Influencing factors of willingness to promote human papillomavirus vaccination in Chinese male university students
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摘要:
目的 描述中国男大学生对人乳头瘤病毒（HPV）的认知现状，探讨其对HPV疫苗推广意愿的影响因素。 方法 于2020年2月21日 — 4月30日，便利选取3 570名在读本科男大学生，采用一般资料问卷、健康与性行为问卷、HPV相关知识及态度问卷进行调查。 结果 3 570名研究对象中，有3 213人愿意鼓励周围的人接种HPV疫苗。赞成疫苗可有效预防疾病（OR = 2.011，P < 0.001）、自费接种过二类疫苗（OR = 1.652，P < 0.001）、接受过性教育或性知识（OR = 1.619，P < 0.001）、接受婚前性行为（OR = 1.366，P = 0.012）、高HPV知识掌握水平（OR = 1.498，P = 0.002）、感知益处（OR = 3.225，P < 0.005）为男大学生向其他人推广HPV疫苗的促进因素。 结论 相关部门可针对男大学生对健康与性行为的认知及态度、对HPV的认知及态度进行干预，以提高男大学生对HPV疫苗的推广意愿，进而提高我国HPV疫苗的接种率。 Abstract:Objective To describe the awareness of human papillomavirus (HPV) among male university students in China, and to explore potential influencing factors of the students' intention to encourage others to have HPV vaccination. Methods Using convenient sampling and a self-designed questionnaire on demographics, health and sexual behavior, and knowledge and attitude about HPV, we conducted an online voluntary survey among 3 570 male undergraduates of 7 universities in 7 provincial-level administrative divisions across China during February 21 – April 30, 2021. Results Of all the participants, 3 213 reported the willingness of promoting HPV vaccination in their friends. The results of logistic regression analysis showed that the students with following characteristics were more likely to promote HPV vaccination in their friends: agreeing with that HPV vaccination could prevent some diseases effectively (odds ratio [OR] = 2.011, P＜0.001), ever receiving a self-paid category II vaccine (OR = 1.652, P＜0.001), ever participating in education programs about sexual health (OR = 1.619, P＜0.001), with positive attitude towards premarital sex (OR = 1.366, P = 0.012), having high knowledge about HPV (OR = 1.498, P = 0.002), and with a perceived benefit of HPV vaccination (OR = 3.225, P＜0.005). Conclusion The survey results suggest that relative departments could conduct interventions on the awareness and attitude about HPV vaccination among male university students to promote HPV vaccination in China. -
表 1 研究对象一般资料与HPV疫苗推广意愿分布情况
项目 人数 构成比（%） HPV疫苗推广意愿 χ2 值 P 值 否 构成比（%） 是 构成比（%） 年龄（岁） 2.936 0.23 18 435 12.18 45 12.61 390 12.14 19 2016 56.47 187 52.38 1829 56.92 ≥ 20 1119 31.34 125 35.01 994 30.94 民族 14.652 ≤ 0.001 汉族 3239 90.73 304 85.15 2935 91.35 其他 331 9.27 53 14.85 278 8.65 居住地 22.196 ≤ 0.001 农村 1266 35.46 167 46.78 1099 34.20 城市 2304 64.54 190 53.22 2114 65.80 父母居住地 18.942 ≤ 0.001 农村 1248 34.96 162 45.38 1086 33.80 城市 2322 65.04 195 54.62 2127 66.20 父母婚姻状况 2.807 0.094 离婚/分居/丧偶 570 15.97 68 19.05 502 15.62 在婚 3000 84.03 289 80.95 2711 84.38 父母教育水平 12.161 ≤ 0.001 中学及以下学历 1582 44.31 189 52.94 1393 43.36 高中及职高学历 1147 32.13 94 26.33 1053 32.77 本科（包含技术学院）及以上学历 841 23.56 74 20.73 767 23.87 生活费（元/月） 18.989 ≤ 0.001 ＜1000 728 20.39 102 28.57 626 19.48 1000～2000 2522 70.64 234 65.55 2288 71.21 2001～3000 275 7.70 17 4.76 258 8.03 ＞3000 45 1.26 4 1.12 41 1.28 亲朋好友或关系密切人中是否有人患有癌症 4.636 0.031 无 2769 77.56 293 82.07 2476 77.06 有 801 22.44 64 17.93 737 22.94 
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表 2 研究对象健康和性行为现况与HPV疫苗推广意愿的相关性
项目 人数 构成比（%） HPV疫苗推广意愿 χ2 值 P 值 否 构成比（%） 是 构成比（%） 是否赞成这种说法：疫苗可以有效地预防疾病 78.002 ≤ 0.001 否 265 7.42 68 39.50 197 6.13 是 3305 92.58 289 80.95 3016 93.87 是否接种过自费的二类疫苗（如乙肝疫苗、流感疫苗） 53.348 ≤ 0.001 否 1237 34.65 186 52.10 1051 32.71 是 2333 65.35 171 47.90 2162 67.29 是否接受过性教育或性知识 63.929 ≤ 0.001 否 939 26.30 157 43.98 782 24.34 是 2631 73.70 200 56.02 2431 75.66 是否有过性行为 6.291 0.012 否 3314 92.83 343 96.08 2971 92.47 是 256 7.17 14 3.92 242 7.53 目前是否单身 2.315 0.128 否 730 20.45 62 17.37 668 20.79 是 2840 79.55 295 82.63 2545 79.21 是否能接受婚前性行为 22.331 ≤ 0.001 否 1099 30.78 149 41.74 950 29.57 是 2471 69.22 208 58.26 2263 70.43
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表 3 研究对象HPV知识及态度现况与HPV疫苗推广意愿的相关性
项目 人数 构成比（%） HPV疫苗推广意愿 χ2 值 P 值 否 构成比（%） 是 构成比（%） 听说过HPV 48.067 ≤ 0.001 否 2077 58.18 269 75.35 1808 56.27 是 1493 41.82 88 24.65 1405 43.73 听说过HPV相关疾病 46.948 ≤ 0.001 否 1816 50.87 243 68.07 1573 48.96 是 1754 49.13 114 31.93 1640 51.04 听说过HPV疫苗 46.887 ≤ 0.001 否 2160 60.5 276 77.31 1884 58.64 是 1410 39.5 81 22.69 1329 41.36 主动搜索或咨询过HPV疫苗 14.784 ≤ 0.001 否 2796 78.32 308 86.27 2488 77.44 是 774 21.68 49 13.73 725 22.56 HPV知识掌握水平 79.156 ≤ 0.001 低 1512 42.35 230 64.43 1282 39.9 高 2058 57.65 127 35.57 1931 60.1 感知严重性 21.468 ≤ 0.001 无 1646 46.11 206 57.7 1440 44.82 有 1924 53.89 151 42.3 1773 55.18 感知易感性 0.904 0.342 无 3166 88.68 322 90.2 2844 88.52 有 404 11.32 35 9.8 369 11.48 感知益处 197.27 ≤ 0.001 无 1022 28.63 216 60.5 806 25.09 有 2548 71.37 141 39.5 2407 74.91
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表 4 研究对象HPV疫苗推广意愿影响因素多因素分析
项目 参照组 β $S_{\bar x}$ Wald χ2 值 P 值 OR 值 95 % CI 赞成这种说法：疫苗可以有效地预防疾病 否 0.699 0.169 17.023 ＜0.001 2.011 1.443～2.803 接种过自费的二类疫苗（如乙肝疫苗、流感疫苗） 否 0.502 0.123 16.573 ＜0.001 1.652 1.297～2.104 接受过性教育或性知识 否 0.482 0.127 14.304 ＜0.001 1.619 1.261～2.079 接受婚前性行为 否 0.312 0.125 6.25 0.012 1.366 1.07～1.745 HPV知识掌握水平高 低 0.404 0.131 9.47 0.002 1.498 1.158～1.937 感知益处 无 1.171 0.131 79.701 ＜0.001 3.225 2.494～4.171
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