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      Knowledge and awareness of Human Papillomavirus (HPV) and HPV vaccines among Caribbean youth: the case of the Bahamas

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          ABSTRACT

          There is a high burden of cervical cancer in the Caribbean region, particularly in the Bahamas, yet there are few studies of Human Papillomavirus (HPV) and HPV vaccine in the region. The objective of this study was to assess the knowledge and awareness of HPV and the HPV vaccine among school-aged youth (15–18 years) living in the Bahamas.

          Cross-sectional data were obtained from the “Getting to Zero” HIV study in the Bahamas conducted in 2014/2015 (n = 1553). The questionnaire elicited information on knowledge of HPV and HPV vaccines, using previously validated scales. Data analysis included Chi-square tests and Mann Whitney U test.

          In this sample of school-aged youth, only 10.7% (146/1364) had ever heard of HPV. With respect to those who were sexually active (n = 685), only 10.7% had ever heard of HPV. For those who had heard of HPV, knowledge of HPV and HPV vaccines was assessed on an HPV Knowledge and HPV Vaccine Knowledge scale, respectively. There was no statistically significant difference in mean HPV knowledge score between males and females, or HPV vaccine knowledge scores, between males and females.

          There was a general lack of awareness of HPV and HPV vaccines among school-aged youth in the Bahamas. This is an important gap in the HPV vaccine strategy and cancer prevention, as this is the age at which most people acquire HPV. It emphasizes the importance of developing a careful implementation plan, with an evaluation of knowledge and attitudes, in order to have an effective HPV vaccine uptake.

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          Most cited references33

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          US Assessment of HPV Types in Cancers: Implications for Current and 9-Valent HPV Vaccines

          This study sought to determine the prevaccine type-specific prevalence of human papillomavirus (HPV)-associated cancers in the United States to evaluate the potential impact of the HPV types in the current and newly approved 9-valent HPV vaccines.
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            Human Papillomavirus-Associated Cancers - United States, 2008-2012.

            Human papillomavirus (HPV) is a known cause of cervical cancers, as well as some vulvar, vaginal, penile, oropharyngeal, anal, and rectal cancers (1,2). Although most HPV infections are asymptomatic and clear spontaneously, persistent infections with one of 13 oncogenic HPV types can progress to precancer or cancer. To assess the incidence of HPV-associated cancers, CDC analyzed 2008-2012 high-quality data from the CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results program. During 2008-2012, an average of 38,793 HPV-associated cancers were diagnosed annually, including 23,000 (59%) among females and 15,793 (41%) among males. By multiplying these counts by the percentages attributable to HPV (3), CDC estimated that approximately 30,700 new cancers were attributable to HPV, including 19,200 among females and 11,600 among males. Cervical precancers can be detected through screening, and treatment can prevent progression to cancer; HPV vaccination can prevent infection with HPV types that cause cancer at cervical and other sites (3). Vaccines are available for HPV types 16 and 18, which cause 63% of all HPV-associated cancers in the United States, and for HPV types 31, 33, 45, 52, and 58, which cause an additional 10% (3). Among the oncogenic HPV types, HPV 16 is the most likely to both persist and to progress to cancer (3). The impact of these primary and secondary prevention interventions can be monitored using surveillance data from population-based cancer registries.
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              Abstinence and abstinence-only education: a review of U.S. policies and programs.

              Abstinence from sexual intercourse is an important behavioral strategy for preventing human immunodeficiency virus (HIV), other sexually transmitted infections (STIs), and pregnancy among adolescents. Many adolescents, including most younger adolescents, have not initiated sexual intercourse and many sexually experienced adolescents and young adults are abstinent for varying periods of time. There is broad support for abstinence as a necessary and appropriate part of sexuality education. Controversy arises when abstinence is provided to adolescents as a sole choice and where health information on other choices is restricted or misrepresented. Although abstinence is theoretically fully effective, in actual practice abstinence often fails to protect against pregnancy and STIs. Few Americans remain abstinent until marriage; many do not or cannot marry, and most initiate sexual intercourse and other sexual behaviors as adolescents. Although abstinence is a healthy behavioral option for teens, abstinence as a sole option for adolescents is scientifically and ethically problematic. A recent emphasis on abstinence-only programs and policies appears to be undermining more comprehensive sexuality education and other government-sponsored programs. We believe that abstinence-only education programs, as defined by federal funding requirements, are morally problematic, by withholding information and promoting questionable and inaccurate opinions. Abstinence-only programs threaten fundamental human rights to health, information, and life.
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                Author and article information

                Journal
                Hum Vaccin Immunother
                Hum Vaccin Immunother
                KHVI
                khvi20
                Human Vaccines & Immunotherapeutics
                Taylor & Francis
                2164-5515
                2164-554X
                2020
                23 September 2019
                23 September 2019
                : 16
                : 3
                : 573-580
                Affiliations
                [a ]University of Ontario Institute of Technology and Faculty of Medical Sciences, Oshawa, Ontario and the University of the West Indies , Cave Hill, Barbados
                [b ]UWI School of Clinical Medicine and Research , Nassau, The Bahamas
                [c ]Ministry of Health , Nassau, The Bahamas
                [d ]Division of Infectious Diseases, The Hospital for Sick Children, University of Toronto , Toronto, Ontario, Canada
                Author notes
                CONTACT Clemon George clemon.george@ 123456cavehill.uwi.edu Faculty of Medical Sciences, University of the West Indies - Cave Hill Campus , Bridgetown, Barbados
                Author information
                http://orcid.org/0000-0001-6125-8900
                http://orcid.org/0000-0003-2528-0806
                http://orcid.org/0000-0002-8356-9133
                http://orcid.org/0000-0001-7035-0282
                Article
                1661205
                10.1080/21645515.2019.1661205
                7227632
                31464555
                5df603e7-afff-4d91-8cbb-5721017ca962
                © 2019 The Author(s). Published with license by Taylor & Francis Group, LLC.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

                History
                : 23 April 2019
                : 6 August 2019
                : 18 August 2019
                Page count
                Tables: 4, References: 48, Pages: 8
                Funding
                Funded by: Canadian Foundation for AIDS Research 10.13039/100008220
                Award ID: 4-24
                Funded by: Canadian Institutes of Health Research 10.13039/501100000024
                Award ID: New Investigator
                This work was supported by the Canadian Foundation for AIDS Research [4-24];Canadian Institutes of Health Research [New Investigator Award].
                Categories
                Research Paper

                Molecular medicine
                human papillomavirus,knowledge,youth,caribbean,bahamas
                Molecular medicine
                human papillomavirus, knowledge, youth, caribbean, bahamas

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