Awareness of human papillomavirus after introduction of HPV vaccination: a large population-based survey of Scandinavian women

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Using a large, population-based survey, we assessed the levels and correlates of human papillomavirus (HPV) awareness among Scandinavian women after introduction of HPV vaccination. In 2011–2012, a random sample of women aged between 18 and 45 years from Denmark, Sweden and Norway received a questionnaire on lifestyle, health and HPV awareness. We included 47 895 women (response rate 60.6%) in our study. Country-specific and age-specific proportions of women who had heard of HPV in 2011–2012 (postvaccination survey) were compared with corresponding proportions in an identical survey from 2004–2005 (prevaccination survey, n=54 079, response rate 71.3%). Correlates of HPV awareness in the postvaccination survey were assessed by logistic regression. In all countries and age groups, awareness of HPV increased from the prevaccination to the postvaccination survey. In the postvaccination survey, HPV awareness was higher in Denmark (75.8%) and Sweden (74.8%) compared with Norway (62.4%), with greatest discrepancy among women aged between 18 and 19 years (Denmark: 74.9%, Sweden: 70.4%, Norway: 39.6%). Variables associated with low HPV awareness included the following: low education [≤12 vs. >16 years of schooling: odds ratio (OR)=0.45, 95% confidence interval (CI): 0.42–0.48], being a virgin (vs. nonvirgins: OR=0.74, 95% CI: 0.66–0.83), never having used condoms (vs. ever: OR=0.62, 95% CI: 0.56–0.67), nonuse of contraception at first intercourse (vs. use: OR=0.83, 95% CI: 0.79–0.88) and daily smoking (vs. never: OR=0.86, 95% CI: 0.80–0.92). HPV awareness in Scandinavia has increased since the introduction of HPV vaccination. However, 24–38% of Scandinavian women still have never heard of HPV. Future information efforts should target groups with low HPV awareness.

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