Awareness of primary health care physicians about human papilloma virus infection and its vaccination: a cross-sectional survey from multiple clinics in Saudi Arabia

Ebtehaj S Almughais,1 Ali Alfarhan,1 Mahmoud Salam2 1Department of Family Medicine and PHC, King Abdullah International Medical Research Center/King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; 2Science and Technology Unit, King Abdullah International Medical Research Center/King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia Background: The incidence of human papilloma virus (HPV) infections in conservative populations is increasing, yet vaccination is not routinely recommended by primary health care (PHC) physicians. The aim of this study is to evaluate PHC physicians’ awareness of HPV infections and vaccination in Saudi Arabia. Materials and methods: A self-administered survey was conducted in 2017 at eleven PHC clinics in Saudi Arabia. Their knowledge on HPV infections (six statements) and HPV vaccines (ten statements), their perceived importance of HPV vaccine, and if they recommended this vaccine to their patients was evaluated. Knowledge scores were summated and commuted into percentage mean scores (PMS). Analyses were conducted to identify factors associated with these outcomes. Results: Almost 80% of physicians perceived HPV vaccine as necessary and important, while 33 (16.5%) actually recommend HPV vaccine to their patients. Overall PMS± standard deviation of knowledge on HPV infections and vaccine was 61.8±10.4 and 91.3±11.4, respectively. Female physicians had a better perception of the importance of the vaccine (94; 84.7%), compared to male physicians (65; 73.0%), P=0.043. Younger physicians (<38 years) had better perception of the importance of HPV vaccine (75; 88.2%), compared to older physicians (≥38 years) (84; 73%), P=0.009. Family medicine physicians were more knowledgeable about both HPV infections (62.1±9.7) and HPV vaccine (91.2±12.0), compared to physicians of other specialties (56.3±13.7 and 85.8±10.2), P=0.03 and P=0.007, respectively. PHC physicians who routinely recommended HPV vaccine were also more knowledgeable (96.7±5.4), P=0.005. Compared to males, females were 3.1 times more likely to recommend HPV vaccines, adjusted P=0.015. Physicians who had better perception of the importance of vaccine were 4.8 times more likely to recommend vaccination, adjusted P=0.042. Conclusion: Enhancing PHC physicians’ knowledge about HPV infections and the efficiency of its vaccine boosts the physicians’ confidence to recommend HPV vaccination. Special consideration should be paid to male PHC physicians and older physicians, who had poorer perception of the importance of HPV vaccines in comparison to their counter groups. Keywords: perception, HPV, vaccine, knowledge, conservativ