Volume 9, Issue 8, August – 2024 International Journal of Innovative Science and Research Technology

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Assessment of Knowledge, Attitude and

Adoption of Human Papilloma Virus
Vaccine among Females in Kwara State
Osueke N. O.1*, Udeze S. E.2, Igbolekwu C. O.3, Ogunwole E. A.4, Ogundoyin O. S.5, Eze M.6
1,5,6
Department of Mass Communication, Bowen University, Iwo, Nigeria
2
Department of Mass Communication, Enugu State University of Science and Technology, Enugu, Nigeria
3
Centre for Gender, Humaniterian and Development Studies, Redeemer’s University, Ede, Nigeria
4
Department of Guidiance and Councelling, Federal University Oye Ekiti, Nigeria

Corresponding Author: N. O. Osueke1*

Abstract:- Cervical cancer, though preventable, is a prevailing gynecological cancer in sub-Sahara and the second
disease caused by infection with high-risk strains of commonest female cancer worldwide (Adesina, Saka, Isiaka-
human papillomaviruses (HPVs). Adoption of cancer Lawal, Adesiyun, Gobir, Olarinoye, Ezeoke. 2018). The high
preventing activity such as the uptake of the HPV vaccine epidemic of cervical cancer is currently a global concern and
is essential for limiting incidences of cervical cancer as such continuously calls for primary prevention especially
globally. This study was to ascertain the knowledge, in countries with high prevalence. In the world, the current
attitude and adoption of the HPV vaccine among females new cases of cervical cancer as of February 2019 reported by
in Kwara state of North Central Nigeria. A descriptive Globocon factsheet, are estimated at 569,847 with attendant
cross-sectional survey involving 400 females from sixteen death cases of about 311,365 in women and young female
local government areas in Kwara State was used. Data adults (GLOBOCAN 2018). It is the commonest genital tract
were obtained and presented by simple descriptive malignancy in female and the chief cause of cancer death
statistics using tables and charts. Stepwise regression among women world over.
were used to test the correlation between the
sociodemographic variables and acceptance of HPV An approximate of 85% of the world incidences of
vaccination. The study showed that 351(87.8%) out of the cervical cancer is found in the developing nations, accounting
400 female respondents were not knowledgeable about for almost 12% of all cancers in female. More than 80% of
the HPV, while 49(12.2%) persons were knowledgeable of the 274,000 deaths of women and young female adults
the HPV. The 49 persons that are aware, got the attributed to cervical cancer each year occur in developing
information from print media 17(35%), broadcast 20 countries, and this proportion is expected to rise to 90% by
(41%) health personnel's 12 (24%). 87% of those aware 2020 (Parkin, Bray, 2006). The result of the survey on the
of HPV, know that it is transmitted sexually. However, females in developing nations on the prevalence of cervical
only 31 (63%) of these 49 respondents which is equivalent cancer is disturbing, even though cervical cancer can be
to 8% of the total study participants were aware of the detected through a Pap smear test and treated upon early
existence of the HPV vaccines. Therefore, we can dictation. This is in contrast with the occurrence in the
conclude that the female in Kwara state have little developed world. According to Globocon (2018) factsheet,
knowledge about the HPV and HPV vaccine. Also from the current new cases of cervical cancer as of May 2019 in
the regression analysis, the study showed that factors such Nigeria are estimated at 14,943 with attendant death cases of
as educational background, marital status and religion about 10,403 in women and young female adults.
had p-values of (0.562, 0.08, 0.104) which is greater than
α=0.05 and so influenced the adoption of the HPV vaccine. Human Papillomaviruses (HPVs) are a family of over
100 viruses, out of which 40 have been found to cause
Keywords:- Human Papillomaviruses; Human infection of the genital region. There are low-risk and high-
Papillomaviruses Vaccine; Cervical Cancer; risk strains of the human papillomavirus, the low-risk strains
Sociodemographical Variables; Knowledge; Attitude; seldom cause cancer whereas the high-risk strains are more
Adoption. likely to cause cancer. Both strains of human
papillomaviruses can cause the growth of abnormal cells,
I. INTRODUCTION however only the high-risk strains of human papillomaviruses
may result in genital cancers, such as anal, vaginal, vulvar,
The human papillomavirus infection has been described penile, and oropharyngeal cancers. The genital HPV infection
clinically as the commonest cause of cervical dysplasia, can lead to the development of genital warts and are also
cancer, and genital warts (Adejuyigbe, Balogun, Sekoni, implicated in tumors of the genital tract, but the most
Adegbola, 2015; Adesina, Saka, Isiaka-Lawal, Adesiyun, prominent of all the incidences of HPV is cervical cancer also
Gobir, Olarinoye, Ezeoke, 2018). Cervical cancer is the most

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known as the cancer of the cervix. (Shetty, Prabhu, Shetty, seeking knowledge about their health status and this was
Shetty, 2019). found to be true about the HPV vaccine (Patel, Pcolkina,
Strazdina, 2017; Prayudi, Permatasari, Gde Sastra Winata,
Through sexual intercourse, one partner stands the risk 2016). Various studies found that there is a strong
of contracting over 30 strains of the Human Papillomavirus relationship between education and knowledge of the vaccine
from another. Statistically, 50 to 80% of the people especially among the different populations of the study. (Islam, Khatun,
females are infected at some time in their lives, most of the Alam, 2018). Parents with higher education are more inclined
genital human papillomavirus infection takes its full course to have their children receive the HPV vaccine as observed
and exit the system after a few years, without symptoms and by Maier, Maier, Neagu, (2015). Studies on different
no treatment, however, some strains linger for many more populations have shown that persons with higher knowledge
years and may or may not cause abnormal cell growth. of HPV vaccine are most likely to make a positive decision
Continuous infection of the high-risk strains of the HPV on the utilization of the vaccine for their health benefit (De
increases the risk of developing invasive cervical cancer. Visser, Waites, Parikh, Lawrie, 2011). A study on a group of
Nigeria, for instance, records about 10,403 cervical cancer women on their knowledge of HPV infection, cervical cancer,
deaths out of about 14,943 fresh cervical cancer cases Pap tests, and HPV vaccine showed that the majority of the
annually (estimate for 2018). In Nigeria, cervical cancer participants have a good understanding of the Pap test;
ranks as the 2nd leading cases of female cancer which occur however, they did not understand the risk factors for HPV
in women aged 15 to 44 years (ICO/IARC Nigeria. Summary infection and the consequences of long term persistent HPV
Report 2019). infection like cervical cancer. This general low knowledge
about HPV resulted in the poor perception of the risk of
The reason for the disparities in the rate of morbidity contracting the HPV infection and developing HPV related
and mortality between the developed and developing nations diseases such as cervical cancer. Olubodun, Odukoya,
could be attributed to the fact that even though there is an Balogun, (2019) Friedman, Shepeard (2007) found that lack
awareness of the disease among women and about its of Knowledge about HPV serve as a barrier to adopting the
prevention through Pap smear test, for its pre-malignant vaccine. It was also observed from various literature that
stage, the adoption of the test in the developing nations is low knowledge of HPV and the HPV vaccine is very inconstant
(Tervonen et al., 2917). Aside from pap smear test, and very dependent on the studied populations. For instance,
vaccinating young female adults before their sexual activities a review that assessed HPV knowledge in over 20,000
can prevent the incidence of cervical cancer in them (Khan individuals across many countries noted that correct
and Savoy, 2020). Also, those who have not been exposed to responses to questions regarding common facts about HPV
any of the two high-risk HPV strains are potentially not at risk differed greatly. Various studies have also shown that there
of the incidence of cervical cancer by 70%. Vaccination may are significant racial and ethnic differences in HPV
lead to a 66% reduction in pre-cancerous lesions which awareness and knowledge. A study done by Joseph et al.
translates to about 76% decline in cervical cancer deaths. (2014) observed that only 42% of African-American
However, the HPV vaccine is not free or available in the individuals identified HPV as a risk factor for cervical cancer
public health centres, but obtainable at a cost in private health compared to 90% of Caucasian individuals. These racial
i According to available data: ICO/IARC information centre disparities in awareness and knowledge of HPV and the HPV
on HPV and cancer in Nigeria (ICO/IARC, 2021), HPV vaccine also have been reported in a study done on only
infection is extremely widespread, estimating the new women by Gelman, Nikolajski, Schwarz, & Borrero (2011).
incidences of the cervical cancer in Nigeria to be about Kennedy, Osgood, Rosenbloom, Feinglass, & Simon, (2011)
14,943 annually. Most of the cancer deaths are preventable conducted a study to determine if there were any difference
through the use of the human papillomavirus vaccine. in knowledge between publicly and privately insured women
However, the HPV vaccine is neither widely available nor and noted that the privately insured women had more
affordable in Nigeria. In the same vein, knowledge of cervical knowledge, this finding is suggestive of a link between the
cancer, HPV infection, and the vaccine is fundamental to socioeconomic status and knowledge of HPV and HPV
making an informed decision as regards HPV vaccine vaccine. Socioeconomic status may be confounded by other
acceptance. Little or no health information is currently factors such as cultural background, level of education,
available in terms of HPV vaccination specifically on the ethnicity, and religion, as each of these variables has been
female population, which is of paramount importance to meet associated with differences in HPV knowledge levels (Joseph
the Healthy People 2020 immunization goal. Kilic (2012) et al., 2014; Klug et al., 2008; Marlow, Zimet, McCaffery,
noted that the knowledge of HPV vaccine in Turkey among Ostini, & Waller, 2013; Waller, McCaffery, & Wardle,
adolescent girls was as low as 43.5% while a similar study 2004).
carried out in the United States of America showed that the
uptake of the vaccines was up to 60%, implying that Furthermore, people who are younger, female, and who
developed nations have more knowledge about the virus and have more education are significantly more likely to have
vaccine. The severity of HPV necessitates that females have heard of the HPV vaccine (Gollust, Attanasio, Dempsey,
adequate knowledge of the HPV vaccine. It has been found Benson, & Fowler, 2013). Increases in awareness and
by Pelullo, Esposito and Di Giuseppe (2019) that high knowledge are also strongly correlated to receive the HPV
knowledge of HPV could serve as a good way to prevent it vaccine (Kang & Kim, 2011; Krawczyk, Stephenson, Perez,
by taking the necessary vaccine early. Some scholars found Lau, & Rosberger, 2013), engage in health-protective
that females that are educated usually gravitate towards

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behaviours (Pask & Rawlins, 2015), and adoption of vaccine C. Sample Size
(Donadiki et al., 2013; Laz, Rahman, & Berenson, 2013). The research employed the Wimmer and Dominick
online sample calculator to determine the sample size. with a
1n 2006, the HPV vaccine was internationally accepted confidence level of 95% and a margin error of 0.05% the
as the vaccine to help reduce greatly the burden of HPV and calculated sample size was 385. Taking into cognizance the
some of its related diseases ( WHO,2008), many studies have probable mortality of instruments, a total of 420 questionnaire
been done to ascertain the attitude of females towards the were distributed within the 16 Local Government Areas of
vaccine. Studies by (Hoque, Monokoane, Van-hall, 2014; the State. The population of females in the Local Government
Bal-Yilmaz, Koniak-Griffin, 2018; Shetty, Prabhu, Shetty, Areas of Kwara State was collected from the State National
Shetty, 2019) showed that persons with higher level of Population Commission. The number of questionnaire to be
Education have higher knowledge of the HPV and display distributed in each Local Government Area was determined
positive attitude towards the vaccine uptake. Although in using a simple ratio formular:
Nigeria there are studies on cancer of the cervix among
women, the issue of human papillomavirus and vaccine QK  PL
among females in Kwara state, Nigeria has received little QL 
attention resulting in scarce data on the state of awareness, PK (1)
knowledge, attitude, and adoption of the HPV and the
vaccine. Where:
QL is the number of distributed questionnaire in a Local
The research explored the current level of acceptance Government Area
and the use of the vaccine in combating this deadly but QK is the number of distributed questionnaire for the entire
preventable female aliment in Kwara state. Also the state
influences of social characteristics such as age, educational PK is the total population of females in Kwara State
qualification, religion, on the use of the HPV vaccine was PL is the total population of females in each Local
investigated. Government Area of the State

This research will be beneficial to all females in Nigeria D. Sampling Technique

and particularly those in Kwara State, this is because females The sampling technique used in this study was the
are prone to contract the virus and so will be guided rightly multi-staged sampling technique. This technique enabled the
as health workers will be better informed of the state of researcher to get a true representation of the population
knowledge and attitude of the females in the state with especially since the population is very large. The females in
regards to HPV and its vaccine and address health seekers Kwara State were grouped into 16 clusters and each Local
correctly in their routine health talks in the various health Government area represented a cluster. For each Local
facilities within the state. Similarly, media campaign planners Government Area systematic sampling was used to select
will also benefit immensely from the findings of this study four towns a market day for each town. The questionnaire
because it will eable them come up with strategic messages were distributed using simple random sampling of females at
that will address the perculiarity of females in Kwara State the markets on the select market days.
and in that wise avoid media waste of their planned
campaigns. E. Measuring Instrument
The measuring instrument used by the researcher in the
II. METHODOLOGY study were questionnaire and interview guide. These were
used to generate both qualitative and quantitative data for the
A. Research Design study.
The research design was based on the utilization a
concurrent method such as quantitative data:survey research III. RESULTS AND DISCUSSIONS
method and qualitative data: in-depth interview in investigate
the effect of media campaigns on knowledge, attitude and The data were analyzed using a descriptive statistical
adoption of human papillomavirus vaccine among market analysis program including Frequencies, Mean, and Standard
woman in Kwara State, Nigeria (Creswell, 2012). Deviation (SD) and Percentage. A codebook was developed
to ensure that data were entered correctly into the system. The
B. Population of the Study returned copies of questionnaire were reviewed carefully for
The population of the study is the The entire population data clarification before entering data into IBM SPSS
of females (1,171,570) in Kwara State of North Central software program. The data were then analyzed to present
Nigeria was used in this research using the data available at sample and result in an organized arrangement, all numeric
National Population Census of 2006 (Nigerian Population data of the questionnaire were presented as frequency
Commission). However, the 2010 projected female distribution in tables.
population from the National Population Commission and the
National Bureau of Statistics is 1,320,941. Table 1 showed that the sample size is 400, while the
minimum and maximum age were 15 and 39 respectively.
Also, the mean and standard deviation age were 24.35 and
standard deviation 4.889 respectively.

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Table 1: Descriptive Statistics

Variables N Minimum Maximum Mean Std. Deviation
Knowledge 400 0 1 .12 .328
Attitude 400 0 1 .79 .406
Adoption 400 0 1 .80 .399
Mar.status 400 1 2 1.41 .492
Edu.bckgrd 400 1 2 1.47 .499
Religion 400 1 2 1.53 .499
Age 400 15 39 24.35 4.889
Valid n (listwise) 400

Table 2 shows the marital status of the participants, that 59% of the respondents were married and 41% were
where we have single (= 164) and married (=236), implying single.

Table 2: Marital Status of the Participant

Variable Frequency Percent Valid Percent Cumulative Percent
Married 236 59.0 59.0 59.0
Single 164 41.0 41.0 100.0
Total 400 100.0 100.0

The frequency of the religion of the participants were 3), indicating the fact that Kwara State was a predominantly
mostly muslim with 214 respondence, while 186 are a Muslim state.
Christians representing 53.5 and 46.5% respectively (Table

Table 3: Showing the Religion of the Participant

Frequency Percent Valid Percent Cumulative Percent
Christain 186 46.5 46.5 46.5
Muslim 214 53.5 53.5 100.0
Total 400 100.0 100.0

The minimum age was 15 and the maximum 39, the mean age was (=24.35) with standard deviation (=4.889)

Table 4: Age Distribution of the Participant

Age (Mean =24.35, SD= 4.889) N (%)
≤ 20 102 (25.5)
21-25 130 (32.5)
26-30 116 (29)
>30 52 (13)

Table 5 shows the frequency and percentage of the 49 respondents which was equivalent to 8% of the total study
Knowledge of HPV vaccine among females in Kwara state. participants were aware of the existence of the HPV vaccines.
351 out of the 400 female respondents were not Therefore, comparing the percentages, we can conclude that
knowledgeable about the HPV vaccine which was equivalent the female in Kwara state have little knowledge about the
to 87.8% of female in Kwara state, while 49 persons were HPV and HPV vaccine. This satisfies the research question
knowledgeable of the HPV representing 12.2% of female in one which sought to know the level of knowledge of females
Kwara state. The 49 persons that are aware, got the in Kwara State about HPV vaccine. This finding agrees with
information from print media 17(35%), broadcast 20 (41%) similar research by Adesina, Saka, Isiaka-Lawal, Adesiyun,
health personnels 12 (24%). 87% of those aware know that Gobir, Olarinoye, Ezeoke. (2018), which showed that there
it is transmitted sexually. However, only 31 (63%) of these was low knowledge of HPV in the Ilorin Kwara state.

Table 5: Frequency and Percentage of Knowledge of HPV Vaccine among Females in Kwara State
Frequency Percent Valid percent Cumulative percent
Not knowledgeable 351 87.8 87.8 87.8
Knowledgeable 49 12.2 12.2 100.0
TOTAL 400 100.0 100.0

Table 6 indicates shows that 83 persons representing probably because of their remarkably low level of awareness
20.8% of the respondents were worried about implication of of HPV, HPV vaccines, and cervical cancer. Greater number
the HPV vaccine on their health and 317 persons representing of the respondents were not aware of the existence of the
79.2% indicated no concern about HPV vaccine, this is vaccine and so they had no idea of the implication of the

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Volume 9, Issue 8, August – 2024 International Journal of Innovative Science and Research Technology
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vaccine on the cervical cancer. This is in line with the knowledge of HPV vaccine, HPV infection and cervical
findings of a similar study by Ndikom, Oboh 2017 which cancer.
indicated that female adolescents in Ibadan Nigeria had low

Table 6: Showing the Attitude of Females Towards HPV Vaccine

Frequency Percent Valid Percent Cumulative Percent
Worried 83 20.8 20.8 20.8
Not worried 317 79.2 79.2 100.0
Total 400 100.0 100.0

From Table 7, the number of persons not willing (No) respondents who were unwilling or indifferent to taking the
to take the HPV vaccine was 9, representing 2.3% of the HPV vaccine were the high cost 167 (51%), concerns about
respondents the number of persons willing to take (Yes) the the side effects 115(35%), and poor availability 40 (12%) of
HPV vaccine if available were 70 accounting for 17.5 % and the vaccines. 8 (2%) respondents could not give any specific
those that were not sure if they will take the vaccine if reason for their lack of willingness to accept this vaccination.
available were 321 representing 80.3%. The percentage of However this implies that if the HPV vaccine is available and
adoption is 17.5.% (Yes). The reasons given by those affordable in Kwara State 17.5% of the females will take it.

Table 7: Showing the Adoption of HPV Vaccine Reaction (Willing (Yes), Not Willing (No) and Not Sure of Taking the Vaccine.
Frequency Percent Valid percent Cumulative percent
Yes 70 17.5 17.5 17.5
No 9 2.25 2.3 19.8
Not sure 321 80.25 80.3 100
Total 400 100.0 100.0

The bar chart (Figure 1) depicts the percentage Kwara State. It can be deduced that a low level of knowledge
distribution of knowledge of HPV vaccine among females in of HPV vaccine was recorded among females in Kwara State.

Fig 1: Graphical Representation Showing the Level of Knowledge of HPV among Females in Kwara State

The bar chart (Figure 2) shows the Attitude flow among and not worried suggests positive attention towards the
Kwara State females towards the awareness of HPV. From availability of vaccine in Kwara State.
the bar chart (Figure 2), It can be seen that the level of worried

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Volume 9, Issue 8, August – 2024 International Journal of Innovative Science and Research Technology
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Fig 2: Graphical Representation of the Attitude of Kwara State Females towards the Awareness of HPV

The chart flow (Figure 3) indicates that more respondents were not sure if they will adopt HPV vaccine. This shows the
correctness of the analysis in table 7 (=80.3%)

Fig 3: Graphical Representation showing the level of willingness and not willing to take the HPV vaccine if available in Kwara
State

Figure 4 confirmed the correctness of Table 6, which show that the married participants in the survey were more than the
single.

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Fig 4: Graphical Representation of the Marital Status of the Participant

This age distribution chart (Figure 5) shows that the minimum age participant was 15, while the maximum age of the participant
was 39.

Fig 5: Flow Chart of the Age of the Participant

Results obtained from Table 8 and 9 shows that there independent variables and the dichotomous outcomes of
were three outcomes of interest in our dependent variable (Y): interest (Adoption of HPV Vaccine). Variables were selected
Adoption (willingness to take) of HPV vaccine (no = 0; not for the multivariate model, using a p-value of 0.05 for entry
sure=1; yes =2), In the models, the independent variables and 0.10 for exclusion, based on the likelihood ratio test
included were: age (four categories: ≤20 years; 21–25 years; statistic. Odds ratios (ORs) and 95% confidence intervals
26-30 ; >30 years), educational level (tertiary= 1; secondary (CIs) were presented for logistic regression models; p-values
= 2), The following variables were also included: Marital > 0.05 were considered to be statistically significant. IBM
status (Married=1,single=2 ), Religion (Christian=1, Stata statistical software, version 23 was used for the
Muslim=2). Binary logistic regression analysis was analyses.
performed to evaluate the association between the

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 The Logistic Regression Model is given by: The collected data were analyzed and interpreted using
appropriate statistical methods to actualize the
 Logit (P (𝑋)) = β1x1+ β2x21+ β3x31+ β4x41 aforementioned aims and objectives of the study.

Given that, H1: Age, Religion, level of Education, marital status also
Y= {0 if No ; 1 if Yes } affect the adoption of the HPV vaccine in Kwara state
X= X1, X2, X3, X4 H0: Age, Religion, level of Education, marital status do not
affect the adoption of the HPV vaccine in Kwara state
Where,
X1 Age of the Participant Decision Rule: Reject H0 if the p-value is less than α=0.05
X2 Religion of the Participant and accept H1
X3 Marital Status of the Participant
X4 Education level of the Participant

IV. DECISION

 Step : Regressing other Factors that Affect the Adoption of the HPV Vaccine with the Adoption Reaction Data

 H0 Level of Education p-value (0.562) is greater than α=0.05 ACCEPT

 H0 Marital Status p-value (0.08) is greater than α=0.05 ACCEPT
 H0 Religion p-value (0.104) is greater than α=0.05 ACCEPT
 H0 Age p-value (0.000) is less than α=0.05 REJECT

Therefore, we can see that throughout the tests that only Religion- are some of the other factors that affect the
Age suggested the Rejection of H0 which simply means that adoption of HPV vaccine in Kwara State
all other factors - marital status, education level, and

Table 8: Demographic Characteristics of the Respondents

Age Marital Status Education Level Religion
< 20 102(25.5) Married 236 (59) SSCE 186 (46.5) Muslim 214 (53.5)
20- 25 130 (32.5) Unmarried 164 (41) Higher degree 214 (53.5) Christian 186 (46.5)
26 – 30 116 (29)
>30 52 (13)

Table 9: Variables in the Equation

DF P-value
Step Education Background 1 .562
Marrital Status 1 .082
Religion 1 .104
Age 1 .000

V. CONCLUSION AND RECOMMENDATIONS Again the government should include the HPV vaccine
in the national expanded programme on immunization
The poor awareness and knowledge of the existence and schedule to ensure that almost everyone especially the young
availability of the HPV vaccine found in this study showed female adult take the vaccine before their sexual debut for
that for the incidence of cervical cancer and other genital maximum effects of the vaccine.
infections to be greatly reduced if not eradicated in Nigeria,
there is still need to create more awareness for HPV vaccines Further studies could also be conducted to include all
in Nigeria. The study also indicated that providing education the North Central States to get a wholestic status of the states.
about HPV infection and vaccine to the general public will
help bring about a change in the peoples attitude, as well as ACKNOWLEDGMENTS
improve the HPV vaccine uptake.
The Authors appreciate the Management of Bowen
It is recommended that continuous efforts should be University Iwo for their immernse contribution to the
made to improve knowledge of the HPVs and HPV vaccine publication of this study.
through education so as to reduce drastically the incidences
of cervical cancer in Nigeria.  Authors Contributions: Osueke and Udeze conceiced
the theory, formulation and methodology. Osuek,
Igbolekwu and Adeoti prepared and edited the

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manuscripts. The results were discussed and commented Human Papillomavirus and Related Diseases in
by all the authors. Osueke, Ogunwole and Ayo-Oberemi. Nigeria. Summary Report ICO/IARC Information
Centre on HPV and Cancer (HPV Information
 Availabiliy of Data and Materials: Extra data that Centre). Accessed 9th December 2019.
support the findings of this study ar available from the [11]. De Visser, R., Waites, L., Parikh, C. and Lawrie, A.
corresponding author [N. O. Osueke] upon reasonable (2011). The importance of social norms for uptake of
request. catch up human papillomavirus vaccination in young
women. Sex Health. 8(330–337). Doi:
 Disclosure Statement: Authors declare that there is no 10.1071/SH10155.
competing interest whatsoever. [12]. Donadiki, E. M., Jimenez-Garcia, R., Hernandez-
Barrera, V., Carrasco-Garrido, P., De Andres, A. L.,
 Funding: This research was not funded by any third Jimenez-Trujillo, I. and Velonakis, E. G. (2013).
party. Knowledge of the HPV vaccine and its association
with vaccine uptake among female higher-education
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