UPTAKE AND INTENTIONS TOWARDS SCREENING FOR CERVICAL CANCER AND HUMAN PAPILLOMA VIRUS VACCINATION AMONG FEMALE UNDERGRADUATE STUDENTS IN OSUN STATE, NIGERIA

Abstract

Cervical cancer ranks the second most frequent cancer among women in Nigeria. Despite the licensure of HPV vaccines in Nigeria since 2009, uptake is still poor. The uptake of cervical cancer screening is also below 10% in many studies carried out in different parts of the country. Most of the available studies on cervical cancer interviewed women of child bearing age without many on female undergraduates, a group at risk of cervical cancer. Not many studies assessed uptake intentions of women. This study assessed the uptake and uptake intentions of cervical cancer screening and HPV vaccination among female undergraduate students in Osun State. The study was a descriptive cross-sectional study among female undergraduate students in Osun State, Nigeria. Using a multistage sampling technique, 440 consenting female students were selected from 2 universities and 2 polytechnics. Data was collected using self-administered, pretested semi-structured questionnaires. The knowledge scores were graded into good(≥75%), fair (50% - 74%) and poor (<50%) of the total score. Uptake of HPV vaccination and cervical cancer screening was dichotomized as "at least once" and "never". Uptake intention was dichotomized as "willing" and "not willing" to use screening and HPV vaccination services. Analysis was done with the Statistical Package for Social Sciences (SPSS) version 20, using descriptive statistics, Chi square and logistic regression model as appropriate. The significance level was 95% and a p-value of less than or equals to 0.05 was considered significant. The mean age of the respondents was 22.2 ± 3. 9 years and more than half of them (239, 54.3%) were within the 20-24 age group. Majority of the respondents, (313, 71.1 %), earned an average monthly allowance of 10,000 naira (about $30) or less. One hundred and sixty four (37.3%) were not aware of cervical cancer, 420 (95.9%), 257 (58.4%) and 27 (6.1 %) had poor knowledge on cervical cancer, cervical cancer screening and HPV vaccination respectively. The internet was the source of information for 200 (45.5%) of respondents while the hospital was the source of information for 154 (35.0%) on cervical cancer. Uptake of cervical cancer screening and HPV vaccination among the female undergraduate students were 2.3% and 2.0% respectively while uptake intentions were 86.8% and 87.3% respectively. Factors responsible for non-uptake were lack of information, poor access and no recommendation from health care workers on cervical cancer screening and HPV vaccination. Factors significantly associated with uptake intentions were current sexual activities, type of institution, tribe and knowledge about cervical cancer screening. Uptake of cervical cancer screening and HPV vaccination among the female undergraduate students was low, however uptake intentions for these services were high. Youth friendly cervical cancer prevention services, characterized by easy economic access, appropriate communication strategies between health workers and female students through the social media, good interaction with health care workers and dissemination of comprehensive information are recommended.