Understanding the awareness of HPV and related disease amongst women in Yogyakarta Special Province, Indonesia
by Dr. Teresa Pfeiffenberger teresa.pfeiffenberger@outlook.at 2018
Background: Invasive cervical cancer (ICC) is caused by high risk (HR) types of Human Papilloma Virus (HPV). It leads to high mortality, if detected late. HPV is primarily sexually transmitted. Different screening options to detect precancerous cervical lesions and vaccination against HR HPV types can prevent development and progression of ICC. Low and middle-income countries carry 80% of the world’s burden of ICC. Incidence rate in Indonesia is 17.3 per 100.000 persons per year – the 4th highest incidence within South East Asia. Screening uptake and levels of awareness concerning ICC, HPV and preventive interventions are still low.
Aim: To assess awareness of ICC, HPV infection and HPV vaccination amongst women in urban and rural areas of Yogyakarta Special Region.
Methods: A cross-sectional survey among 132 women in urban and 101 women in rural areas was conducted. The questionnaire was designed with both open and closed questions and was conducted electronically on mobile phones or tablets. Data analysis included displaying demographic data as well es logistic regression to find associations of different risk factors.
Results: Statistically significant differences were found comparing urban vs. rural areas concerning ICC (OR = 1.80, 95%-CI [1.00; 3.25] p = .049) and HPV awareness (OR = 2.35, 95%-CI [1.31; 4.19] p = .004). In the multivariate analysis only education had a significant effect on both ICC and HPV awareness with p – values of p < .001 and p = .002 respectively. Nevertheless, a trend towards association of location could be detected in the HPV awareness model with p = .062. Willingness to vaccinate their child was high with 79.6% (n = 105) urban and 61.0% (n = 61) rural areas, even though general awareness of HPV was low with 31.1% (n = 77) of this study population. 63.1% (n =147) were aware about PAP smear screening and 31.3% (n= 73) have been screened before with no significant difference between urban and rural areas.
Conclusion and Recommendation: The association between education and awareness of ICC and HPV allows the assumption that women of both urban and rural areas have the same chance to be aware of ICC and HPV, if they achieve the same level of education. Nevertheless, general HPV awareness was low and programmes to raise awareness are needed in order to achieve better access to prevention. Furthermore, a study to find out about the willingness to pay for an HPV vaccine is needed.