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Comparison of Knowledge and Attitudes Toward Human Papillomavirus, HPV Vaccine, Pap Tests, and Cervical Cancer Between US and Peruvian Women

Han, Chi-Son BS1; Ferris, Daron G. MD2,3,4,5; Waller, Jennifer PhD6; Tharp, Philip BS1; Walter, Jessica BA7; Allmond, Lynn FNP2,3

Journal of Lower Genital Tract Disease: April 2012 - Volume 16 - Issue 2 - p 121–126
doi: 10.1097/LGT.0b013e31823a05a3
Original Articles

Objectives The purpose of this study was to determine and compare the knowledge and attitudes toward human papillomavirus (HPV), HPV vaccine, Pap tests, and cervical cancer among US and Peruvian women.

Materials and Methods A convenience sample of 275 US women in Augusta, GA, and 702 Peruvian women living in or near Cusco, Peru, completed 22- or 21-item questionnaires, respectively. These questionnaires determined their knowledge about HPV, the HPV vaccine, Pap tests, and cervical cancer. Simple logistic regression was used to determine the relationship between location and language on the correct responses. Odds ratios (ORs) and 95% confidence intervals were calculated.

Results US Spanish- (OR = 0.02), Quechua- (OR = 0.05), and Peru Spanish-speaking women (OR = 0.03) were significantly less likely to know that HPV causes cervical cancer compared with US non–Spanish-speaking women. US Spanish- (OR = 10.61, OR = 5.74), Quechua- (OR = 11.08, OR = 9.89), and Peru Spanish-speaking women (OR = 17.25, 14.43) were significantly more likely to be embarrassed and afraid, respectively, to get a Pap test compared with US non–Spanish-speaking women. US Spanish- (OR = 0.11), Quechua- (OR = 0.14), and Peru Spanish-speaking women (OR = 0.11) women were significantly less likely to know the HPV vaccine is safe and effective compared with US non–Spanish-speaking women.

Conclusions Education must be implemented to address serious misconceptions and worrisome attitudes toward Pap tests and the HPV vaccine to decrease the rate of cervical cancer in Peru and US Spanish-speaking women.

A significant knowledge gap exists among US non–Spanish-speaking women and US Spanish-speaking and Peruvian women with respect to human papillomavirus and cervical cancer.

1Georgia Health Sciences University, 2The Gynecologic Cancer Prevention Center, and Departments of 3Family Medicine and 4Obstetrics and Gynecology, Georgia Health Sciences University, Augusta, GA; 5CerviCusco, Cusco, Peru; 6Department of Biostatistics, Georgia Health Sciences University, Augusta, GA; and 7Harvard Medical School, Boston, MA

Correspondence to: Daron G. Ferris, MD, Georgia Health Sciences University, 1423 Harper St, HH-1013, Augusta, GA 30912-3500. E-mail:

The authors did not receive funding for this study.

©2012The American Society for Colposcopy and Cervical Pathology