high (92.8%, 95.2% if free) and did not differ significantly by age or education level.
  
  
  CONCLUSIONS
  Higher-risk young women may have high levels of HPV infection/vaccine awareness but lack knowledge of HPV consequences. Those who missed or did not complete HPV vaccination opportunities would support free catch-up vaccination programs in accessible, youth-friendly centres.
authors.affiliation: Department of Obstetrics and Gynecology and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ahken
authors.affiliation: Department of Obstetrics and Gynecology and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON; Division of Gynecology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa ON; Children's Hospital of Eastern Ontario Research Institute, Ottawa ON.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fleming
authors.affiliation: Department of Obstetrics and Gynecology and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON; Division of Gynecology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa ON.
authors.forename: Tania
authors.initials: T
authors.lastname: Dumont
authors.affiliation: Department of Obstetrics and Gynecology and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON; Division of Gynecology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa ON.
authors.forename: Amanda
authors.initials: A
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000328:Adult; D003159:Community-Institutional Relations; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control / Q000523:psychology*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccines; adolescent; awareness; community outreach centres; high risk; human papillomavirus; vaccination uptake; youth