A nationwide survey on knowledge, attitude, and practice regarding human papillomavirus (HPV), HPV-related disease, and HPV vaccine among adolescents and their parents in China.

Abstract

Although human papillomavirus (HPV) infection constitutes a significant public health challenge, the HPV vaccination coverage remains suboptimal in China. Recent roll-out of new policies calls for an updated evaluation on the knowledge, attitude, and practice on HPV and HPV vaccination among adolescents and their parents. This nationwide cross-sectional survey targeted adolescents aged 9-17 y paired with one of their parents. Sociodemographic factors and the awareness, knowledge, attitude, practice and willingness toward HPV and HPV vaccination were collected for adolescents and their parents. Univariable and multivariable regression analyses were conducted to evaluate the factors associated with the knowledge, attitude, and practice of adolescents and their parents. A total of 1,000 pairs of adolescents and their parents were included. Awareness of HPV and HPV vaccine was 34.2% and 43.9% among adolescents, and 61.0% and 68.0% among parents. Although 77.0% of the adolescents and 78.2% of the parents believed in the benefits of HPV vaccine on adolescents, the vaccination rate remained low among adolescents (7.4%). The willingness toward HPV vaccination was significantly higher among the unvaccinated adolescents whose parents acknowledged the risk of HPV infection on themselves or communicated with their children about reproductive health. The findings underscored critical gaps in knowledge, attitude, and practice toward HPV and HPV vaccination among Chinese adolescents and their parents. To address these challenges, family-oriented, school-based and physician-led educational initiatives, enhancement of the accessibility and convenience of HPV vaccination, expansion of HPV vaccine indications, and evidence to support its inclusion in the National Immunization Program are needed. Human papillomavirus (HPV) is a very common virus that can cause several cancers and other diseases in both women and men. Vaccination during adolescence, especially before sexual activity begins, is one of the most effective ways to prevent HPV-related diseases. However, HPV vaccination coverage among adolescents in China remains low. This study surveyed 1,000 pairs of adolescents aged 9–17 y and one of their parents from across China to understand their knowledge, attitudes, and behaviors related to HPV and HPV vaccination. We found that awareness of HPV and the HPV vaccine was limited, particularly among adolescents. While most adolescents and parents believed that the HPV vaccine is beneficial, only a small proportion of adolescents had actually received the vaccine. Importantly, parents played a key role in adolescents’ willingness to be vaccinated. Adolescents were more likely to want the HPV vaccine if their parents understood the health risks of HPV, discussed reproductive health topics with them, or recognized the benefits of vaccination. Concerns about vaccine safety and limited access were common reasons for not getting vaccinated. These findings highlight the need for family-based education programs that target both adolescents and parents, improve understanding of HPV and vaccine safety, encourage open family communication and physician engagement in education initiatives, and provide evidence supporting the inclusion of HPV vaccination in the national immunization program, which may increase uptake and reduce HPV-related diseases in the future.