The Relationship Between Knowledge and Beliefs About Human Papillomavirus, Acceptance of the Human Papillomavirus Vaccine, and Intentions to Practice Safer Sex Behaviors Among Female College Students

Introduction. Sexually transmitted infections (STIs) continue to be highly prevalent among young women, and STIs continue to be a challenging health issue on college campuses. Studies have shown that the highest prevalence of human papillomavirus (HPV) is among young adult women, ages 20 to 24, including female college students. While the HPV vaccine has proven to be highly effective in preventing certain high-risk types of HPV, it is not effective in preventing all types of HPV or other STIs. Practicing other safer sex behaviors, in addition to condom use, also can help individuals protect themselves and their partners from acquiring HPV and other STIs. Purpose. Relationships between knowledge about HPV and the HPV vaccine, beliefs about HPV, acceptance of the HPV vaccine, and intentions to practice safer sex behaviors were assessed to determine if female college students who had a high acceptance of the HPV vaccine were also more likely to practice safer sex behaviors. Methods. A convenience sample of 2,706 undergraduate female college students, ages 18 to 24, from three U.S. public universities, completed an online survey that measured the following study variables: knowledge about HPV; knowledge about the HPV vaccine; acceptance of the HPV vaccine, specifically influential factors and barriers to vaccination; as well as attitudes, normative beliefs, control beliefs and intentions for practicing safer sex behaviors. Results. The majority of participants had a high level of knowledge of HPV (70.4%) and the HPV vaccine (73.7%). Over one-third of the participants (37.3%) received at least one dose of the HPV vaccine. Most participants thought they had a low susceptibility to HPV, as 54% thought they were unlikely to contract HPV; however, most (53.6%) thought that HPV would be a serious problem for them. The safer sex behavior that participants thought was the easiest was refusing to have sex with a partner that would not use a condom (51.8% “Strongly agree”) and the safer sex behavior that participants thought to be the most difficult was asking a partner to get tested for STIs (54.5% “Disagree”). Attitudes, normative beliefs, and control beliefs combined to strongly predict intentions (R = .730, p \u3c .001), and attitudes was the strongest predictor for intentions to practice safer sex behaviors (β = .666), 95% CI [.649, .711]. There was a significant positive correlation between vaccine acceptance and intentions to practice safer sex behaviors (r = .087, p \u3c .001), including likelihood of getting vaccinated against HPV (r = .098, p \u3c .001). Conclusions. Findings from this study demonstrate the need for university student health centers to provide information about the HPV vaccine as part of broader STI prevention and social marketing campaigns, targeting female college students who are single, as well as those in monogamous relationships. Furthermore, because young men can be carriers of HPV and the HPV vaccine is now available to them, follow-up studies are needed to determine acceptance of the HPV vaccine among male college students as it relates to HPV knowledge, knowledge of the vaccine, and intentions to practice safer sex behaviors