KNOWLEDGE AND ACCEPTABILITY OF THE HUMAN PAPILLOMA VIRUS VACCINE AMONG STUDENTS IN TERTIARY INSTITUTIONS IN LAGOS, NIGERIA

Abstract

Provision of Human Papillomavirus (HPV) vaccines in low and middle income countries is a critical pillar for meeting the global action for closing the cancer divide. However, high cost of vaccine and vaccine delivery, low awareness and knowledge of cervical cancer and HPV infection and failure of cervical cancer to be recognized as a major health concern poses a problem to this achievement. This study was aimed at assessing the knowledge of cervical cancer, HPV infection and HPV vaccine, and acceptability of HPV vaccine among students in tertiary institutions in Lagos. The study was a cross sectional survey and a multi-stage sampling technique was used 10 select 997 students in tertiary institutions. A self administered questionnaire was used to elicit information on awareness, knowledge of cervical cancer, knowledge of HPV infection and vaccine, and willingness to receive the HPV vaccine. Data was analyzed using descriptive statistics; frequencies and percentages, and using inferential statistics; Chi square and logistic regression at 5% level of significance. The respondents were aged 15 to 40 years with a median age of 22 years. Majority were Christians (71.0%) and single (94.7%). Compared to respondents who were aware of cervical cancer (67.2%), only 36.1% of the respondents had ever heard of HPV infection. The commonest source of information of HPV was school (30.8%). Majority of the respondents had poor knowledge of cervical cancer (24.8%) and HPV (14.8%). Only 1.3% of the respondents had ever received the HPV vaccine and very few (7.2%) were willing to receive the vaccine. High cost (63.3%) was the major reason of willingness to receive the vaccine. Respondents aged 20 to 24 years (OR= 3.4, CI=1.26- 8.91), in a polytechnic (OR=6.8 , CI=7.49- 94.45) and those who had good knowledge of cervical cancer (OR=3.4, CI=1.59- 7.37) were more likely to have good knowledge of HPV infection and vaccine while accounting students (OR=0.27, CI=0.09- 0.77) were less likely to have good knowledge of HPV infection and vaccine. Likewise, polytechnic students (OR=S. 7, CI=1.68- 18.99),engineering students (OR= 3.8, CI=1.15- 12.33), those with income greater than 20000 naira (OR=3.97, Cl=1.30-12.06) and respondents having previous history of STI (OR=2.9, CI=1.28- 6.38) were more likely to be willing to receive the HPV vaccine while respondents from Igbo ethnic group (OR= 0.26, CI=0.10- 0.67) were less likely to be willing to receive the HPV vaccine. Generally, knowledge of students in Nigeria tertiary institution in Lagos about HPV infection and cervical cancer was very low, so was willingness to receive the HPV vaccine. Knowledge of HPV infection and cost reduction of the HPV vaccine are important factors that can influence willingness to accept the vaccine. Nigeria needs to partner with foreign agencies to ensure cost reduction of the HPV vaccine.