1. Knowledge Base of Female College Students Regarding Human Papillomavirus (HPV) and Vaccination Lynn Takeshita Chloe Nobuhara Earl Hishinuma, Ph.D. Junji Takeshita, M.D.

2. No funding Participants and survey distributors were not compensated for their efforts Disclosure

3. Determine female college students’ awareness and perceptions of HPV and its vaccine Identify differences between knowledge bases of each ethnic group Learning Objectives

4. Limited number of studies involving Asian and Hawaiian participants regarding knowledge of HPV and its vaccine With more than 20 million infected and an estimated 6.2 million new cases annually, HPV is the most widespread sexually transmitted infection in America Gardasil (human papilloma quadrivalent) and Cervarix (human papilloma bivalent) are two main vaccines against carcinogenic strains of HPV Risk of contracting virus high in college students due to the majority (75%-90%) being sexually active Background

5. Anonymous 10 question online survey regarding HPV risk factors, consequences of infection, personal HPV vaccination status, and demographics Link to survey and letter with explanation distributed via email to students by professors Letter specified that only female students ages 18-25 were to take the survey Neither students nor professors received compensation for their time No written consent as voluntariness assumed if survey returned University of Hawaii IRB approved Methods

6. Results Of the initial 738 females who were eligible, 102 completed the survey for a 13.8% participation rate

7. European American females are more likely to receive the HPV test every three years than Asian Americans, Hawaiians, or "Other" ethnic groups (50% European Americans compared to 15.9% Asian Americans, 26.7% Hawaiians, and 20.0% "Other") The “Other” ethnic group had the highest rate of knowledge that HPV can be transmitted by oral sex (93.3% "Other" compared to 77.3% Asian Americans, 60.7% European Americans, and 53.3% Hawaiians) Asian Americans had a higher rate of believing that vomiting was a possible result of HPV; the prevalence was 0% for the other three ethnic groups (11.4% Asian Americans) Results (cont.)

8. Majority of the female sample comprised of those with health related majors (81.8% Asian Americans, 60.7% European Americans, 86.7% Hawaiians, and 80.0% Other) Majority understood HPV can result from vaginal sex (95.5% Asian Americans, 100.0% European Americans, 86.7% Hawaiians, and 100.0% Other) Majority knew HPV can possibly result in cervical cancer (93.2% Asian Americans, 96.4% European Americans, 80.0% Hawaiians, and 93.3% Other) Results (cont.)

9. However, 1 in 4 to 1 in 3 believed HPV can be contracted through dirty needles ( 31.8% Asian Americans, 25.0% European Americans, 26.7% Hawaiians, and 33.3% Other) 1 in 4 to 1 in 2 understood HPV can possibly result in abnormal skin lesions (43.2% Asian Americans, 25.0% European Americans, 46.7% Hawaiians, and 46.7% Other) Alarming percentage believed HPV can result in infertility (47.7% Asian Americans, 67.9% European Americans, 60.0% Hawaiians, and 60.0% Other) Results (cont.)

10. Knowledge base of students varied from one ethnic group to another Misconceptions were noted in a few specific areas for the non- European American ethnic groups, despite the majority being sexually active Health-related majors were not as knowledgeable as one would expect given the possible increased exposure to information on HPV. This points to the need for increased exposure and reinforcement of curriculum/instruction on HPV. Discussion

11. Effective education regarding HPV infection and vaccine is needed to overcome misconceptions about the infection and vaccine for all ethnicities Education is needed, particularly for those who are not yet sexually active and could benefit from receiving the HPV vaccination Health majors require increased instruction on HPV to advise future patients Conclusion

12. Sample was restricted to a single university, and therefore, the findings may not be a representative of overall college students Male students may have accidentally or intentionally completed the survey, although we have no evidence of this Response rate was low with less than 14% of those contacted participating in the study; this may have resulted in a non- representative sample of female college students from the university in question, the effects of which can only be speculated As with most survey research, we did not have corroborative evidence for the students’ self-report Limitations

13. Those who were health-related majors were over-represented in the sample, perhaps due to a higher interest in the topic, and/or being more comfortable discussing sexual and reproductive health Unclear whether the results can be generalized to other ethnic groups in college-age samples due to the high percentage of Asian Americans and Hawaiians in our sample Limitations (cont.)

14. Lynn Takeshita email: ltakeshita13@punahou.edu Chloe Nobuhara email: cnobuhara13@punahou.edu Earl Hishinuma, Ph.D. email: hishinumae@dop.hawaii.edu Junji Takeshita, M.D. email: takeshitaj@dop.hawaii.edu Contact Info