Attitudes and knowledge of HPV vaccination in women being treated for an abnormal Pap smear

Objectives: We evaluated the attitudes and knowledge of patients undergoing evaluation for abnormal Pap smears towards vaccinating their children against HPV. Methods: This institutional review board (IRB)-approved patient survey was conducted at the colposcopy clinic at a major academic center. The surveys were collected between 3/2020 and 8/2020. Patients are referred to this colposcopy clinic from various clinics throughout the state. English-speaking patient being evaluated at the colposcopy clinic who had a child at least nine years old (the minimum age for HPV vaccination) were offered the survey. Data collected included: patient demographics, family history, Pap smear history, reason for current visit, prior biopsy/excisional procedure, and knowledge of HPV and the vaccine. Results: During the study period, 226 patients were treated in the colposcopy clinic. Of these, 101 (44.7%) met inclusion criteria for participation. 39 surveys were completed (38.6%). The median age was 35.8 age of patients surveyed was from 25 to 67 years old (median 35.8), with 69% African-American and 31% Caucasian patients. 21 patients had a prior biopsy or excisional procedure for cervical dysplasia. With regards to HPV and the vaccine, 76.9% of patients heard of the HPV virus, and 56.4% knew a vaccine existed. 28% of patients felt that the HPV vaccine was effective at preventing cervical cancer and the majority of patients surveyed were unsure of the efficacy of the vaccine. Only 6 patients had received the HPV vaccine themselves and 11 patients (28.2%) reported that they had obtained the vaccine for their children. Of the patients who had not vaccinated their children, 64% reported they were interested in obtaining the HPV vaccine for their children in the future. Overall, 38.4% of patients said a healthcare provider discussed the HPV vaccine with them. Out of the patients who either intended on vaccinating their children or have already done so, 62% stated they did so because it was recommended by a healthcare provider. The most common reasons cited by patients who refused to vaccinate their children against HPV were a lack of knowledge about the vaccine and that their children were not at risk of HPV infection (36.4% each). Conclusions: Women who have been adversely impacted by the HPV infection represent a population of patients who should have motivation to vaccinate their children in an effort to prevent them from having similar negative experiences. However, our data shows that even patients being treated for abnormal pap smears have limited knowledge of HPV and the vaccine. Successful vaccination of adolescent patients requires parental buy-in. This stresses the importance of gynecology providers counseling their adult patients not only for their own benefit, but the benefit of their children. Patients visiting clinic for management of an abnormal pap smear should be a focus for providers to increase knowledge and uptake of the HPV vaccine among children.