Determining the Knowledge Levels of University Students About HPV and HPV Vaccine
Yıl 2024,
Cilt: 6 Sayı: 3, 133 - 141
Arzu Torlak
Ayşe Dost
Öz
Objective: The purpose of this study is to determine the knowledge levels of university students about human papillomavirus (HPV) and the HPV vaccine.
Methods: This descriptive study was conducted with 802 university students staying in the student dormitory of a foundation university on the Anatolian Side of Istanbul. The data of the study were collected using the "Student Information Form" and the "Human Papilloma Virus Knowledge Scale".
Results: 16.5% of the participants had previous sexual experience, 5.1% had genital wart problems before, 15.8% had the HPV vaccine, the total score average of the "HPV Knowledge Scale" was 10.142±7.364 (Min:0-Max:33). When the sub-dimension mean scores are examined, the "general HPV knowledge" sub-dimension mean score is 6.657±4.276, the "HPV screening test knowledge" sub-dimension mean score is 1.029±1.316, the "general HPV vaccine knowledge" sub-dimension mean score is 1.591±1.737, the "current HPV knowledge" sub-dimension mean score is 1.591±1.737. The mean score of the "information about vaccination program" subscale was found to be 0.865±1.240.
Conclusion: In this study, the level of knowledge about HPV and HPV vaccine among university students is quite low, and it is seen that this situation may affect general health awareness and protective behaviors.
Etik Beyan
This study was approved by Non-Invasive Clinical Research Ethics Committee of Medipol University, (approval date 26.05.2024 and number 10840098-772.02-3057). Consent regarding participation in the study was obtained from each participant. The study was conducted in accordance with the principles of the Declaration of Helsinki.
Destekleyen Kurum
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors
Teşekkür
The researchers would like to thank university students who participated in the study. This article was produced from Arzu Torlak's master's thesis, which was carried out under the supervision of Ayşe Dost.
Kaynakça
- Alsancak, A., Yazıcı, B. B., Sakar, H. H., Bala, N. B., Uçarer, S., & Bakar, C. (2024). University students' attitudes and knowledge levels regarding Human Papillomavirus (HPV) and the HPV vaccine. Journal of Public Health Research and Practices, 2(1), 30–43. https://doi.org/10.5281/zenodo.11047068
- Alsulami, F. T., Sanchez, J., Rabionet, S. E., Popovici, I., & Baraka, M. A. (2023). Predictor of HPV vaccination uptake among foreign-born college students in the U.S.: An exploration of the role of acculturation and the health belief model. Vaccines, 11(2), 422. https://doi.org/10.3390/vaccines11020422
- Aslan, G., & Bakan, A. B. (2021). Identification of the knowledge level of students receiving health education about the human papilloma virus, screening tests, and human papilloma virus vaccination. Journal of Community Health, 46(2), 428–433. https://doi.org/10.1007/s10900-020-00888-8
- Ayazöz, Y., & Çadırcı, D. (2020). Tıp fakültesi öğrencilerinin HPV enfeksiyonu ve HPV aşısı hakkındaki bilgi düzeyleri ve tutumlarının değerlendirilmesi [Unpublished doctoral thesis]. Yükseköğretim Kurulu. https://tez.yok.gov.tr/UlusalTezMerkezi/ (Erişim tarihi: 03.06.2022) (in Turkish)
- Aynaci, G., & Guksu, Z. (2019). Awareness of HPV and HPV vaccination in undergraduate students in the North West region of Turkey: Near future outlook. Journal of Infection in Developing Countries, 13(6), 516–525. https://doi.org/10.3855/jidc.11405
- Barnard, M., George, P., Perryman, M. L., & Wolff, L. A. (2017). Human papillomavirus (HPV) vaccine knowledge, attitudes, and uptake in college students: Implications from the precaution adoption process model. PLOS ONE, 12(8), e0182266. https://doi.org/10.1371/journal.pone.0182266
- Başar, F., Çiçek, S., & Sağlam, H. (2019). Hemşirelik bölümü öğrencilerinin human papilloma virüsü ve aşısına yönelik bilgi düzeyleri. Uluslararası Toplum Araştırmaları Dergisi, 10(17), 23–28. https://doi.org/10.26466/opus.499635 (in Turkish)
- Başlı, M., Aksu, H., & Toptaş, B. (2019). Bir üniversitede öğrenim gören sağlık yüksekokulu öğrencilerinin human papilloma virüs ve HPV aşısı ile ilgili bilgi ve görüşleri. Ankara Sağlık Bilimleri Dergisi, 8(1), 1–17. https://dergipark.org.tr/tr/download/article-file/736473 (in Turkish)
- Blodt, S., Holmberg, C., Muller-Nordhorn, J., & Rieckmann, N. (2012). Human papillomavirus awareness, knowledge and vaccine acceptance: A survey among 18-25 year old male and female vocational school students in Berlin, Germany. European Journal of Public Health, 22(6), 808–813. https://doi.org/10.1093/eurpub/ckr188
- Chen, G., Wu, B., Dai, X., Zhang, M., Liu, Y., Huang, H., Mei, K., & Wu, Z. (2021). Gender differences in knowledge and attitude towards HPV and HPV vaccine among college students in Wenzhou, China. Vaccines, 10(1), 10. https://doi.org/10.3390/vaccines10010010
- Chen, X., Wang, L., Huang, Y., & Zhang, L. (2024). Risk perception and trust in the relationship between knowledge and HPV vaccine hesitancy among female university students in China: A cross-sectional study. BMC Public Health, 24(1), 667. https://doi.org/10.1186/s12889-024-18166-w
- Çeşmeci, Y., Köylü, B., Sulaiman, J., Sancak, E., Şenel, S., Baki, H. E., ... & Zık, S. (2015). İnternlerin gözünden HPV enfeksiyonları ve HPV aşısı. Türk Jinekolojik Onkoloji Dergisi, 18(3), 85–92. https://dergipark.org.tr/tr/download/article-file/439557 (in Turkish)
- Daylan Koçkaya, P., Çakır, E. E., Öztürk, B., Terzi, S. C., Soylu, M. F., Barış, M. A., Çobanoğlu, S., Rahmani, A. W., & Topaloğlu, E. S. (2024). Üniversite öğrencilerinin human papilloma virüs ile ilgili bilgi düzeylerinin değerlendirilmesi. Acta Medica Nicomedia, 7(1), 30-37. https://doi.org/10.53446/actamednicomedia.1320163 (in Turkish)
- Demir Bozkurt, F., & Özdemir, S. (2023). Validity and reliability of a Turkish version of the human papillomavirus knowledge scale: A methodological study. Journal of the Turkish German Gynecological Association, 24(3), 177–186. https://doi.org/10.4274/jtgga.galenos.2023.2022-10-9
- Dibble, K. E., Maksut, J. L., Siembida, E. J., Hutchison, M., & Bellizzi, K. M. (2019). A systematic literature review of HPV vaccination barriers among adolescent and young adult males. Journal of Adolescent and Young Adult Oncology, 8(5), 495–511. https://doi.org/10.1089/jayao.2019.0004
- Egawa, N., & Doorbar, J. (2017). The low-risk papillomaviruses. Virus Research, 231, 119–127. https://doi.org/10.1016/j.virusres.2016.12.017
- GLOBOCAN. (2022). Global cancer statistics: Turkey. https://gco.iarc.fr/today/data/factsheets/populations/792-turkey-fact-sheets.pdf
- Food and Drug Administration. (2018). Gardasil 9 (human papillomavirus 9-valent vaccine, recombinant). Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2018. https:// www.fda.gov/media/90064/download
- Hathaway, J. K. (2012). HPV: Diagnosis, prevention, and treatment. Clinical Obstetrics and Gynecology, 55(3), 671–680. https://doi.org/10.1097/GRF.0b013e31825caa36
- Jeannot, E., Viviano, M., Follonier, M. C., Kaech, C., Oberhauser, N., Mpinga, E. K., Vassilakos, P., Kaiser, B., & Petignat, P. (2019). Human papillomavirus infection and vaccination: Knowledge, attitude and perception among undergraduate men and women healthcare university students in Switzerland. Vaccines, 7(4), 130. https://doi.org/10.3390/vaccines7040130
- Karakuş Selçuk, A., & Yanıkkerem, E. (2018). Serviks kanseri ve human papillomavirus (HPV) prevalansı ile HPV aşı programları. Kadın Sağlığı Hemşireliği Dergisi, 4(2), 40–55. https://dergipark.org.tr/tr/pub/kashed/issue/41825/422074#article_cite (in Turkish)
- Kasymova, S., Harrison, S. E., & Pascal, C. (2019). Knowledge and awareness of human papillomavirus among college students in South Carolina. Infectious diseases, 12, 1-9. https://doi.org/10.1177/1178633718825077
- Kunt İşgüder, Ç., Oktay, G., Yılmaz Doğru, H., Delibaş, İ., et al. (2017). Sağlık yüksekokulu öğrencilerinin HPV aşısı bilgi düzeyinin değerlendirilmesi. Çağdaş Tıp Dergisi, 7(1), 1–7. https://doi.org/10.16899/gopctd.28865 (in Turkish)
- López, N., Garcés-Sánchez, M., Panizo, M. B., de la Cueva, I. S., Artés, M. T., Ramos, B., & Cotarelo, M. (2020). HPV knowledge and vaccine acceptance among European adolescents and their parents: A systematic literature review. Public Health Reviews, 41, 10. https://doi.org/10.1186/s40985-020-00126-5
- Mavundza, E. J., Iwu-Jaja, C. J., Wiyeh, A. B., Gausi, B., Abdullahi, L. H., Halle-Ekane, G., & Wiysonge, C. S. (2021). A systematic review of interventions to improve HPV vaccination coverage. Vaccines, 9(7), 687. https://doi.org/10.3390/vaccines9070687
- Monteiro, J. C., Tsutsumi, M. Y., de Carvalho, D. O., da Silva Costa, E. D. C., Feitosa, R. N. M., Laurentino, R. V., de Souza Fonseca, R. R., Silvestre, R. V. D., Oliveira-Filho, A. B., & Machado, L. F. A. (2022). Prevalence, diversity, and risk factors for cervical HPV infection in women screened for cervical cancer in Belém, Pará, Northern Brazil. Pathogens, 11(9), 960. https://doi.org/10.3390/pathogens11090960
- Natipagon-Shah, B., Lee, E., & Lee, S. Y. (2021). Knowledge, beliefs, and practices among U. S. College students concerning papillomavirus vaccination. Journal of community health, 46(2), 380–388. https://doi.org/10.1007/s10900-020-00922-9
- Park, I. U., Introcaso, C., & Dunne, E. F. (2015). Human papillomavirus and genital warts: A review of the evidence for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clinical Infectious Diseases, 61(Suppl 8), S849–S855. https://doi.org/10.1093/cid/civ813
- Rathfisch, G., Güngör, İ., Uzun, E., Keskin, Ö., & Tencere, Z. (2015). Human papillomavirus vaccines and cervical cancer: Awareness, knowledge, and risk perception among Turkish undergraduate students. Journal of Cancer Education, 30(1), 116–123. https://doi.org/10.1007/s13187-014-0703-1
- Sanjosé, S., Brotons, M., & Pavón, M. A. (2018). The natural history of human papillomavirus infection. Best Practice & Research: Clinical Obstetrics & Gynaecology, 47, 2–13. https://doi.org/10.1016/j.bpobgyn.2017.08.015
- Şahin, M. A., Şenel, U., Şahin, R. A., Ataç, Ö. (2022). Üniversite öğrencilerinin human papilloma virüsü ve aşısı ile ilgili bilgi, tutum ve davranışları. Sağlık Bilimleri Dergisi, 31(1), 1-8. https://doi.org/10.34108/eujhs.794249 (in Turkish)
- Tapera, R., Manyala, E., Erick, P., Maswabi, T. M., Tumoyagae, T., Letsholo, B., & Mbongwe, B. (2017). Knowledge and attitudes towards cervical cancer screening amongst university of botswana female students. Asian Pacific Journal of Cancer Prevention, 18(9), 2445–2450. https://doi.org/10.22034/APJCP.2017.18.9.2445
- Toshkov, D. (2023). Explaining the gender gap in COVID-19 vaccination attitudes. European Journal of Public Health, 33(3), 490–495. https://doi.org/10.1093/eurpub/ckad052
- Turhan, E., Çetin, S., Çetin, M., & Abacigil, F. (2019). Awareness and knowledge levels of 18-year-old and older individuals regarding human papillomavirus (HPV) and HPV vaccine in Hatay, Turkey. Journal of Cancer Education, 34(2), 234–241.
- Türkiye Sağlık Bakanlığı. (2023, January 3). Cervical cancer. https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer#:~:text=HPV%20is%20the%20most%20common,populations%20eventually%20clear%20the%20infection
- Waller, J., Ostini, R., Marlow, L. A., McCaffery, K., & Zimet, G. (2013). Validation of a measure of knowledge about human papillomavirus (HPV) using item response theory and classical test theory. Preventive Medicine, 56(1), 35–40. https://doi.org/10.1016/j.ypmed.2012.10.028
- Wanderley, M. D. S., Sobral, D. T., Resende, C. N., & vd. (2021). Medical students’ knowledge of the human papillomavirus (HPV), cervical cancer, and HPV vaccination. Revista Brasileira de Educação Médica, 45(3), e155. https://doi.org/10.1590/1981-5271v45.320210071.ING
- Wilson, K. L., Lee Smith, M., Rosen, B. L., Pulczinski, J. C., & Ory, M. G. (2017). HPV vaccination status and mandate support for school-aged adolescents among college females: A descriptive study. Journal of School Nursing, 33, 232–245. https://doi.org/10.1177/1059840516686442
Üniversite Öğrencilerinin HPV ve HPV Aşısı Hakkındaki Bilgi Düzeylerinin Belirlenmesi
Yıl 2024,
Cilt: 6 Sayı: 3, 133 - 141
Arzu Torlak
Ayşe Dost
Öz
Amaç: Bu çalışmanın amacı, üniversite öğrencilerinin human papillomavirüs (HPV) ve HPV aşısı hakkındaki bilgi düzeylerinin belirlenmesidir.
Yöntem: Tanımlayıcı nitelikteki bu çalışma, İstanbul Anadolu Yakası'ndaki bir vakıf üniversitesinin öğrenci yurdunda kalan 802 üniversite öğrencisi ile yürütülmüştür. Çalışmanın verileri "Öğrenci Bilgi Formu" ve "Human Papilloma Virüsü Bilgi Ölçeği" kullanılarak toplanmıştır.
Bulgular: Katılımcıların %16,5'i daha önce cinsel deneyim yaşadığını ve %5,1'i daha önce genital siğil sorunu yaşadığını ve %15,8'i HPV aşısı yaptırdığını belirtti. "HPV Bilgi Ölçeği" toplam puan ortalaması 10,142±7,364 (min.0-maks.33) idi. Alt boyut puan ortalamaları incelendiğinde, “genel HPV bilgisi” alt boyut puan ortalaması 6.657±4.276, “HPV tarama testi bilgisi” alt boyut puan ortalaması 1.029±1.316, “genel HPV aşısı bilgisi” alt boyut puan ortalaması 1.591±1.737, “mevcut HPV bilgisi” alt boyut puan ortalaması 1.591±1.737 olarak bulunmuştur. “Aşılama programı hakkında bilgi” alt ölçeğinin puan ortalaması 0.865±1.240 olarak bulunmuştur.
Sonuç: Bu çalışmada üniversite öğrencileri arasında HPV ve HPV aşısı hakkında bilgi düzeyi oldukça düşük olup, bu durumun genel sağlık farkındalığını ve koruyucu davranışları etkileyebileceği görülmektedir.
Kaynakça
- Alsancak, A., Yazıcı, B. B., Sakar, H. H., Bala, N. B., Uçarer, S., & Bakar, C. (2024). University students' attitudes and knowledge levels regarding Human Papillomavirus (HPV) and the HPV vaccine. Journal of Public Health Research and Practices, 2(1), 30–43. https://doi.org/10.5281/zenodo.11047068
- Alsulami, F. T., Sanchez, J., Rabionet, S. E., Popovici, I., & Baraka, M. A. (2023). Predictor of HPV vaccination uptake among foreign-born college students in the U.S.: An exploration of the role of acculturation and the health belief model. Vaccines, 11(2), 422. https://doi.org/10.3390/vaccines11020422
- Aslan, G., & Bakan, A. B. (2021). Identification of the knowledge level of students receiving health education about the human papilloma virus, screening tests, and human papilloma virus vaccination. Journal of Community Health, 46(2), 428–433. https://doi.org/10.1007/s10900-020-00888-8
- Ayazöz, Y., & Çadırcı, D. (2020). Tıp fakültesi öğrencilerinin HPV enfeksiyonu ve HPV aşısı hakkındaki bilgi düzeyleri ve tutumlarının değerlendirilmesi [Unpublished doctoral thesis]. Yükseköğretim Kurulu. https://tez.yok.gov.tr/UlusalTezMerkezi/ (Erişim tarihi: 03.06.2022) (in Turkish)
- Aynaci, G., & Guksu, Z. (2019). Awareness of HPV and HPV vaccination in undergraduate students in the North West region of Turkey: Near future outlook. Journal of Infection in Developing Countries, 13(6), 516–525. https://doi.org/10.3855/jidc.11405
- Barnard, M., George, P., Perryman, M. L., & Wolff, L. A. (2017). Human papillomavirus (HPV) vaccine knowledge, attitudes, and uptake in college students: Implications from the precaution adoption process model. PLOS ONE, 12(8), e0182266. https://doi.org/10.1371/journal.pone.0182266
- Başar, F., Çiçek, S., & Sağlam, H. (2019). Hemşirelik bölümü öğrencilerinin human papilloma virüsü ve aşısına yönelik bilgi düzeyleri. Uluslararası Toplum Araştırmaları Dergisi, 10(17), 23–28. https://doi.org/10.26466/opus.499635 (in Turkish)
- Başlı, M., Aksu, H., & Toptaş, B. (2019). Bir üniversitede öğrenim gören sağlık yüksekokulu öğrencilerinin human papilloma virüs ve HPV aşısı ile ilgili bilgi ve görüşleri. Ankara Sağlık Bilimleri Dergisi, 8(1), 1–17. https://dergipark.org.tr/tr/download/article-file/736473 (in Turkish)
- Blodt, S., Holmberg, C., Muller-Nordhorn, J., & Rieckmann, N. (2012). Human papillomavirus awareness, knowledge and vaccine acceptance: A survey among 18-25 year old male and female vocational school students in Berlin, Germany. European Journal of Public Health, 22(6), 808–813. https://doi.org/10.1093/eurpub/ckr188
- Chen, G., Wu, B., Dai, X., Zhang, M., Liu, Y., Huang, H., Mei, K., & Wu, Z. (2021). Gender differences in knowledge and attitude towards HPV and HPV vaccine among college students in Wenzhou, China. Vaccines, 10(1), 10. https://doi.org/10.3390/vaccines10010010
- Chen, X., Wang, L., Huang, Y., & Zhang, L. (2024). Risk perception and trust in the relationship between knowledge and HPV vaccine hesitancy among female university students in China: A cross-sectional study. BMC Public Health, 24(1), 667. https://doi.org/10.1186/s12889-024-18166-w
- Çeşmeci, Y., Köylü, B., Sulaiman, J., Sancak, E., Şenel, S., Baki, H. E., ... & Zık, S. (2015). İnternlerin gözünden HPV enfeksiyonları ve HPV aşısı. Türk Jinekolojik Onkoloji Dergisi, 18(3), 85–92. https://dergipark.org.tr/tr/download/article-file/439557 (in Turkish)
- Daylan Koçkaya, P., Çakır, E. E., Öztürk, B., Terzi, S. C., Soylu, M. F., Barış, M. A., Çobanoğlu, S., Rahmani, A. W., & Topaloğlu, E. S. (2024). Üniversite öğrencilerinin human papilloma virüs ile ilgili bilgi düzeylerinin değerlendirilmesi. Acta Medica Nicomedia, 7(1), 30-37. https://doi.org/10.53446/actamednicomedia.1320163 (in Turkish)
- Demir Bozkurt, F., & Özdemir, S. (2023). Validity and reliability of a Turkish version of the human papillomavirus knowledge scale: A methodological study. Journal of the Turkish German Gynecological Association, 24(3), 177–186. https://doi.org/10.4274/jtgga.galenos.2023.2022-10-9
- Dibble, K. E., Maksut, J. L., Siembida, E. J., Hutchison, M., & Bellizzi, K. M. (2019). A systematic literature review of HPV vaccination barriers among adolescent and young adult males. Journal of Adolescent and Young Adult Oncology, 8(5), 495–511. https://doi.org/10.1089/jayao.2019.0004
- Egawa, N., & Doorbar, J. (2017). The low-risk papillomaviruses. Virus Research, 231, 119–127. https://doi.org/10.1016/j.virusres.2016.12.017
- GLOBOCAN. (2022). Global cancer statistics: Turkey. https://gco.iarc.fr/today/data/factsheets/populations/792-turkey-fact-sheets.pdf
- Food and Drug Administration. (2018). Gardasil 9 (human papillomavirus 9-valent vaccine, recombinant). Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2018. https:// www.fda.gov/media/90064/download
- Hathaway, J. K. (2012). HPV: Diagnosis, prevention, and treatment. Clinical Obstetrics and Gynecology, 55(3), 671–680. https://doi.org/10.1097/GRF.0b013e31825caa36
- Jeannot, E., Viviano, M., Follonier, M. C., Kaech, C., Oberhauser, N., Mpinga, E. K., Vassilakos, P., Kaiser, B., & Petignat, P. (2019). Human papillomavirus infection and vaccination: Knowledge, attitude and perception among undergraduate men and women healthcare university students in Switzerland. Vaccines, 7(4), 130. https://doi.org/10.3390/vaccines7040130
- Karakuş Selçuk, A., & Yanıkkerem, E. (2018). Serviks kanseri ve human papillomavirus (HPV) prevalansı ile HPV aşı programları. Kadın Sağlığı Hemşireliği Dergisi, 4(2), 40–55. https://dergipark.org.tr/tr/pub/kashed/issue/41825/422074#article_cite (in Turkish)
- Kasymova, S., Harrison, S. E., & Pascal, C. (2019). Knowledge and awareness of human papillomavirus among college students in South Carolina. Infectious diseases, 12, 1-9. https://doi.org/10.1177/1178633718825077
- Kunt İşgüder, Ç., Oktay, G., Yılmaz Doğru, H., Delibaş, İ., et al. (2017). Sağlık yüksekokulu öğrencilerinin HPV aşısı bilgi düzeyinin değerlendirilmesi. Çağdaş Tıp Dergisi, 7(1), 1–7. https://doi.org/10.16899/gopctd.28865 (in Turkish)
- López, N., Garcés-Sánchez, M., Panizo, M. B., de la Cueva, I. S., Artés, M. T., Ramos, B., & Cotarelo, M. (2020). HPV knowledge and vaccine acceptance among European adolescents and their parents: A systematic literature review. Public Health Reviews, 41, 10. https://doi.org/10.1186/s40985-020-00126-5
- Mavundza, E. J., Iwu-Jaja, C. J., Wiyeh, A. B., Gausi, B., Abdullahi, L. H., Halle-Ekane, G., & Wiysonge, C. S. (2021). A systematic review of interventions to improve HPV vaccination coverage. Vaccines, 9(7), 687. https://doi.org/10.3390/vaccines9070687
- Monteiro, J. C., Tsutsumi, M. Y., de Carvalho, D. O., da Silva Costa, E. D. C., Feitosa, R. N. M., Laurentino, R. V., de Souza Fonseca, R. R., Silvestre, R. V. D., Oliveira-Filho, A. B., & Machado, L. F. A. (2022). Prevalence, diversity, and risk factors for cervical HPV infection in women screened for cervical cancer in Belém, Pará, Northern Brazil. Pathogens, 11(9), 960. https://doi.org/10.3390/pathogens11090960
- Natipagon-Shah, B., Lee, E., & Lee, S. Y. (2021). Knowledge, beliefs, and practices among U. S. College students concerning papillomavirus vaccination. Journal of community health, 46(2), 380–388. https://doi.org/10.1007/s10900-020-00922-9
- Park, I. U., Introcaso, C., & Dunne, E. F. (2015). Human papillomavirus and genital warts: A review of the evidence for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clinical Infectious Diseases, 61(Suppl 8), S849–S855. https://doi.org/10.1093/cid/civ813
- Rathfisch, G., Güngör, İ., Uzun, E., Keskin, Ö., & Tencere, Z. (2015). Human papillomavirus vaccines and cervical cancer: Awareness, knowledge, and risk perception among Turkish undergraduate students. Journal of Cancer Education, 30(1), 116–123. https://doi.org/10.1007/s13187-014-0703-1
- Sanjosé, S., Brotons, M., & Pavón, M. A. (2018). The natural history of human papillomavirus infection. Best Practice & Research: Clinical Obstetrics & Gynaecology, 47, 2–13. https://doi.org/10.1016/j.bpobgyn.2017.08.015
- Şahin, M. A., Şenel, U., Şahin, R. A., Ataç, Ö. (2022). Üniversite öğrencilerinin human papilloma virüsü ve aşısı ile ilgili bilgi, tutum ve davranışları. Sağlık Bilimleri Dergisi, 31(1), 1-8. https://doi.org/10.34108/eujhs.794249 (in Turkish)
- Tapera, R., Manyala, E., Erick, P., Maswabi, T. M., Tumoyagae, T., Letsholo, B., & Mbongwe, B. (2017). Knowledge and attitudes towards cervical cancer screening amongst university of botswana female students. Asian Pacific Journal of Cancer Prevention, 18(9), 2445–2450. https://doi.org/10.22034/APJCP.2017.18.9.2445
- Toshkov, D. (2023). Explaining the gender gap in COVID-19 vaccination attitudes. European Journal of Public Health, 33(3), 490–495. https://doi.org/10.1093/eurpub/ckad052
- Turhan, E., Çetin, S., Çetin, M., & Abacigil, F. (2019). Awareness and knowledge levels of 18-year-old and older individuals regarding human papillomavirus (HPV) and HPV vaccine in Hatay, Turkey. Journal of Cancer Education, 34(2), 234–241.
- Türkiye Sağlık Bakanlığı. (2023, January 3). Cervical cancer. https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer#:~:text=HPV%20is%20the%20most%20common,populations%20eventually%20clear%20the%20infection
- Waller, J., Ostini, R., Marlow, L. A., McCaffery, K., & Zimet, G. (2013). Validation of a measure of knowledge about human papillomavirus (HPV) using item response theory and classical test theory. Preventive Medicine, 56(1), 35–40. https://doi.org/10.1016/j.ypmed.2012.10.028
- Wanderley, M. D. S., Sobral, D. T., Resende, C. N., & vd. (2021). Medical students’ knowledge of the human papillomavirus (HPV), cervical cancer, and HPV vaccination. Revista Brasileira de Educação Médica, 45(3), e155. https://doi.org/10.1590/1981-5271v45.320210071.ING
- Wilson, K. L., Lee Smith, M., Rosen, B. L., Pulczinski, J. C., & Ory, M. G. (2017). HPV vaccination status and mandate support for school-aged adolescents among college females: A descriptive study. Journal of School Nursing, 33, 232–245. https://doi.org/10.1177/1059840516686442