低卫生资源地区青春期女孩监护人HPV及HPV疫苗知晓率与接种意愿的影响因素分析

Analysis of factors influencing HPV and HPV vaccine awareness and vaccination willingness among guardians of adolescent girls in low-resource areas

摘要

目的 本研究是一项以人群为基础的大规模宫颈癌防控研究,分析低卫生资源地区青春期女孩监护人对人乳头瘤病毒(HPV)及HPV疫苗的认知、接种意愿及其影响因素,为疫苗接种策略制定提供科学依据。方法 研究于2022年7月至2024年4月采用横断面研究设计开展,在甘肃合作市、四川甘孜县和新疆托里县和山西武乡县通过问卷调查收集监护人基本人口学信息、HPV及HPV疫苗的知晓情况、接种意愿等.采用卡方检验和Logistic回归方法进行统计分析。结果 本研究共收集有效问卷623份,监护人对HPV和HPV疫苗的知晓率分别为76.73%和88.60%.针对监护人HPV知晓率,多因素Logistic回归显示,35~39岁比45岁及以上的监护人HPV知晓率高(OR=1.911,95%CI:1.039~3.513);汉族比少数民族高(OR=2.332,95%CI:1.489~3.653);与小学及以下学历的监护人相比,初中与高中及以上学历HPV知晓率较高(OR=4.553,95%CI:2.618~7.919、OR=5.282,95%CI:2.878~9.693);已婚状态比其他婚姻状态HPV知晓率高(OR=2.416,95%CI:1.333~4.380);男性低于女性监护人(OR=0.559,95%CI:0.351~0.889).针对监护人HPV疫苗知晓率,多因素Logistic回归显示,35~39岁及40~44岁的监护人与45及以上的监护人相比HPV疫苗知晓率较高(OR=2.430,95%CI:1.118~5.284、OR=2.778,95%CI:1.151~6.702)、初中与高中及以上学历较小学及以下学历高(OR=4.874,95%CI:2.477~9.588、OR=14.702,95%CI:5.699~37.928);汉族(OR=3.864,95%CI:1.943~7.684)的监护人知晓HPV疫苗的可能性较少数民族高;男性(OR=0.320,95%CI:0.173~0.593)监护人HPV疫苗知晓率相对女性较低.接种意愿方面,99.64%监护人愿意接种HPV疫苗,71.20%倾向二价疫苗.53.44%监护人可接受疫苗价格低于300元/每剂.监护人希望获取HPV疫苗信息的途径以医生咨询(86.41%)和权威讲座(81.70%)为主。结论 研究表明,青春期女孩监护人对HPV及HPV疫苗认知水平及接种决策受性别、民族、学历等多因素影响,建议针对男性、少数民族及低学历人群制定更为精准宣教策略,并通过价格补贴等形式提升接种可及性,以提高我国HPV疫苗接种率.

Abstract

Objective This study is a large-scale population-based cervical cancer prevention and control research project that analyzes the awareness of human papillomavirus (HPV) and HPV vaccines, vaccination willingness, and influencing factors among guardians of adolescent girls in low-resource areas. The findings aim to provide a scientific basis for vaccine policy formulation. Methods A cross-sectional study design was conducted from July 2022 to April 2024 in Hezuo City of Gansu Province, Ganzi County of Sichuan Province, Tuoli County of Xinjiang Province, and Wuxiang County of Shanxi Province. Questionnaires were used to collect demographic information, awareness of HPV and HPV vaccines, and willingness to vaccinate. Chi-square tests and logistic regression analyses were performed for statistical analysis. Results A total of 623 valid questionnaires were collected. The awareness rates of HPV and the HPV vaccine among guardians were 76.73% and 88.60%, respectively. Multivariate logistic regression analysis showed that, compared to guardians aged 45 and above, those aged 35-39 had a higher awareness of HPV (OR=1.911, 95%CI: 1.039-3.513). Han ethnicity guardians had a higher awareness rate than ethnic minorities (OR=2.332, 95%CI: 1.489-3.653). Compared to guardians with primary school education or below, those with junior high school and high school or above had higher awareness rates (OR=4.553, 95%CI: 2.618-7.919 and OR=5.282, 95%CI: 2.878-9.693). Married guardians had higher awareness than those with other marital statuses (OR=2.416, 95%CI: 1.333-4.380). Male guardians had lower awareness than female guardians (OR=0.559, 95%CI: 0.351-0.889). Regarding guardians' HPV vaccine awareness, multifactorial logistic regression showed that guardians aged 35-39 and 40-44 had higher awareness than those aged 45 and above (OR=2.430, 95%CI: 1.118-5.284 and OR=2.778, 95%CI: 1.151-6.702). Guardians with junior high school and high school or above education had higher awareness than those with primary school education or below (OR=4.874, 95%CI: 2.477-9.588 and OR=14.702, 95%CI: 5.699-37.928). Han ethnicity guardians were more likely to be aware of the HPV vaccine than ethnic minorities (OR=3.864, 95%CI: 1.943-7.684). Male guardians had lower awareness compared to female guardians (OR=0.320, 95%CI: 0.173-0.593). Regarding vaccination willingness, 99.64% of guardians expressed willingness to vaccinate their children, with 71.20% preferring the bivalent vaccine. A total of 53.44% of guardians found an acceptable vaccine price to be below 300 CNY per dose. The most preferred sources for obtaining HPV vaccine information were consultations with doctors (86.41%) and authoritative lectures (81.70%). Conclusion This study indicates that the awareness level and vaccination decision-making of adolescent girls' guardians regarding HPV and HPV vaccines are influenced by multiple factors, including gender, ethnicity, and education level. Targeted educational strategies should be implemented for male, ethnic minority, and low-education populations. Additionally, price subsidies should be considered to improve vaccine accessibility and increase the HPV vaccination rate in China.

关键词

人乳头瘤病毒 / 人乳头瘤病毒疫苗 / 监护人 / 知晓率 / 接种意愿 / 影响因素

Key words

human papillomavirus / HPV vaccine / guardian / awareness rate / vaccination willingness / influencing factor

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基金资助

国家重点研发项目(2023YFC2705501)

中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-004)

北京协和医院中央高水平医院临床科研专项(2022-PUMCH-D-003)