Young Deaf Adults' Knowledge of Human Papillomavirus (HPV) and Perceived Risk of Vaccine Preventing Cervical, Anal, Penile and Oral Cancer

Summary (Abstract)

Abstract
Study Objective
To describe knowledge and risk perception of human papillomavirus (HPV) among deaf adults who use American sign language (ASL) comparison with hearing adults in the United States.

Design
Secondary HPV knowledge data for the deaf subset sample were drawn from the Health Information National Trends survey in ASL that was administered between 2015 and 2018. HPV knowledge data for the hearing subset sample were drawn from cycle 5 of the Health Information National Trends survey in English that was administered in 2017.

Setting
Surveys are a nationally based survey of deaf ASL users in the United States and a nationally based survey of hearing non-ASL users in the United States.

Participants
The age of the deaf and hearing subset samples was determined on the basis of catchup vaccine eligibility criteria as outlined by the Centers for Disease Control and Prevention that recommends catchup vaccination in women, men who have sex with men, immunocompromised individuals, and those who identify as transgender.

Interventions and Main Outcome Measures
We examined HPV, HPV vaccine, and HPV-related cancer knowledge in deaf and hearing subsets.

Results
Our sample consisted of 235 deaf and 115 hearing adults aged 18-26 years. Of the deaf participants 58% (136/235) reported knowledge of HPV compared with 84% (97/115) of hearing participants (P < .001). Hearing participants showed higher accuracy in risk perception of HPV relation to cervical cancer compared with deaf participants (P < .001). Hearing participants were more likely to have heard of the HPV vaccine as well as believe it is successful in preventing cervical cancer compared with deaf participants (P < .001).

Conclusion
Deaf ASL users are less likely to have knowledge of HPV, virus-related cancer risk, and preventative vaccination compared with hearing peers.

Video Transcript
Another film produced by our outstanding team of students, staff, and community members! Transcript: Nurse: Good, and can you hold it there for me? Thank you. Okay, great. So, I\'ll go tell the doctor now, and she\'ll be in soon. Patient: Okay, sounds great! Doctor: Hi! I\'m Dr. Spellun. So how are you doing today? Patient: I\'m great, actually, but my dad won\'t stop talking about me being a baby. I feel like, \'Come on!\' Doctor: I hate to say it, but you\'re gonna be his baby forever. So I was looking at your records, and it looks like you\'re actually due for one more vaccine. You\'ve had the flu vaccine, the Tdap vaccine, the hepatitis vaccine, and the varicella vaccine, but you\'re still due for the HPV vaccine. Dad: Excuse me, HPV? Can you tell us more about that? What exactly does that prevent? Doctor: So, HPV stands for human papilloma virus, and this is a virus that can be transmitted sexually and can cause different types of genital warts as well as cancer, but the vaccine can actually prevent the transmission of that virus. Dad: Uhh... umm... Doctor. You are talking about sexual activity. My daughter\'s far too young for that. She\'s only 11 years old. Why would you need to give her a shot right now? Doctor: Lots of parents have the same question. It\'s actually important for kids to get the vaccine before they\'re even sexually active. That way, the body can build up an immunity to the HPV virus so that they\'re protected when they do get exposed later. Dad: Did you understand what the doctor\'s saying? Patient: No. Dad: So basically, the doctor wants you to get this vaccination now for a disease called human papilloma virus, or HPV. Right, and so, my concern is that obviously you\'re not making out with anyone. You\'re far too young for any of that kind of activity, so don\'t worry about it. Narrator: This father\'s concerns are completely understandable and not uncommon among parents of young children. However, it\'s crucial that children be vaccinated early on, between the ages of 11 and 12, so that their bodies have time to develop an immunity against HPV. If children are not vaccinated ahead of time, they may be susceptible to HPV when they later become sexually active. For this reason, early vaccination is key. Doctor: Any other questions? Patient: I do, actually, I have a question. So, I just looked at that paper, and it said something about causing cancer? Like, how does that work? Doctor: Another great question. So, the way that HPV can cause cancer is, it can go into different cells that are at the surface of the mouth, or the vagina, or the anus, and can cause those cells to grow and multiply and divide very quickly, and sort of take over, and that\'s what cancer is. And there are actually 30,000 new cases of cancer caused by HPV every year. But the vaccine can prevent 90% of those cancers. Narrator: You\'ve just seen this patient and her parent discussing the HPV vaccine with their doctor. Now watch as this next Deaf man shares his communication experience with his doctor regarding the HPV vaccine. Emmanuel: To date, I\'ve taken various health-related classes and worked in a lab setting for two public health internships, the second of which I\'m completing now. We see the term HPV coming up frequently, and HPV vaccination is something I\'ve recently been becoming more aware of. For a long time, I had thought the HPV vaccine was only for young women. But it turns out that young men also need to be vaccinated. So being a young man myself, this applied to me. Wondering if I had ever received the HPV vaccine in the past, I decided to check my medical records online, and sure enough, I had been vaccinated back in 2013 when I was 16 years old. This was surprising, though, since I couldn\'t remember any of the details surrounding the vaccine. Looking back, I wish that my doctor had checked in with me and made sure I had understood what the HPV vaccine meant for me and my health. And for myself, I wish I had been more assertive and asked more questions until I fully understood. HPV awareness is vital. Be sure to talk with your doctor about any questions you may have. Narrator: HPV awareness is vital. Be sure to talk with your doctor about any questions you may have. Dr. Kushalnagar: I would like to thank the National Institutes of Health for their support in funding this project.

Author(s)

Spellun, A., Moreland, C. & Kushalnagar, P.

Publication Date

2018

Journal

Journal of Pediatric and Adolescent Gynecology

Volume

32

Issue

3

DOI

10.1016/j.jpag.2018.11.013
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