Exploring Cultural Influence of Knowledge and Beliefs of Human Papillomavirus (HPV) Infection and HPV Vaccination among U.S. Chinese International Students (CIS)

This study was the first examined Chinese and western cultures’ influence on Chinese International Students’ (CIS) intentions and beliefs regarding HPV vaccination, prevention of cervical cancer and sexually transmitted infections. Participants were recruited among CIS attending a U.S. Midwestern university. Ten small focus group discussions (five female & five male groups) were conducted and guided by seven open ended questions. 44 CIS (mean age=24.6) with 23 females participated the study. Discussions lasted an average of 1.5 hours and were conducted in Mandarin. Five major themes emerged: (1) Limited knowledge: Most participants had not heard of the word “cervix” and misunderstood the cervical cancer cause as “abortion” and “miscarriage”. Participants perceived genital warts as “dirty” and “secret” disease. (2) Participants had informal sources for STI information: e.g. street advertisements and social websites such as “Renren” (Chinese version of “Facebook”). (3) Participants discussed concerns regarding vaccine: “Nine years old is too young for CIS to receive HPV vaccine”; “The vaccine was developed in western countries, not suit for Chinese”; “No sex, No vaccine”. (4) Most participants thought “women”, “Promiscuous people”, “gay” and CIS born in the “90s” should be vaccinated. (5) Participants perceived stigma about HPV infection changed by knowledge level during discussion: “HPV infection is different from syphilis and gonorrhea.” The result suggested that sexual cultures and behaviors were perceived different between CIS born in the 1990s and 1980s. Future implementation is that governmental and school based intervention programs should take into consideration of CIS’ acculturated attitudes and beliefs.