Health Care Provider's HPV knowledge and HPV Vaccine Knowledge, Attitudes, and Practices

Purpose: A vaccine that protects against human papillomavirus (HPV) types 16 and 18 which are responsible for over 70% of cervical cancers, and HPV types 6 and 11 which cause anogenital warts, has been available in the US since June 2006 for females ages 9-26. Health care providers play a significant role in vaccine decisions of parents. This study assesses health care provider's knowledge, attitudes, and practices regarding HPV vaccination, as well as perceived barriers to HPV vaccine recommendations. Methods: A 10-minute Internet-based survey was conducted between October and November 2009. A total of 229 Ob/Gyn, pediatric, and family practice residents and attending physicians at the University of Texas Health Science Center in Houston, Texas were invited to participate. Resident versus attending physician responses were compared in each of the categories surveyed and statistical analyses were performed using chi-squared. Results: Response rate was 40%. Overall, HPV knowledge was fair and not statistically different between residents and attending physicians. A significant discrepancy was found between residents (82%) and attending physicians (59%) concerning knowledge of HPV vaccine licensure for women older than 26 years of age (p<0.05). All residents surveyed report recommending the vaccine to females ages 13-26, compared to 93% of attending physicians. Both residents (64%) and attending physicians (56%) were less likely to recommend HPV vaccination to girls ages 9-10. Most of the attending physicians and residents reported spending only 1 to 4 minutes talking to parents about the HPV vaccine. Attending physicians cited parental concerns about “vaccine safety” and residents reported parental concern about vaccination encouraging earlier/riskier sexual behavior ; significantly more attending physicians (79%) than residents (52%) reported parental opposition to vaccination for moral/religious reasons (p<0.05) as barrier to treatment. Conclusions: Most of the health care providers surveyed recommend HPV vaccination appropriately to adolescents; however, they hesitate to recommend vaccination to girls under age 10 and express concerns about parental resistance to a new vaccine that could promote earlier sexual behavior. Findings may impact patients/parents counseling.